ASVAC proof 13-0605

PLATINUM SPONSORS

MABUHAY!

It is with a deep sense of pride and excitement that we welcome all of you to the 4th Asian Vaccine Conference to be held in Cebu City . This is the original place where the explorer Ferdinand Magellan under the service of the King of Spain, Philip II landed in 1621 to discover these beautiful islands and named it in honor of his King. The Philippines has then become a country noted for its diverse culture, a land with plenty of blue skies and sunshine with hospitable and smiling people willing to learn and share.

Today, we are honored by your presence and we are ready to discuss with you various aspects of vaccinology especially where it will contribute to saving lives and promoting better health for all ages. We believe that through the cooperation, collaboration , coordination and communication among partners and stakeholders in vaccinology, we can effect a change in the way both government and the private sector value vaccination to insure the quality of life of our people.

Vaccination programs are an investment for the future generation that can produce social and economic gains as proven by the outcome of many countries benefiting from such health programs. There is a need however to disseminate and champion vaccine advocacy since many governments and private entities lack awareness of the burden of disease and its prevention and control. Surveillance data are much wanted and the lack of it becomes an excuse for not making good use of vaccines. We hope that with the continued efforts to bring the evidences and the much sought after data to our stakeholders, we will succeed in promoting disease prevention and control through vaccination.

We are grateful to the Organizing committee from the PSMID-Cebu Chapter , led by Dr Jonathan Lim for hosting us and showing us what great things networking and partnerships can do for our country and our people.

With our best wishes for a great interaction and discussion with all of you!

Professor LULU C. BRAVOPresident, IPAP

As a pediatrician and vaccine advocate, I am proud to welcome our highly-esteemed speakers, colleagues and guests to the 4th Asian Vaccine Congress (ASVAC 2013)!

The historic city of Cebu, also known as the “Queen city of the South”, is the venue of this very important event. It is a gathering of physicians, healthcare workers and other vaccine enthusiasts who are here to discuss, collaborate, and create linkages and networks among colleagues and experts.

The Board of the Immunization Partners in Asia Pacific, Inc. along with the local organizing committee have painstakingly prepared for you very interesting topics that are of value to you, regardless of your profession or specialty. We are very honoured of your presence, and we take pride in our City and in what it has to offer to you even beyond ASVAC 2013. It is our hope that you will not only be able to learn something new about vaccines, but more importantly, that you will be able to strengthen your partnership with other stake holders in the fight to improve health and save lives across all age groups.

Once again, welcome to ASVAC 2013 and MABUHAY!

Jonathan G. Lim, MD, FPPS, FPIDSPOver-all Chair4th ASVAC

TIME SESSIONS1330-1730H

Part 1

Part 2

1900-2100HLantaw Restaurant

Fourth Asian Vaccine Congress (ASVAC 2013) SCIENTIFIC PROGRAM

PRE-ASVAC CONFERENCE June 11, 2013 By Invitation Only

Mexico experienceWorkshop properSynthesis and closing

May Montellano (Philippines)

POLIO ERADICATION WORKSHOP

OpeningGlobal epidemiology of polio, polio eradication and end-game strategyPhilippine situation: NIP/AFP surveillanceCoffee/Tea Break

Polio options

Asec. Enrique Tayag (Philippines)

T Jacob John (Chair), India

SPEAKERS

Josefina Carlos (Chair), Philippines

Emmanuel Vidor (France)Francisco Espinosa (Mexico)Josefina Carlos (Moderator), Philippines

Lulu Bravo (Philippines)

SPEAKERS' NIGHT

1

12-14 June 2013 Radisson Blu Hotel, Cebu City Philippines

TIME SESSIONS0900-1200HSan Martin 1-3

0900-0915 Opening0915-0935 Barriers to introduction of new vaccines0935-0950 Vaccine safety surveillance0950-1015 Country reports 11015-1030 Coffee/Tea break1030-1050 Post-eradication: The need for IPV1050-1105 Public health impact of rotavirus vaccine1105-1130 Country reports 21130-1150 General Discussion1150-1200 Closing

1100-1300HSta. Maria 2-3

1100-1110 Welcome and Introduction1110-1140 Optimizing rotavirus protection: Success and unmet needs1140-1210 Preventing invasive and non-invasive pneumococcal

disease in young children1210-1240 A decade of life experience with a hexavalent combination

vaccine1240-1300 Question and Answer

William Hausdorff (Belgium)

Susanna Esposito (Italy)

Lulu Bravo (Philippines)Miguel O'Ryan (Chile)

Irma Asuncion (Chair), Philippines

H.T. Wickramasinghe (Co-chair), Sri lanka

H.T. Wickramasinghe (Sri Lanka)Maricel DQ Castro (WHO Philippines)

T Jacob John (India)Tony Nelson (Hong Kong)

GlaxoSmithKline LUNCHEON SYMPOSIUMImproving protection against childhood infectious diseases: Looking back and moving forward

SPEAKERSEPI PROGRAM MANAGERS CONFERENCE (by invitation only)


DAY 1, June 12, 2013

1


TIME SESSIONS1200-1330H

1330-1430HSta. Maria 2-3 Cultural presentation

Welcome remarksIntroduction of Keynote SpeakerKeynote AddressLaunching of the ASVAC 2013 Theme Song - "Just the 3 of Us"Opening ceremony gong

1430-1500HSta. Maria 1

1500-1630HSta. Maria 2-3

1500-1530 Global vaccine action plan1530-1600 IVI's role in vaccine innovation for the developing world1600-1630 New influenza vaccines to control epidemics and pandemics

1630-1700HSta. Maria 2-3 Usec. Teodoro Herbosa (Philippines)

1700-1730HSta. Maria 2-3

1730-1830HSta. Maria 1

1830-2100HNiña 1-2

VISIT EXHIBIT

WELCOME RECEPTION and FELLOWSHIP GALA DINNER

Mayor of Cebu City or RepresentativeAsec. Enrique Tayag, MD (Philippines)Sec. Enrique Ona, MD (Philippines)Tony Nelson (Hong Kong)Jonathan Lim (Philippines)

PLENARY SESSION 1

Vaccination in special circumstances

Strengthening public-private partnerships

PLENARY SESSION 2

Coffee/Tea BreakCUTTING OF EXHIBIT RIBBON

PLENARY SYMPOSIUM 1Global goals for vaccines and immunization

OPENING CEREMONIES

PRESS CONFERENCESPEAKERS

Lance Jennings (New Zealand-APACI)

Tony Nelson (Chair), Hong Kong

Cissy Kartasasmita (Chair), Indonesia

Iqbal Ahmad Memon (Pakistan)

Maricel DQ Castro (WHO Philippines)Christian Loucq (South Korea - IVI)


T Jacob John (Chair), India

Josefina Carlos (Co-chair), Philippines

DAY 1, June 12, 2013

1


TIME SESSIONS

0730-0900HSan Cristobal 1-2

0730-0830HNiña 1

Niña 2

0900-0930HSta. Maria 2-3

0930-1000H Coffee/Tea break

1000-1130HNiña 1

1000-1030 Vaccine safety: The Brighton collaboration1030-1100 Anti-vaccine groups: Countering their tricks and tropes1100-1130 National immunization days: PROs and CONs

Niña 2

1000-1030 Adolescent vaccination1030-1100 Cholera, typhoid and meningococcal vaccines: Scaling up use Anna Lena Lopez (Philippines)1100-1130 Rabies vaccines: Road to rabies elimination

Sta. Maria 2

1000-1030 Combination vaccines1030-1100 Pertussis resurgence1100-1130 Measles and rubella elimination

Fourth Asian Vaccine Congress (ASVAC 2013) SCIENTIFIC PROGRAMDAY 2, June 13, 2013

Issues and controversies in adult and elderly vaccination

PLENARY SESSION 3

SPEAKERS

Joseph Domachowske (USA)

Moderator

Usa Thisyakorn (Chair), Thailand

Charung Muangchana, Thailand

Moderator

Remedios Coronel (Philippines)

ASAP BUSINESS MEETING (for members only)

MEET THE EXPERTS (simultaneous)Prevention of invasive meningococcal disease

Shelley Ann de la Vega, Philippines

Ping-Ing Lee (Taiwan)

APPA Symposium: Vaccinology for the pediatrician

PIDSP Symposium: Vaccines in special groups

Elfleda Hernandez (Chair), Philippines

Evelyn Alesna (Co-chair), Philippines

Francoise Sillan (France-Sanofi Pasteur)

Vaccine delivery: Advances in methodology

SIMULTANEOUS SYMPOSIA 1PSMID CEBU Symposium: Addressing vaccine concerns

HT Wickramasinghe (Sri Lanka)Joyce Ducusin (Philippines)

Salvacion Gatchalian (Chair), Philippines

Belle Ranile (Co-chair), Philippines

Cynthia Aguirre (Philippines)

Beatriz Quiambao (Philippines)

Musa bin Mohd Nordin (Malaysia)

Zulkifli Ismail (Chair), Malaysia

Yonghong Yang (Co-chair), China

Usa Thisyakorn (Thailand)Zulkifli Ismail (Malaysia)

1


TIME SESSIONS

1200-1330H Jaime Santos (Chair), Philippines

Sta. Maria 2-3

1330-1500H

Niña 1

1330-1400 Championing vaccination: Sharing the vision1400-1430 Pneumonia vaccines: Transcending age barriers1430-1500 Rotavirus vaccines: Making headway slowly but surely

Niña 2

1330-1335 Welcome and introduction1335-1410 The CoMO Change Equation

Parent and patient advocates Healthcare professionals Policymakers and influencers

1410-1425 Communication and advocacy tools1425-1440 Advocacy in practice: The Malaysia experience

Sta. Maria 2-3

1330-1400 Immunization and MDGs1400-1430 Polio elimination: Sustaining gains1430-1500 Evidence-based decision making process for vaccine

1500-1530H

1530-1630HSta. Maria 2-3

1530-1600 Adjuvanted vaccines at work1600-1630 Role of new adjuvants in vaccine advancement

1630-1800HSta. Maria 2-3

ASAP Symposium: PCV for the Asian EPI

Bruce Langoulant (Chair), Australia

Asec. Enrique Tayag (Co-chair), Philippines

Prioritizing rotavirus vaccine or PCV in the NIP

Innovations in vaccine research and developments

Kimberly Fox (Philippines-WPRO)

Cecilia Maramba-Lazarte (Chair), Philippines

introduction in the NIP

PLENARY SYMPOSIUM 2

Tony Nelson (Hong Kong)

Coffee/Tea break

Lyndon Lee Suy (Co-chair), Philippines

Charung Muangchana (Thailand)T Jacob John, John (India)

DOH-NCDPC Symposium: Public health impact

Bruce Langoulantvaccine coverageCoMO Symposium: Partners in an Equation for Change for

Ma. Liza Gonzales (Co-chair), Philippines

Lulu Bravo (Philippines)Sajid Maqbool (Pakistan)

Communities and individuals demand immunization

Joseph Domachowske (USA)

PFV Symposium: Advocacy in action

What's new in pediatric hexavalent combination vaccination?

SIMULTANEOUS SYMPOSIA 2

Somsak Lolekha (Thailand)

Emmanuel Vidor (France)

Shelley Ann de la Vega (Chair), Philippines

Encephalitis vaccination

the use of quadrivalent conjugate vaccines

SANOFI PASTEUR LUNCHEON SYMPOSIUMAdvanced prevention of meninngococcal disease through

Introducing Sanofi Pasteur's latest advance in Japanese

Zulkifli Ismail (Chair), Malaysia

Daniel Y.T. Goh (Co-chair), Singapore

SPEAKERS

Sajid Maqbool (Pakistan)

Musa bin Mohd Nordin (Malaysia)Iqbal Ahmad Memon (Pakistan)

Librada Fortuna (Co-chair), Thailand

Leilani Sanchez (Philippines-Novartis)Alberta Di Pasquale (Belgium-GSK)


PCV: More serotypes, more protection?

Bruce Langoulant (Australia)Zulkifli Ismail/Musa Nordin (Malaysia)Asec. Enrique Tayag (Philippines)Jessica Langoulant (Australia)Li Jin Chan (Malaysia)

Irma Asuncion (Chair), Philippines

Ping-Ing Lee (Taiwan)

1


TIME SESSIONS

0730-0900HSan Cristobal 1-2

0730-0830HNiña 1

Niña 2

0830-1000HSta. Maria 2-3

0830-0900 New approaches in vaccine development0900-0930 New vaccines on the horizon0930-1000 Meningococcal B vaccine: Updates and expectations

1000-1030H

1030-1200HSta. Maria 2-3

1030-1100 Dengue: Getting stronger in time1100-1130 Dengue vaccine: Is it worth the wait?1130-1200 The strategy of the DVI in accelerating the introduction of

dengue vaccines

1200-1330H

1330-1530HSta. Maria 2-3


SPEAKERS

CLOSING CEREMONIES

Somsak Lolekha (Thailand)

Closing remarks

ASAP BUSINESS MEETING (for members only)

MEET THE EXPERTS (simultaneous)The re-emergence of pertussis

HPV: The adolescent vaccine

Charissa Fay Tabora, Philippines

Announcements

Moderator

Cecilia Ladines-Llave (Philippines)Sudath Peiris, Sri Lanka

Moderator

Daniel Y.T. Goh (Chair), Singapore

Jonathan Lim (Co-chair), Philippines

PLENARY SYMPOSIUM 3Vaccine technology: Nice to know

Hans Bock (Germany-Novartis)Emilio Ledesma (Singapore-GSK)Miguel O'Ryan (Chile)

Distribution of awards and certificates

Entertainment

Coffee/Tea break

ISTP PLENARY SYMPOSIUM on Focus: Dengue Usa Thisyakorn (Chair), Thailand

Ma. Rosario Capeding (Co-chair), Philippines

Lunch break

Pornthep Chanthavanich (Thailand)Alain Bouckenooghe (Singapore-Sanofi Pasteur)Georges Thiry (South Korea-IVI)

1


APACIAPPAASAPASPIDCoMODOH-NCDPC Department of Health - National Center for Disease Prevention and ControlISTPIVIPFVPIDSPWPROWR

Asia Pacific Pediatrics Association

International Vaccine Institute

Asia Pacific Alliance for the Control of Influenza

IPAP's CO-HOSTS & PARTNERS for the 4th ASVAC

Asian Strategic Alliance for Pneumococcal Disease Prevention

Sanofi Pasteur

Philippine Foundation for VaccinationPediatric Infectious Disease Society of the PhilippinesWHO Regional Office for the Western Pacific

Asian Society for Pediatric Infectious DiseaseConfederation of Meningitis Organizations

International Society for Tropical Pediatrics

WHO Representative to the PhilippinesGlaxoSmithKlineNovartisMSD

1


SPEAKERS’ PROFILES AND

TOPIC ABSTRACTS

H.T.Wickramasinghe

Dr.H.T.Wickramasinghe, is a Consultant Paediatrician who is currently the President of the Asian Siciety of paediatric infectious diseases. Though a general Paediatrician by profession, Dr. Wickramasinghe is a person of many interests in the field of Paediatrics. His main interest has always been Paediatric Neurology. In this sphere, his contribution to children with neurological disabilities was very commendable especially at a time when there were no Paediatric Neurologists in Sri Lanka. Dr.Wickramasinghe single handedly managed three epidemics of Japanese Encephalitis and a massive epidemic of Shigella dysentery, while working in a semi-urban city in the early 1980s. This instigated an unrelenting interest in infectious diseases. Currently his interest is diverted to the management of dengue as this disease is currently hyper-endemic in Sri Lanka. He has been a resource person for many international conferences on this subject. He graduated from the University of Ceylon in 1974 with honours and later obtained his MD in Paediatrics in 1980. He further obtained his MRCP in the United Kingdom in 1982 and DCH London in 1983. Upon his return to Sri Lanka in 1983, Dr. Wickramasinghe was employed as a consultant Paediatrician in many parts of the country. He joined Sri Jayewardenepura Post Graduate Training Centre as the Head of the Department of Paediatrics in 1990. During this period, he was actively involved in the post graduate training of junior paediatricians. He was also involved in training undergraduates from Sri Jayewardenepura University in Sri Lanka. Moreover, he was appointed as the Head of the Department of Paediatrics at Sri Jayewardenepura University at the initial phase of its formation. He was the Secretary to Board of Studies in Paediatrics at Post Graduate Institute of Medicine (PGIM) in Sri Lanka since 1995 to 1999. In 1999, He left the country to accept the Post of the Head of the department of Paediatrics at RIPAS hospital in Brunei, where he was employed for nearly eight years and returned home in 2008. In 2009, he was appointed as the President of the Sri Lanka College of Paediatricians. He has given many lectures in both National and International conferences and symposiums and has published many articles in prestigious international journals. Apart from being passionate about Paediatrics, Dr. Wickramasinghe is also a wild life enthusiast and a wild life photographer. His is also interested in collecting scientific literature on herbal medicines.

President- Asian Society of Paediatric Infectious diseases 2012-2014 Immediate President of Epilepsy Association of Sri Lanka2010-2012 Past President of Sri Lanka College of Paediatricians-2009 Former Head of the Department of Paediatrics- RIPAS Hospital, Bruei Darussalam/Visiting Senior Lecturer- University of Queensland Former head of the Department of Paediatrics- Sri Jayewardenepura Post graduate training center

BARRIERS TO THE INTRODUCTION OF NEW VACCINES

ANTI-VACCINE GROUPS: COUNTERING THEIR TACTICS AND TROPES

H.T.Wickramasinghe

H.T.Wickramasinghe

Newhealthinterventionstendtobenefittherichestcountriesfirstandonlymuchlatertrickledowntobenefitthepoorestcountries.Poorestcountriesmaynothaveaccesstolatestvaccinesfor10-20yearsafterinitiallicensureintherichcountries.

However,theintroductionofanewvaccineisprimarilyanationalissuerelatedtononacceptancebythepolicymakers.LessonslearntfromtheHIBinitiativehighlightedfewmajorbarriersfortheintroductionofvaccinesnamely,thepoorunderstandingofthenewvaccine,lackofpoliticalwillandfinancialconstraints,andpublicresistanceduetomisunderstandings.

Poorunderstandingofthevalueofthenewvaccinesinthelocalsettingintermsofefficacy,sideeffectsandLackofdiseaseburdendata,areallimportantargumentsagainsttheintroductionofthevaccines.

SomecountriesdonothaveaNationalImmunizationAdvisoryCommitteeorotherlocalbodiestopressurizethegovernmenttobuilditspoliticalwilltointroducenewvaccines.ManyGAVInon-eligiblemiddleincomecountriesareoftenreluctanttoinvestonnewexpensivevaccines,restrainingtheirotherhealthprioritiesandoftenfearthattheymaynotbeabletoprovidecontinuedfinancestosustaintheavailabilityofthevaccines.Although,thereissometierpricingavailabletoGAVIandUNICEFforbulkpurchasingvaccines,thefinancialburdenformiddleincomecountriesremainunaffordable.

Publicresistancetovaccinehasbeeninexistencesinceitsinventionin1796.Whenintroducingnewvaccines,thereisasenseofdistrustandsuspiciontowardsgovernmentandWesternmultinationalvaccinemanufacturers,andsomepublicskepticismprevailsduetomythsandconcernsaboutnewtechnology.Thatitselfcompelpolicymakerstotakeastepbackbeforeintroducingvaccines.

Withtheadventofinternet,medicalinformationbefallsfreelyonthehandsofthepublic.Newparadigmofhealthcarehasemerged,whereauthorityofdecisionmakinghasshiftedfromdoctorstopatientsandtheauthenticityofscienceisquestionedwiththeevolutionofpseudo-expertstocriticizescientificdata.Anti-vaccineactivistsareabletousethisinternetplatformveryeffectivelyandpersuasively.EvidenceshowsthatindividualswhoutilizedtheInternettoseekinformationonvaccinationsmaynegativelybeinfluencedbysuchsourcesonvaccinationdecisions.Thetacticscommonlyusedbyanti-vaccineactivistsincludeskewingscience,shiftinghypotheses,censoringdissent,attackingcriticsandorganizingPseudo-ScientificConferences.Fewtropestheyuseregularlyincludethatvaccinesareharmful,containstoxins,non-effectiveandcausesAutism,MultipleSclerosis,CancerandDiabetes.CounteractingtheirargumentsisaglobalpriorityasmanyoftheVaccinepreventablediseasesarehoveringaroundtheglobeandre-emergingasepidemicsinsomeclosedcommunities.Thisisduetononimmunizationofchildrenontheadviceofanti-vaccinegroups.Maincounteringtacticthatshouldbeusedistoapplythesameplatformprovidingmoreandmorewebsiteswithpro-immunizationarguments,andallowingthemtoappearfirstinpopularsearchengines.Itisveryimportantthattheinformationplacedontheinternetshouldnotbe100%positive.Studieshadshownthatthereis“norisk”ledtoahigherperceivedvaccinationriskthanweaknegations.Informationstatingthepresenceofriskdecreasesriskperceptions,whileinformationnegatingtheexistenceofriskincreasessuchperceptions.Communitybasedhealtheducationandeffectivecommunicationstrategiescouldbeusedatregionallevelwhereneeded.

Maricel de Quiroz-Castro, RN

EDUCATION

1992 – 1996 Bachelor of Science in Nursing Pamantasan ng Lungsod ng Maynila (University of the City of Manila)

TRAININGS, WORKSHOPS AND OTHER PROFESSIONAL EXPERIENCE

25 Jul - 3 Aug 2012 Regional Workshop on Monitoring and Evaluation of Population Health And Nutrition Programs New Delhi, India by MEASURE Evaluation

26-27 Jan 2012 Resource Mobilization Capacity Building Workshop WHO-WPRO, Manila

20 Dec. 2011 Effective Vaccine Management Training WHO Philippines, Manila

15-17 Nov. 2010 Communication Enhancement and Focus Group Discussion Training UNICEF, Davao City

1-3 November 2010 AFP Surveillance Field Review jointly by the DOH, WHO and the Regional Certification Commission for the Global Polio Eradication in the Western Pacific Region, Region I

27-30 Sept. 2010 6th Pacific EPI Strengthening Workshop WHO –WPRO, Manila

23 September 2010 AEFI Training for National Capital Region (Resource person Department of Health, Makati)

14-17 Sept. 2010 Planning Workshop for Maternal and Neonatal Tetanus Elimination (Resource person), Department of Health, Davao City,

31 Aug.-3 Sep. 2010 Vaccine Supply and Stocks Management Training Department of Health, Tagaytay City

11-13 August 2010 Writeshop on Revision of the National Preparedness Plan for Wild Poliovirus Importation (Resource person), Department of Health, Manila

3-6 August 2010 Writeshop on the AEFI Training Modules (Resource person) of Health, Cavite

15-16 June 2010 Technical Consultation on Verification of Measles Elimination in the Western Pacific Region, WHO –WPRO, Manila

22-23 April 2010 WHO-WPRO Accreditation Review of National Reference Laboratories for Polio and Measles, Research Institute for Tropical Medicine 17-18 March 2010 Resource Person for the National Training on AH1N1 Immunization (Resource speaker, Pasig City

1-3 March 2010 Joint DOH, WHO and UNICEF Advocacy of Maternal and Neonatal Tetanus Elimination with the LGU and Communities Solana, Cagayan

February 2010 Surveillance and Laboratory Network Meeting and Workshop WHO –WPRO, Manila

January 2010 Training of Trainors for Adverse Event Following Immunization Surveillance and Response, Tagaytay City,

Oct. & Dec. 2009 Lot Quality Assurance Cluster Survey for MNTE (Validator and Monitor) Department of Health, Negros Oriental

12-13 Nov. 2009 10th Philippine National Immunization Conference (Resource Speaker) Philippine Foundation for Vaccination, Manila

September 2008 Data Management and Field Staff Training STOP Transmission of Polio Team 29 U.S. Centers for Disease Control and Prevention (CDC), U.S.A.

March 2008 Training on Philippine Integrated Disease Surveillance and Response (Resource person), Department of Health, Subic, Zambales

PROFESSIONAL EXPERIENCE

March 2013 External Monitor for Laos PDR JE-DTP-OPV Supplemental Immunization Activity World Health Organization Western Pacific Region

5-13 Dec 2011 Technical Assistance to Measles – Rubella Supplemental Immunization Activity Laos People’s Democratic Republic Jan.–Dec. 2011 Technical Assistant for Expanded Program on Immunization World Health Organization – Philippines March 1, 2002 to National Coordinator – Vaccine Preventable Disease (VPD) Surveillance August 15, 2008 National Epidemiology Center, Department of Health *formerly known as Expanded Program for Immunization Disease Surveillance

February 2001 to Corporate SecretaryFebruary 2002 Museo Pambata Foundation, Inc.

January 2000 to Associate Director for AdministrationFebruary 2002 Museo Pambata Foundation, Inc.

June 1999 to Health Project Coordinator June 2000 Museo Pambata Foundation, Inc.

March 1998 to STD/ AIDS Project Coordinator March 1999 Museo Pambata Foundation, Inc.

November 1997 to Documentation OfficerDecember 1999 Museo Pambata Foundation, Inc.

VACCINE SAFETY SURVEILLANCE Maricel de Quiroz Castro

Immunizationisoneofthebasicpublichealthserviceswhichhavethewidestreach.Itsavesmillionsoflivesofchildrenbyprovidingprotectionagainstvaccine-preventablediseaseinfections.Ithasledtoeradicationofatleastonediseasefromthefaceoftheearth,e.g.smallpox.Overtheyears,thenumberofinfantsreceivingvaccineshasincreasedsubstantiallyandthiswasmadepossiblethroughthecollaborationofdifferentstakeholders/partnersworkingtosustainahealthsystemthataddressespeople’sneeds.

Althoughmodernvaccinesaresafe,novaccineisentirelywithoutrisk;adversereactionswilloccasionallyoccurfollowingvaccination.Somepeopleexperienceadverseeventsfollowingimmunization(AEFI)rangingfrommildside-effectstorarelife-threateningillnesses.Inthemajorityofseriouscasestheseeventsaremerelycoincidences.Inothers,theyarecausedbythevaccineorbyanerrorintheadministrationorhandlingofthevaccine.Sometimesthereisnocausalrelationshipbetweenthevaccineandtheadverseeffects.Maintainingpublictrustinvaccinesafety,therefore,iskeytothesuccessofallvaccinationprogrammes.

Astechnologycontinuestoimprovewithtime,sodothequality,efficacyandeffectivenessofthevaccines.Yet,AEFIsmaystilloccur.Thus,havingafunctionalAEFIsurveillanceiscriticalinbothvaccineandnon-vaccineproducingcountries.ReportingandinvestigatingAEFIsarecrucialtoidentifyandcorrectimmunizationerrors-relatedreactionsandmayhelptodistinguishacoincidentaleventfromatrueAEFI.SurveillanceofAEFIsisaneffectivemeansofmonitoringimmunizationsafetyanditcontributestothecredibilityoftheimmunizationprogramme.ItallowsforpropermanagementofAEFIsandavoidsinappropriateresponsestoreportsofAEFIsthatcancreateasenseofcrisisintheabsenceofimmunizationsafetysurveillance.

Tomaintainandimprovepublicconfidenceinnationalimmunizationprogrammes,allhealthcareprovidersshouldbecomprehensivelyawareofallaspectsofAEFIsandremainpreparedtorespondtopublicconcernsatanytime.Communicatingeffectivelyandaddressingpublicconcernspromptlywillprotectthepublicandpreservetheintegrityoftheimmunizationprogramme.

THE DECADE OF VACCINES GLOBAL VACCINE ACTION PLAN (GVAP)Maricel de Quiroz Castro

Theglobalvaccineactionplan(GVAP)buildsonthesuccessoftheGlobalImmunizationVisionandStrategy(GIVS),2006–2015,whichwaslaunchedin2005asthefirst10-yearstrategicframeworktorealizethepotentialofimmunization.Developingtheplanhasbroughttogethermultiplestakeholdersinvolvedinimmunizationfromdifferentgovernment,non-governmentandprivatesectors.Intotal,theglobalconsultationprocessreachedover1100individualsrepresentingmorethan140countriesand290organizations.

Itrecognizesimmunizationasacorecomponentofthehumanrighttohealthandanindividual,communityandgovernmentalresponsibility.Vaccinesandimmunizationaspartofacomprehensivepackageofinterventionsfordiseasepreventionandcontrol,areessentialinvestmentinacountry’sandtheworld’sfuture.

ThecollectiverecognitionoftheopportunityforcountriestoshowcommitmenttoachievingthefullpotentialofimmunizationhasledtheglobalhealthcommunitytocallforaDecadeofVaccines,inlinewiththerequestsmadeinresolutionWHA61.15ontheGIVS.ThevisionfortheDecadeofVaccines(2011–2020)isofaworldinwhichallindividualsandcommunitiesenjoylivesfreefromvaccine-preventablediseases.ThemissionoftheDecadeofVaccinesistoextend,by2020andbeyond,thefullbenefitofimmunizationtoallpeople,regardlessofwheretheyareborn,whotheyareorwheretheylive.

Thedraftglobalvaccineactionplanreiteratesexistinggoalsandsetsnewgoalsforthedecade,proposessixstrategicobjectivesandtheactionsthatwillsupporttheirachievement,andprovidesaninitialestimateofresourcerequirementsandreturnoninvestment.Italsosummarizesrecommendedindicatorstomonitorandevaluateprogress.Beyondtheactionplan,country,regionalandglobalstakeholdersneedtotakeresponsibilityforspecificactions,translatetheactionplanintodetailedoperationalplans,completethedevelopmentofanaccountabilityframeworkfortheDecadeofVaccinesandmobilizeresourcestoensurethatthevisionfortheDecadeofVaccinesbecomesareality.

T Jacob John T Jacob John graduated in Medicine and Surgery (MBBS) and specialized in Pediatrics in India (DCH), UK (MRCPE, later FRCPE) and USA (Infectious Diseases Fellowship) where he completed MSc in Microbiology and back in India, PhD in Virology. As teaching faculty in the pediatrics department of Christian Medical College (CMC), Vellore, India, he expanded the small research virology unit into India’s first diagnostic clinical virology centre in 1967. It eventually became the Department of Clinical Virology. Jacob John was appointed Head of the Clinical Microbiology Laboratory in 1987, while continuing as Head of Clinical Virology Department also. He retired from service in 1995, but continued as Emeritus Medical Scientist in CMC till 2000. In 1994 he was elected President of the Indian Association of Medical Microbiologists and in 1999 as President of the Indian Academy of Pediatrics. He is elected Fellow of Indian National Science Academy, Indian Academy of Science, National Academy of Science of India, Indian National Academy of Medical Sciences, Indian Academy of Pediatrics, Indian Virological Society, Royal College of Physicians (Edinburgh) and Royal College of Pediatrics and Child Health (London). The Tamil Nadu Medical University conferred DSc (Honoris causa) on him in recognition of: detecting HIV infection in India, designing the multi-pronged control strategy of HIV/AIDS, developing practical disease surveillance, designing pulse immunization as essential elements of polio control, in-depth research into IPV and its role in polio control/eradication and creating an external quality assessment scheme for microbiology laboratories in India. His research contributions included the detection of and remedial measures of low vaccine efficacy of OPV and epidemiology of several infectious diseases – pediatric and adult. He pioneered blood transfusion free from risk of viral infections -- in 1972 (Hepatitis B) and 1986 (HIV). Jacob John has published over 500 scientific papers. He has served on several International and National Committees related to Infectious Diseases and their control, vaccinology and vaccine safety. Jacob John provided critical leadership in eradicating polio not only n India but also globally. He is currently Chairman of Child Health Foundation (New Delhi), Member of WHO SAGE Working Group on Polio Eradication (Geneva), Member of Polio Eradication Technical Advisory Group of WHO Eastern Mediterranean Region (Cairo) and Member of Immunisation Technical Advisory Group of WHO South East Asia Region, New Delhi.

POST-ERADICATION: THE NEED FOR INACTIVATED POLIOVIRUS VACCINE (IPV)

POLIO ERADICATION: SUSTAINING THE GAINS

T Jacob John

T Jacob John

Aftersmallpoxwaseradicated,vaccinationcouldsafelybediscontinued.Thisparadigmisthepopularbeliefforpolioalso,withtheexpectationthataftereradicatingpolio,immunizationcouldsafelybediscontinuedifanycountrydesiresso.Thisisvalidonlyiferadicationiscompletedusingthenon-transmissiblevaccine,namelyIPV.

Ontheotherhand,iferadicationisachievedusingliveoralpoliovirusvaccine(OPV),immunizationmustbeperpetuatedtopreventvaccinevirusesthemselvescontinuingtocirculatecausingpolio–bothsporadicallyandinoutbreaks.Transmissibilityofvaccineviruses,oncetaughttobeanadvantagefor‘contactimmunisation’,hasturnedouttobeafatalflaw.WhenOPVcoveragedeclinesandimmunitygapsdevelopamongchildren,vaccine-derivedpolioviruses(VDPV)emergeandcirculate,capturingthenichevacatedbywildpolioviruses(WPVs).Theproblemiscompoundedbygeneticreversionofvaccinevirusestoneuro-virulence.Thus,circulatingVDPVs(cVDPVs)arewild-like;theycausepoliooutbreaks.IfOPVisusedexclusively,coveragemustbemaintainedhighenoughtopreventpolioduetocVDPVs.

OPVitselfcausesvaccine-associatedparalyticpolio(VAPP)inanoccasionalchild,therebymakingitscontinueduseunethicalonceWPVsareeradicated.DiscontinuingOPVwillleadtouncontrolledemergenceofcVDPVs.TopreempttheemergenceofcVDPVs,polioimmunitymustbebuiltusingIPV,sothatVDPVswillnotcirculate.Thus,itisinevitablethatOPVmustbewithdrawnunderhighimmunitycoverageusingIPV.Trueeradicationiswhennopoliovirusinfectshumans.

Eradicationcreatesaworldinwhichnochildwillgetpolioparalysisanymore.Whereothervaccine-preventablediseasesabound,itis‘surgicalremovalofonelesion,whileotherpathologiespersist’.So,thebroadergoalistocreatetheplatformforeradicatingorcontrollingallvaccine-preventablediseases.

Wildpoliovirusesareasinfectiousasmeaslesvirus:thereforeeverycommunity,howeverremoteordifficulttoreach,hadtobereachedrepeatedlywithOPV.Detailedmicro-planningforcoverageofalltheworld’schildrennomatterwheretheylive,isanewlessoninpublichealth.Itsbestfutureuseisformeasleseradication.Everychildmustreceive2dosesofmeasles-containingvaccine(MCV)tointerruptmeaslesvirustransmissionlocallyandglobally.IfMCVcontainsrubellavaccinealso,rubellacanbeeradicated.Forpolioeradicationahierarchyofqualityviruslaboratorieswasnet-workedglobally;theywillbeinvaluableformeaslesandrubellaeradication.

OPVcampaignswerede-linkedfromExpandedProgrammeonImmunisation(EPI).AsIPVgetsintroducedtocompletepolioeradication,highcoverageunderEPIwillhavetobeachievedusinglessonsfrompolioeradication.Thus,polioeradicationandEPIwillworkhandinhand,ensuringhighcoveragewithallvaccines,andtheestablishmentofdiseasesurveillancetomeasuretheoutcomeofEPI.

Polioresultedinproductivityloss;thebenefitsoferadicationarenotonlyhumanitarian,butalsoeconomic.Generationsofhealthychildrenwillleadsocialdevelopment,acceleratingeconomicdevelopment.Thegainsofpolioeradicationareforever.

Tony Nelson

Tony Nelson is a professor in paediatrics at the Chinese University of Hong Kong. Over the course of his career, he has worked in South Africa, Zimbabwe, Saudi Arabia, New Zealand, Malawi and Hong Kong. His research interests include vaccines and disease surveillance, infant and child nutrition, and sudden infant death syndrome.He is a member of the ROTA Council which works to provide the scientific and technical evidence that policymakers need to accelerate the introduction of rotavirus vaccines. He is member of Hong Kong’s Scientific Committee on Vaccine Preventable Diseases and has previously served on WHO’s Expert Advisory Group on Quantitative Immunization and Vaccines Related Research (QUIVER). Dr. Nelson received his medical degree (MBChB) from the University of Cape Town in South Africa in 1978 and his doctorate from the University of Otago in New Zealand in 1989

Professor in Paediatrics, Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong

ROTAVIRUS VACCINES: MAKING HEADWAY SLOWLY BUT SURELY Tony Nelson

Rotavirusisthecommonestcauseofseverediarrhoeainyoungchildrenunder5yearsofageandremainsaleadingcauseofchildmortalityinthisagegroup.Rotavirusisadouble-strandedRNAviruswithanumberofstrainsserotypedaccordingtotheGandPstructuralproteins.Anumberofrotavirusvaccineshavebeenlicensedfollowingstudiesdemonstratingefficacyinbothdevelopedanddevelopingcountries.TheWorldHealthOrganizationrecommendstheuseofthesevaccinesinallnationalimmunisationprogrammes.Early-adoptercountriesthatintroducedthesevaccinesintotheirnationalimmunisationprogrammeshavedemonstratedrealworldeffectivenessagainstallcirculatingrotavirusstrains.YetthenumberofcountriesfollowingtheWorldHealthOrganizationrecommendationsisstillsuboptimal.InparticularfewcountriesinAsiahaveintroducedthesevaccinesintotheirnationalimmunizationprogrammes.Reasonsforthislowuptakemayrelatetoperceptionsofdiseaseburdens,concernsaboutsafety,concernsaboutpriceandotherfactors.IncontrastchildreninmanycountriesgloballyandparticularlyinLatinAmericahaveroutineaccesstothesevaccines.MorerecentlyanincreasingnumberofGAVI-eligiblecountriesareincorporatingthesevaccinesintothenationalimmunisationprogrammes.FurthereffortisneededinAsiatoensurethatthebenefitsofrotavirusvaccinesareavailabletoallchildren.

Christian Loucq, M.D.

Dr. Christian Loucq, Director-General of the International Vaccine Institute (IVI), is an international expert on the evaluation of vaccines in developing countries. He was appointed as Director General in November 2011. Dr. Loucq’s professional experience spans the globe. He has lived and worked in Algeria, Belgium, Chad, China, India, the Netherlands, Niger, Switzerland, Thailand, the United Kingdom and the United States. Dr. Loucq has been involved in most stages of vaccine development throughout his career from managing vaccine businesses in China, India and Thailand to working with large vaccine companies such as GlaxoSmithKline and Sanofi Pasteur, and biotechnology companies such as Rhein Biotech and Acambis. Before joining IVI, he was the Director of the Malaria Vaccine Initiative at PATH. Due to his extensive experience of working in both the private and public sectors, Dr. Loucq has built dynamic collaborations to foster vaccine development that include partnering with local governments, developing public-private partnerships, and establishing local private collaborations. Dr. Loucq earned his state doctorate of human medicine at the University of Paris X and a diploma of public health and tropical medicine from the University of Aix-Marseilles.

Director GeneralInternational Vaccine [email protected]

IVI’S ROLE IN VACCINE INNOVATION FOR THE DEVELOPING WORLDChristian Loucq, M.D.

Vaccinesareconsideredasoneofthemajorcontributionofthe20thcentury,theyplayanimportantroleinachievingMillenniumDevelopmentGoals4and6(ReduceChildMortalityandCombatHIV/AIDS,MalariaandotherDiseases).VaccinesareoneofthemostcosteffectiveinterventionsproposedinGlobalHealth.Thankstoavaccine,smallpoxhasbeeneradicated,poliomyelitiswillbeeradicatedsoon,measleshasbeencontrolledinmanypartsoftheworld,anddiseaseslikehepatitisB,tetanus,diphtheriahavewitnessedadramaticreductionoftheirincidenceworldwide.OnceuponatimelocatedindevelopedcountriesnewmanufacturersofinternationalcaliberhaveappearedinIndiabutalsomorerecentlyinChina.ThankstoorganizationlikeGAVI,tothesupportofseveraldevelopedcountriesandtothededicationofphilanthropies,existingandnewvaccinesarereachingmorechildrenthaneverbefore.Managingintroductionofmanynewvaccines,overcrowdedimmunization,calendars,anti-vaccinegroups,sustainabilityareamongthechallengesthatvaccinologistsarefacingtoday.

TheInternationalVaccineInstitutewascreatedfifteenyearsagoandestablishinKoreabytheUnitedNationDevelopmentProgram.Itsmissionistodiscover,developanddeliversafe,effective,andaffordablevaccinesfortheworld’sdevelopingNations.Withthedevelopmentandpre-qualificationinpartnershipofanoralcholeravaccine,withthedevelopmentofanimprovedtyphoidvaccinewithalargebodyofworkonallaspectsofvaccinationfromunderstandingthediseasesburdentomeasuringimpactofinterventionsIVIismakingamajorcontributionfrombenchtofield.

Lance C Jennings QSO, PhD, FRCPath, FFSC(RCPA)

Lance Jennings is Clinical Virologist to the Canterbury District Health Board, Director of New Zealand’s WHO National Measles Laboratory, Clinical Associate Professor in the Pathology Department, University of Otago, New Zealand and Fellow of the Royal College of Pathologists, London and a Founding Fellow of the Science Faculty, Royal Australasian College of Pathologists. His principal research interests include the epidemiology, diagnosis, prevention and treatment of influenza and other respiratory viral infections. Dr Jennings has been instrumental in the development of influenza control strategies for New Zealand, including the introduction of free influenza vaccine, establishment of influenza awareness education (NISG) and pandemic planning. He is co-founder and current chairperson of the Asia Pacific Alliance for the Control of Influenza (APACI). Dr Jennings has also been a member of WHO/Western Pacific Region Office (WPRO) Avian Influenza Outbreak Response (2004) and Expert Influenza (2005) teams in Asia and has held WHO short-term consultancies on measles and influenza in Asia and Europe. He serves on several Ministry of Health and Ministry of Agriculture Advisory Committees, is an expert reviewer for research funding agencies, and is on the editorial board of the International Society for Influenza and other Respiratory Virus Disease (ISIRV) journal Influenza and other Respiratory Viruses. His service to virology in New Zealand and internationally was recognised in 2006 with the award of the Queens Service Order.

Microbiology Unit, Canterbury Health Laboratories & Pathology Department, University of Otago, Christchurch, New Zealand

NEW INFLUENZA VACCINES TO CONTROL EPIDEMICS AND PANDEMICSLance C. Jennings

Influenzavaccinationisthemosteffectivewaytopreventinfluenzavirusinfectionandlessentheriskofassociatedsevereoutcomes.RecentglobalpublichealththreatsfrompandemicA(H1N1)pdm09influenzaandtheongoingthreatfromavianinfluenzaA(H5N1)andnowA(H7N9)viruseshavehighlightedmajorgapsinourknowledgebase,abilitytoproducesafeandeffectivevaccinesinarelevanttimeframeandourabilitytocommunicatetopolicymakers,healthcareprofessionalsandthepublic,thebenefitsandrisksassociatedwithinfluenzavaccineuse.

Seasonalinfluenzavaccinescurrentlyinusearepredominantlyegg-derivedinactivatedvaccines,whichhaveconsistentlybeenshowntoprovidegoodprotectionagainstinfluenzavirusinfectionandreducetheriskofhospitalisationanddeath.Howevertheprotectionprovidedisantibody-mediated,strain-specificandisdependentontheclosenessofthematchbetweenthevaccinestrainandthecirculatingvirus,sothatdevelopingvaccineswithbroaderandlongerlastingprotectionisahighpriority,andthe“UniversalVaccine”theultimategoal.

Theincreasedfocusonpandemicpreparednessplanningfollowingthe2004avianinfluenzaepizooticandthedevelopmentofmonovalentA(H5N1)vaccines,hasleadtonewknowledgesurroundingpre-pandemicvaccines;theneedforvaccineswhicharecross-protectiveacrosstheH5N1clades,theroleofadjuvantedvaccinesandcellculturederivedvaccines.However,ourresponsetotheA(H1N1)pdm09pandemichashighlightedthepracticalissuesrelatingtonovelvaccinedevelopment,productionandglobalsupply.Increasedcapacityandnewtechnologiesareneededtoproducevaccinesagainstanovelinfluenzavirusinsufficientquantitiestoprotectpopulationsduringanemergingpandemic,notjustthesecondwave.

Weshouldnotforgetthatseasonalinfluenzaprovidesanongoingthreattousallwiththecumulativeannualburden,eclipsingthatofeachpastpandemic.TheWHOhasrecentlyreviewedtherecommendationsforinfluenzavaccinationwhichnowidentifypregnantwomenasthehighestprioritygroupaheadofhealthcareworkers,childrenaged6monthsto5years,peopleaged65orover,andpeoplewithpre-existingchronicillnesses.Howeverrecommendationsneedtobetranslatedintoacountriespolicy,andthencontrolstrategiesimplemented.IntheAsia-Pacificregion,controlstrategiesvarywidely-fromcountrieswithanappreciationofinfluenzaimpact,goodsurveillance,extensivevaccinationprograms,andfairlygoodvaccineuptake;tothosewithnorecommendations,noprograms,littleinformationaboutimpact,andverylittlevaccineuse.TheexistenceofinfluenzavaccinationprogramsagainstseasonalinfluenzaareanimportantpartofpandemicpreparednessandpreparationshouldtheA(H7N9)virusbecomeanincreasinghumanthreat.

Professor Teodoro J. Herbosa, MD

Educated in primary and secondary school in San Beda College. Graduated from the UP College of Medicine in 1983, General Surgery residency in 1989. In 1990, he was appointed as the Emergency Room Coordinator for the Department of Surgery of the Philippine General Hospital. He pursued further training in Tel Aviv, Israel after the Gulf War in 1991 to study the Emergency Medical Services (EMS) and the Trauma System in the State of Israel. Upon his return, he worked at the Emergency Services of Jose Reyes Memorial Medical Center. He was appointed by former Secretary of Health Dr. Juan Flavier as the Deputy Secretary General of the STOP DEATH (Stop Disasters, Emergencies, Accidents, Trauma for Health) Program of the DOH. His work was recognized by the World Health Organization in the field of Emergency Preparedness and was awarded a WHO Fellowship Grant in the First International Diploma Course on Emergency and Crisis Management at the University of Geneva. He then helped develop and implement the training modules for Emergency training in the Health Emergency Course for this purpose at the UP College of Public Health. He established the Philippine General Hospital Emergency Medical Services (EMS) with a training program for emergency medical technicians (EMT’s) and acquisition of modern ICU ambulances in 1996. Today, his EMT graduates are hired in the Middle East, Australia, Canada and even the USA. The Philippine Society of EMT’s which he established is recognized by the Australasian Registry of EMT’s. He also established the University of the Philippines’ Trauma Surgery Fellowship Program and the Residency Program in Emergency Medicine. He has trained several trauma surgeons and emergency physicians who have become leaders in their fields. The World Health Organization has contracted the expertise of Dr. Herbosa as a Consultant to assist several countries namely: the Republic of Palau, Maldives, Tunisia, Fiji, and many other to formulate an EMS development plan and assess the national and health emergency or disaster plans. He was actively involved in the Safe Hospital Campaign of the UNISDR and the WHO campaign of Safe Health Facilities in Emergencies in 2008 & 2009. He also developed a training course entitled Hospital Preparedness for Emergencies (HOPE Course) and is currently taught in disaster prone countries like Indonesia, Nepal, Bangladesh, Pakistan, India, Philippines and more recently even Vietnam, Laos and Cambodia. He was the Regional Coordinator for this program for the Johns Hopkins Bloomberg School of Public Health. Aside from his work in Disaster Medicine, he

Fellow Philippine College of Surgeons & Fellow American College of SurgeonsUndersecretaryDepartment of HealthRepublic of the Philippines

has been a very active trauma surgeon. He had Fellowship training in Trauma at the Cook County Hospital of Chicago, Illinois. He trained trauma surgeons in the PGH initiating the PGH Trauma Fellowship Program and is a founding member of the Philippine Society of the Surgery for Trauma and was elected President in 2000. He has published several papers in all his fields of interest. His latest paper is published in the New England Journal of Medicine entitled A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population. He has presented several papers abroad and published research in trauma and emergency medical services. He is a member of the Editorial Board in Journal of Emergency Medicine (North America), Reviews articles for Journal of Prehospital and Disaster Medicine (North America), the Philippine Journal of Trauma and the Philippine Journal of Emergency Care. He was a Member of the Board of Directors in the World Association for Disaster and Emergency Medicine (WADEM). He is a member of the International Advisory Board of the Asian Disaster Preparedness Centre (ADPC) in Bangkok, Thailand. e served as Chairman of the Department of Emergency Medicine at PGH and modernized the ER, OR’s, ICU’s and Radiology of PGH through a modernization project Spanish Grant and facilitated the PPP Grant of the Spanish government for the construction of the Dr. Jose Rizal Ophthalmology Center at the OPD complex of the PGH. In November 2006, he established the Health Emergencies and Disasters (HEAD) Study Group in the National Institutes of Health. A multidisciplinary research group aimed at publishing the experiences of Philippine disaster responders. In November 2007, he was invited to be a Professor of the Department of Emergency Medicine of the National University of Malaysia. He was a member of the conjoint board of the Specialty of Emergency Medicine in Malaysia. He was instrumental in establishing the Centre for Research in Emergency Medicine. He has been the Flight Surgeon at the Formula One Malaysian Grand Prix races for the past 3 years (2008, 2009 & 2010). He has also published his experience in Formula One. In September, 2010, he assumed the post of Vice President for Medical and Hospital Operations of the World Citi Medical Center. In November 2010, he was appointed by Sec. Enrique T. Ona as Undersecretary of Health. His initial DOH portfolio was Undersecretary for Hospital Operations for all the 70 DOH-retained hospitals of the DOH. Apart from that, Undersecretary Herbosa was concurrently the Chairman of the DOH Task Force for Public-Private Partnership and also the Health Facilities Enhancement Program. In August 3, 2011, the DOH program of Kalusugan Pangkalahatan was launched with the intent to flatten the DOH organization and make it more responsive to the evolving healthcare needs of the country. With the restructuring of the DOH, Undersecretary Herbosa was designated to be the Cluster Head of the Operational Cluster for NCR and Southern Luzon and has been consistently the Chairman of the Center of Excellence for Public Private Partnership in Health. From the time Usec Herbosa assumes position as Cluster Head of the NCR and Southern Luzon until this present time, he performs oversight functions over the Regional DOH Centers of

NCR, Calabarzon, Mimaropa, Bicol and the DOH- retained Special and Specialty Hospitals --- monitoring and evaluating the implementation of health programs and restructuring of the health systems, providing assistance to accelerate program execution, and addressing issues on program implementation, hospital operations and management as well. Usec Herbosa has always believed in the essential role of partnering with the private sectors to assist the government in the attainment of its goals. With his strong conviction for Public Private Partnership as a means to enhance the country’s health state, he chaired and formed the first PPP Task Force of the DOH and crafted the priority programs for PPP where he and his team successfully submitted and was granted approval for the PDMF grant of the PPP Center of the Philippines for the DOH PPP projects namely VSSPII of the RITM and the Modernization of the POC. He was able to link up with different private entities such as the MMC Foundation for their assistance to the different DOH retained hospitals as well as LGU hospitals and PPP with the Pharmaceutical sector for different medicine subsidies as part of their CSR. He also facilitated the approval of the 3 Billion PPP Strategic Support fund for the 25 Regional Hospitals of the Philippines and forged ties with donor agencies such as the ADB and the World Bank to support PPP programs. In September 2012, he achieved the approval of H.E. President Benigno Aquino for the 5.6 Billion modernization program of the Philippine Orthopedic Center. Apart from all the aforementioned activities and accomplishments, Usec Herbosa is also a dynamic advocate of health bills such as the Reproductive Health, Sin Tax and Corporatization of Hospital Bills.

Professor Iqbal MemonFRCP[C], DABP, FAAP(USA)President Pakistan Pediatric Association CenterMember National Immunization Technical advisory Group [NITAG- EPI & Polio]Head of Department and Professor, Sir Syed Medical College for Girls, KarachiPatron, Child Survival Program, Dept. of Health, Govt. Of Sindh, Karachi. PAKISTAN.

QUALIFICATIONS:M.B.B.S [DOW] KARACHI UNIVERSITY NOV. 1973AMERICAN BOARD OF PEDIATRICS OCT.’ 1979 [DABP]FELLOW AMERICAN ACADEMY OF PEDIATRIC [F.A.A.P] JUNE, 1980.FELLOWSHIP PED-GASTROENTEROLOGY/ LIVER DISEASE AND NUTRITION; UNIV. OF TEXAS MEDICAL BRANCH, GALVESTON TEXAS, USA JUNE 1983.FELLOW ROYAL COLLEGE OF PHYSICIANS AND SURGEONS OF CANADA F.R.C.P.(C) AUGUST 1983

CURRENT TASKS:Head of Department & prof. of Pediatrics, Sir syed Medical College, KarachiPresident Pakistan Pediatric Association CenterFaculty, Agha Khan University, Department of Pediatrics Karachi, October 1990 to date.Consultant Pediatrics/Gastroenterologist, Parklane General Hospital, Clifton, Karachi;Patron Child Survival Program Govt. of Sindh.Member Provincial IMNCI/Child Survival Steering Committee, Sindh, PakistanMember National Pakistan Pediatric Association I.D, Pulmonary, GI, Nutrition & Hepatology groupChairman Expert Review committee Sindh, Polio Eradication Program. (since 1998)Chairman National committee on pre-service IMCI, PakistanMember, Technical advisory committee -Expanded program of Immunization Sindh.Member Asian Strategic Advisory for Pneumococcal infection (ASAP); and convenor, Pakistan Chapter ASAP; and convenor ASAP Pakistan chapter.Council member Commonwealth Association of Pediatric Gastroenterology & Nutrition (CAPGHAN).Council Member Asian Pan Pacific Societies of Pediatric Gastroenterology, Hepatology & Nutrition (APPSPGHAN).

Member National Technical Advisory Group for Polio Eradication Program Pakistan and Afghanistan.Member National Technical advisory group for Exanded Program on immunization.Member of the Standing Committee of the “International Society of Tropical Pediatrics” from 2008 to 2013Member Advisory Board Asia IDEA

Current Liscenses: Pakistan 1370-5; Louisiana USA: MD04579-R Texas, USA: G2782MAILING ADDRESS : 18 G/I, 7th GIZRI STREET, DEFENCE SOCIETY, PHASE IV, KARACHI 75500 PAKISTAN. CONTACT NUMBERS : Clinic # 0092-21-35876383 & 3581-0576 Res. # [0092-21]35860392 & 35875838 Fax # [0092]2135810576, 35875838 E-mail: [email protected]; [email protected] RECENTLY COMPLETED TASKS:-1. Member Advisory committee world congress FISPAGHAN, Taipei, TAIWAN- 20122. Principal/ Project Director, Shaheed Benazir Bhutto Medical College, Lyari, Karachi.3. Project Director Child Survival program, Sindh.4. Chairman Pakistan Pediatric Association G.I. Liver and Nutrition group.5. Member, Center of Excellence for Clinical Management Training for HIV/AIDS Govt. of Sindh.6. Member of Local Technical Advisory Committee of PMRC Research Center, Dow Medical College, Karachi.7. International Advisory committee ASPID, & World Pediatric Congress of Infectious Disease (WPCCID) in Taiwan (2010)8. Director of Diarrhea treatment unit @ Civil Hospital Karachi from 1997 – 20109. Member Data safety and community based research project on multiple micronutrient supplementation in low birth infants, Agha Khan University Hospital.

VACCINATION IN SPECIAL CIRCUMSTANCESProfessor Iqbal Memon

Vaccinationisthemostcosteffectivemodalityforthehealthofourchildren.Overtheyearsmoreandmorevaccinesarebecomingavailable,thusallowingustocontrolandoreliminatemoreandmorediseases,thussavinglotsofmiseriesduetothesepreventablecausesaswellasmanydeathsareaverted.Wemustaddthatthereeverincreasingeffectivenessandsafetyinformationthatispouringindaily.Moreover,specialsituationslike:prematurity,verylowbirthweightbabies,childrenindisasters,possibleepidemicsorepidemicsituations,malignancies,specialimmune-compromisedsituations,HIVandortransplantscenarioshavebeenconcernsofparentsandpediatriciansalikedemandinganswersregarding,ifandwhentovaccinateinthesesituation.Wearelearningthroughstudiesandexperiencethatinmostsituationswecanvaccinateandvaccinatethemwithoutdelaywhilesomesituationsdemandextrastepstoensureprotectionandpreventionofdiseases.

Vaccinesaretoolsofmassprotectionofourchildrenandwemustusethemmaximallyandjudiciouslycumwisely,toreapmaximumbenefitforthechildrenintheworldincludingoneswithspecialsituations.

Joseph B. Domachowske

Dr. Joseph Domachowske is a Professor of Pediatrics, Microbiology, and Immunology at Upstate Medical University in Syracuse, New York. His research fellowship in Pediatric Infectious Diseases was completed in the Laboratory of Host Defenses, NIAID, at the National Institutes of Health under the auspices of the Pediatric Scientist Development Program. His research focuses on preclinical and clinical vaccine efforts, including an emerging interest in vaccine hesitancy. He is involved in several multicenter clinical vaccine trials and has published more than 100 scientific papers in journals including the Journals of Virology, Immunology, Infectious Disease, Pediatrics, Medicine, Vaccine, and Pediatric Infectious Disease. He has been an invited speaker at National conferences in the United States, and Global Conferences in El Salvador, Sweden, The Netherlands, Spain, and Saudi Arabia. This is his first visit to Southeast Asia.

PREVENTION OF INVASIVE MENINGOCOCCAL DISEASEJoseph B. Domachowske

Despiteavailablesupportivecareandeffectiveantibiotictherapy,invasivemeningococcalinfectionhasamortalityrateofapproximately10%,withevenmoredeathsoccurringindevelopingcountriesandduringepidemics.ThemajorityofinfectionsarecausedbymeningococcusserogroupsA,B,C,Y,andW135withclearglobaldifferencesindistribution.VaccineformulationsforthepreventionofcapsulartypesA,C,YandW135havebeenavailableformorethanthreedecades,withevolutionfrompurepolysaccharideformulationstothemoreimmunogenicconjugatevaccinesbeginningin1999.In2005,quadrivalentA,C,Y-W135conjugatemeningococcalvaccinewasaddedtotheuniversalU.S.adolescentvaccineschedulewithexpandedrecommendationsforcertainindividualsathigherriskofinfection.Thisdiscussionwilloutlinetheepidemiologyofmeningococcalinfection,discussthemajordifferencesbetweenpurepolysaccharideandconjugateformulationsofvaccine,andemphasizetheimportanceofpreventionthroughvaccination.

Prof. Remedios Fabra-Coronel, M.D.

CURRENT POSITIONS:• FullProfessor,FacultyofMedicineandSurgeryUniversityofSantoTomas• Chief,SectionofInfectiousDiseases,DepartmentofMedicine,USTFacultyofMedicine and Surgery and Santo Tomas University Hospital• Chair,CommitteeofHospitalInfectionControl,USTHospital• CouncilofAdvisers,Phil.SocietyforMicrobiologyandInfectiousDiseases• Chair,CommitteeonAdultimmunization,PSMID• Member,SpecialtyBoardofPSMID• BoardMember,PhilippineFoundationforVaccination

PAST POSITIONS• President,PhilippineSocietyforMicrobiologyandInfectiousDiseases(1999–2000)• Chief,SectionofInfectiousDiseases,StLukesMedicalCenter(1986–2000)• Chair,InfectionControlCommittee,StLukesMedicalCenter(1986–2000)• CurrentinterestonVaccinology.Attendedthe6thInternationalAdvancedCoursein Vaccinology in Asia-Pacific Regions, International Vaccine Institute, Seoul, Korea 2006. Chair of the committee on the• HandbookofadultimmunizationamongFilipinos.

Dr. Ping-Ing Lee graduated from the medical faculty of the National Taiwan University, and obtained his Ph.D. from Institute of Clinical Medicine, National Taiwan University. He is currently serving as associate professor of the Department of Pediatrics at the College of Medicine, National Taiwan University, and is attending physician at the Department of Pediatrics, National Taiwan University Hospital. Dr. Lee serves as a committee member of the Advisory Committee on Immunization Practices and the Committee of Vaccine Injury Compensation Program, Center for Disease Control, Department of Health, Taiwan. He is the leader of pediatrics in Taiwan and is currently acting secretary-general of Taiwan Pediatrics Association. He is the president of Asian Society for Pediatric Infectious Diseases from 2010 to 2012. Dr. Lee is engaged in pediatrics, infectious diseases, vaccination, pneumonia, hepatitis and gastroenteritis. He also served as a chief editor and editor of several medical books, and has published more than one hundred peer-reviewed academic papers in English, and more than two hundreds health-related articles for the public in Chinese.

Ping-Ing Lee, M.D. PhDAssociate Professor of Department of Pediatrics, National Taiwan University Hospital

VACCINE DELIVERY: ADVANCES IN METHODOLOGY

PCV: MORE SEROTYPES, MORE PROTECTION?

Ping-Ing Lee, M.D. PhD

Ping-Ing Lee, M.D. PhD

In1990,theChildren’sVaccineInitiativewaslaunchedattheWorldSummitforChildrenandproposedthattheidealvaccinewouldprovideallindicatedantigensinasingledose(preferablythroughmucosalroute),wouldbeheatstable,effectivewhenadministeredsoonafterbirthandaffordable.

Combinationvaccinesthatprotectagainstmultiplepathogensareinkeepingwiththeultimategoalofcombiningalltheantigensintoasinglemultivalentproduct.However,immunologicinteractionbetweencomponentsofacombinationvaccinecanoccur.

Intradermalinjectionmayelicitastrongerimmuneresponsethanintramuscularinjection.Itmayreducethedosesizeandthereforethecost.Itmayalsobeeasierandsaferforadministration.Severaldevicesforintradermalinjectionofvaccineshavebeendeveloped.

Onlyfewcurrentvaccinesareadministeredbymucosalroute,becauseofitslowefficiency.Targetingofmucosalcompartmentstoinduceprotectiveimmunityrepresentsagreatchallenge.Majoreffortsaremadetodevelopnewmucosalcandidatevaccineswithhighimmunogenicity,designingnewroutesofadministrationandselectingstrongadjuvants.

DNAvaccinesweresafebutgenerallypoorlyimmunogenic.Increasingantigenexpressionandinclusionofmolecularadjuvantstoenhanceanddirectimmuneresponsesarecurrentlyindevelopment.Expressinggenesfordifferentantigensinonegene-basedvaccineisalsoattractive.Geneticallyengineeredvaccineviruseshavebeenalteredtocarrygenesfromawidearrayofotherpathogens,includingsubunitvaccinesandlivechimericvaccines.

Threepneumococcalpolysaccharide-proteinconjugatevaccine(PCV)arecurrentlyavailableinthemarket,including7-valentPCV(PCV7;Prevenar,Wyeth,Philadelphia,USA),10-valentPCV(PCV10;Synflorix,GlaxoSmithKlineBiologicals,Rixensart,Belgium),and13-valentPCV(PCV13;Prevenar13,Wyeth,Philadelphia,USA).PCV7andPCV13areformulatedandmanufacturedusingthesameprocesses.Eachpolysaccharidecapsularantigenisconjugatedtoanontoxicdiphtheriacross-reactivematerial(CRM)carrierprotein(CRM197).MostcapsularantigensinPCV10areconjugatedtoproteinD,acommonsurfaceantigenofnontypableHaemophilusinfluenzae.

ItisacommonbeliefthatinclusionofmoreserotypeswillincreasetheeffectivenessofPCV,especiallywithregardtotheinclusionofthemostprevalentorvirulentserotypes.However,itshouldbenoticedthattherearemanyinfluentialfactorsontheeffectivenessofPCV.Immunogenicitymaynotbedirectlyproportionaltoprotectiveefficacy.Inclusionofacertainserotypedoesnotguaranteea100%protectionagainstinfectionscausedbythatparticularserotype.TheprotectionagainstnontypableH.influenzae,thepresenceofcrossprotection,andtheinteractionbetweendifferentbacteriaincarriageareallcrucialfactorsfortheevaluationoftheeffectivenessofdifferentPCV’s.

Francoise Sillan, MD

Françoise Sillan, I am a medical doctor as background working in pharmacovigilance for 18 years and specialized in vaccine safety for 14 years. I am the Qualified Person for Pharmacovigilance in Sanofi Pasteur and responsible for safety signal detection and analysis and Risk Management Plan for travelers and endemic vaccines including vaccines under clinical development like Pneumo conjugate vaccine, Japanese Encephalitis and more recently Dengue vaccine. I have been a member of the CIOMS WHO working group on vaccine safety and now of the new CIOMS working group of vaccine safety launched in May 2013.

Senior Director, Global Pharmagovigilance, Sanofi Pasteur, France

VACCINE SAFETY: THE BRIGHTON COLLABORATIONFrancoise Sillan, Md

Theuseofvaccinesisexpandingworldwideasnewvaccinesandvaccinecombinationsaredevelopedresultingisanincreasedneedofcoordinationandcommunicationbetweenworldwidestakeholders(suchasNationalRegulatoryAgencies,vaccinemanufacturers,WHO,patients).Communicationonvaccinesafetyrequiresthedevelopmentofcommontoolsmethodsandguidancefromtheearlieststagesofvaccinedevelopmenttomonitoringinthepostlicensurephase.Theneedofstandarddefinitionsincludesrareadverseeventsthatmaybeassociatedwithvaccinelikeseizure,thrombocytopeniaandGuillain-Barrésyndrome(GBS)andalsomorecommonsideeffectssuchasfeverandinjectionsitereactions.TheBrightoncollaborationis“aninternationalvoluntarycollaborationtoenhancethescienceofvaccineresearchbyprovidingstandardized,validated,andobjectivemethodsformonitoringsafetyprofilesandbenefittoriskratiosofvaccines”.TheBrightoncollaborationhasproduced25publishedstandarddefinitionsofAdverseEventsFollowingImmunization(AEFI)andguidelinesfortheirusesinceitsofficiallaunchin2000.

TheCIOMS/WHOworkinggrouponVaccinePharmacovigilanceduring2005to2010hasreviewed,improved,endorsedandtranslatedtheBrightonCollaborationCasedefinitions.Further,workonMedDRAmapping,withthedevelopmentofnewStandardMedicalQueries(SMQs)andmodificationofexistingSMQsbasedonthenewdefinitionsoftheBrightoncollaboration,hasimprovedtheabilitytoretrieveAEFIsfromthePharmacovigilancedatabases.ThesestandardshavebeenaninvaluableresourceforthesafetymonitoringofpandemicinfluenzaA/H1N1vaccinationcampaignin2009/2010(inparticularfortheanalysisofpotentialcasesofGBS)andpermittedsharingofinformationobtainedfrommultiplevaccine-safetysystems.

Cynthia A. Aguirre MD.

Educational BackgroundUP Diliman: BS Pre-MedicineUP College of MedicineResidency in Pediatrics: The Medical CityFellowship in Infectious Diseases: UP-PGH Research Institute of Tropical Medicine

Current / Significant past positionChair: PIDSP Committee on ImmunizationHead: Patient Care- Department of Pediatrics The Medical CityConsultant in Infectious Diseases: The Medical CityPart-time medical specialist in Infectious diseases: National Children’s HospitalMember: Liver transplant group The Medical CityMember: PPS TWG on Dengue FeverMember: International Society of Tropical Pediatrics( ISTP- Phils) Philippine Foundation for Vaccination (PFV) Immunization Partners for Asia Pacific (IPAP)

Disclosure UMED faculty and facilitator on the following topics: Immunizations, Rational of Antibiotics, Diarrhea and Fever in ChildrenGave lectures for GSK (MMRV and Tdap ), Pfizer ( Prevenar ), Sanofi Aventis (Erceflora)Lectures for Sanofi-Pasteur on MenactraLectures for Abbott on Brufen

Fellow: Philippine Pediatric SocietyFellow: Pediatric Infectious Disease Society of the Philippines

ADOLESCENT IMMUNIZATIONCynthia A. Aguirre MD.

AccordingtotheCDC,vaccinationhasbeenoneofthetop10PublicHealthAchievementsofthe20thcentury.Theexpandeduseofvaccineshavenowcontrolleddiseasesthatoncekilledmillionsofpeopleworldwide.Immunizationrecommendationsforinfantsandyoungchildrenasahealthpreventivetoolisuniversallyacceptedhowever,adolescentimmunizationismoreproblematic.Adolescentsvisithealthcareprovidersforacutecareandoccasionallyforcatch-upimmunizationsmissedduringchildhood.

Therearemanybarrierstoadolescentvaccination.Themostfrequentcausesmentionedare:lackofawarenessaboutrecommendedvaccines,frequentlychangingschedulesandconcernsaboutvaccinesafety.Programsandpoliciesareneededtomakedeliveryofadolescentimmunizationseffectiveandefficient.BarrierstoadolescentimmunizationsshouldbeaddressedandadolescentimmunizationschedulebepartoftheEPI/Routinechildhoodschedule.

Anna Lena Lopez, MD, MPH

Currently a Research Associate Professor at the University of the Philippines Manila-National Institutes of Health and Clinical Associate Professor at the UP College of Medicine, Dr Lopez is a board-certified pediatrician and pediatric infectious diseases specialist. She has previously worked as Senior Scientist at the International Vaccine Institute, Seoul, South Korea where under her coordination, the first low-cost oral cholera vaccine was licensed in India to a local manufacturer. The WHO has now prequalified this vaccine. She also served as the Regional Director of Scientific Affairs of Pfizer Vaccines for the Asia Pacific, covering more than 10 countries. Dr Lopez received her Bachelor’s degree and Doctor of Medicine from the University of the Philippines. She had her residency training in Pediatrics at Albert Einstein College of Medicine, New York, USA and her fellowship in Pediatric Infectious Diseases at Children’s Hospital Los Angeles and University of California Los Angeles Center for Health Sciences, Los Angeles, California, USA. She obtained her Masters of Public Health from the Johns Hopkins Bloomberg School of Public Health in USA and has practiced in the Philippines and in the United States. Dr Lopez has contributed to numerous scientific papers published in international peer-reviewed journals including The Lancet, Bulletin of the World Health Organization, Vaccine, Journal of Clinical Microbiology, and The Pediatric Infectious Disease Journal.

University of the Philippines Manila-National Institutes of Health623 Pedro Gil St. Manila, Philippines 1000Email: [email protected]: +63-927-397-2099

Cholera, Typhoid and Meningococcal Vaccines: Scaling up Anna Lena Lopez, MD, MPH

Thecontrolofvaccine-preventablediseasesisoneofthegreatestpublichealthachievementsinthiscentury.ThroughtheExpandedProgrammeonImmunization(EPI),countrieshaveimplementedintheirpublichealthsystems,vaccinationagainstmajorchildhooddiseasesresultinginsubstantialreductionsinchildhoodmortality.

However,somevaccinesareavailableforsomediseasesandyettheiruseisnotaswidespread.Effectivecholeraandtyphoidvaccineshavelongbeenavailablebutnotextensivelyused,eveninendemicareas.

MostofAsiaisendemicforcholeraandtyphoid,bothwater-bornediseasesthatcanbecontrolledwithcleanwaterandsanitation.Butincertainareas,accesstocleanwaterandsanitationisnotalwaysavailable,thusvaccinationagainstthesediseasesisaviablepreventionstrategy.TheWHOStrategicAdvisoryGroupofExpertsreleasedpositionpapersonthesevaccines’usesinpublichealth.

Meningococcaldiseaseischaracterizedbyitsrapidonset,fulminantandhighcase-fatalityratio.SomeserogroupsofN.meningitidisarevaccine-preventable.Whileincludedinsomepublichealthimmunizationprograms,meningococcalvaccinesarenotroutinelyusedinmostofAsia.ThisisprimarilybecausethetrueburdenofthediseaseisunknowninmostAsiancountries.Indeed,asidefromoutbreakreports,thelimitationsofcurrentsurveillancesystemssuggeststhatmeningococcaldiseaseisunderreportedinAsia.However,certaingroupsremainathighriskforthesediseaseandthereforeshouldbevaccinated.

Beatriz Puzon Quiambao, M.D.

PERSONAL DATA• WorkAddress:ResearchInstituteforTropicalMedicine(RITM)FilinvestCorporateCity, Alabang, Muntinlupa City Metro Manila, Philippines 1781• Worktelefax:63-2-8072638• Mobilephone:+63-9189387087• Marriedwith3children

EDUCATIONAL BACKGROUND• BachelorofScienceinPsychology,UniversityofthePhilippines,1975-79• DoctorofMedicine,UniversityoftheEastRamonMagsaysayMemorialMedicalCenter (UERMMMC), 1979-1983 • Post-graduateInternship,CapitolMedicalCenter,1983-84• PediatricResidency,UERMMMC,1985-87• FellowshipinInfectiousDiseases,UniversityofthePhilippines-PhilippineGeneralHospital and Research Institute for Tropical Medicine (RITM), 1988-89

PRESENT POSITIONS• RITM• Chief–ClinicalResearchDivision,2001topresent• Chairman-DepartmentofPediatrics,2000topresent• Studygroupleader,RabiesResearchGroup,2004topresent• Member-ExecutiveCommittee,InstitutionalReviewBoard,ResearchGrouponAcute Respiratory Infections, Medical Research group, Novel Influenza A(H1N1) response team (in charge of clinical operations), Selection and Promotions Board, Therapeutics Committee, Infection Control Committee

• HospitalCoordinator-CenterforWellnessProgram,RITM;HospitalPoisoningProgram, RITM

Membership in Committees • DOH-TechnicalWorkinggrouponrabies;TechnicalworkinggrouponClinicalmanagement of Influenza A (H1N1) Infections; • PediatricInfectiousDiseaseSocietyofthePhilippines(PIDSP)-CommitteeonImmunization, Specialty Board• PPS-Guidelinedevelopmentgroup,PediatricCommunityAcquiredPneumonia(PCAP)

Chairman• InfectionControlCommittee,DrMirandoUncianoMedicalCenter,2001topresent• InfectiousDiseaseConsultant-RITM,DelosSantosSTIMedicalCenter,MandaluyongCityMedical Center, Dr. Mirando C. Unciano Sr. Medical Center • PeerReviewerforVaccine,JournalofTravelMedicine,JournalofClinicalVirology,PIDSPjournal, Journal on the Advances in Preventive Medicine• LectureronRabies,Tetanus,EmergingInfections(SARS,H1N1),Pneumonia,Vaccines,Snakebites, TB, Dengue and other infectious diseases; antibiotics

AWARDS• OutstandingAlumniAwardinLeadership,givenbytheUniversityoftheEastRamonMagsaysay Memorial Medical Center Alumni Association, Manila Hotel, Feb 7, 2013

MEMBERSHIP IN LOCAL PROFESSIONAL SOCIETIES• President,PediatricInfectiousDiseaseSocietyofthePhilippines(PIDSP),2012-present• VicePresident,2010to2012;Secretary,2008to2010;BoardofDirectors,1994to2007• LifeFellowandIncorporator• Fellow,PhilippinePediatricSociety(PPS)• LifeMember-PhilippineMedicalAssociation,PhilippineSocietyforMicrobiologyandInfectious Diseases (PSMID),• Member-SanJuanMedicalSociety,PhilippineHospital Infection Control Society (PHICS), Philippine Foundation for Vaccination, Alliance for the Prudent Use of Antibiotics, Philippine chapter

MEMBERSHIP IN INTERNATIONAL GROUPS/SOCIETIES• WHOExpertPanelonRabies,2012topresent• AsianRabiesExpertBureau2005topresent• RabiesInAsiaFoundation,BoardofDirectorsandCountryrepresentative(Philippines),2007 to present• RabiesExpertForum,2011topresent• ExpertAdvisoryCommittee,RabiesVaccine/ImmuneGlobulinEmergencyStockpile (RaVaGES) Project , 2012 to present• InternationalSocietyofTropicalPediatrics,BoardofDirectors,2008topresent• AsianSocietyofPediatricInfectiousDiseases(ASPID),Member

RESEARCH INTERESTSRabies, Maternal immunization, Neonatal Infections, Vaccines, Acute respiratory infections,Tetanus, Snake bite

PUBLICATIONS• 2bookchapters,36publications

RABIES VACCINES: ROAD TO RABIES ELIMINATIONBeatriz Puzon Quiambao, M.D.

Rabiesisanacute,progressive,viralencephalitisthatis100%fatal.ItcontinuestoremainendemicinmanydevelopingcountriesofAsiaandAfrica.Fortunately,safeandeffectivevaccinesandimmuneglobulinsareavailableforitsprevention,makingitthebestexampleofadiseasethatisbetterpreventedthancured.

Rabiesisazoonoticinfectionand,assuch,itspreventionandcontrolliesinthecontrolofrabiesintheanimalpopulation.Inherenttothesecontrolmeasuresisvaccination,bothoftheanimalanditshumanvictim.

RabiesvaccinesforhumanrabiespreventionhavebeenaroundsinceLouisPasteurandEmileRouxfirsttreatedJosephMeisterin1885withacruderabbitbrainextract.Overtheyears,therabiesvaccinehasundergonemanyimprovements,fromanimal-brainderivedproductstothesafeandhighlyefficacioustissueculturederivedvaccines.

Rabieshasbeeneliminatedinmanyindustrializedcountriesbyimplementationofanationalprogramwhichincludesdogvaccination,dogpopulationcontrol,educationandmanagementofhumanrabiesexposure.TheASEANpluscountries,includingthePhilippines,aregearinguptowardsRabiesEliminationbytheYear2020.Coordinatedeffortsareneededtomakethishappen.

Professor Usa Thisyakorn, M.D.

Usa Thisyakorn is presently a Professor of Pediatrics at Chulalongkorn University, an advisor of both Faculty of Tropical Medicine, Mahidol University and Department of Health, Bangkok Metropolitan Administration. She is now concentrating on research projects on dengue. In 1989 she received Rockefeller grant for dengue research at the Centers for Diseases Control and Prevention in Atlanta. In 2000, under Professor Thisyakorn’s guidance as Chair of the medical committee on the Save a child’s life from AIDS project, the project was selected as one of the UNAIDS best practices. She has served as the editorial board of several medical journals and has contributed over 100 indexed publications to date. For her contributions, she has received several awards including ‘Woman of the Year’ from the Foundation for Thai Society, Scientific Awards from the Elizabeth Glaser Pediatric AIDS Foundation, AmFAR, U.S.A. and the Outstanding Asian Pediatrician Award from Asia Pacific Pediatric Association. Her other positions include President of the International Society of Tropical Pediatrics, President of Pediatric Infectious Diseases Society of Thailand, Secretary General of the Asian Society for Pediatric Infectious Diseases as well as Chairman of the ASEAN Member States Dengue Vaccine Advocacy Steering Committee.

COMBINATION VACCINES: IS INTERFERENCE A PROBLEM?Professor Usa Thisyakorn, M.D.

Thecontinualincreaseinthenumberofeffectivechildhoodvaccinesposedsubstantialeconomicandlogisticdifficulties.Providingthesevaccinesasseparateinjectionsrequiresmultipleneedlesticks,leadingtodistressedparents,providers,andvaccinees.Schedulingadditionalvaccinationvisitstoreducethenumberofinjectionspervisitincreasescosts,burdensstaffandjeopardizestheentireimmunizationprogrambyincreasingthelikelihoodofmissedvaccinations.Theshipping,handling,storage,andaccountabilityofaplethoraofvaccinesareburdensome,expensiveandincreasethepossibilityoferror.Theseissueshavestimulatedcontinuingeffortstoprovidenewcombinationvaccines.

Infantsandchildrencanrespondto>10,000kindofantigensatthesametimeandthecurrentvaccinesaremorepurifiedandabletostimulateimmuneresponsestomanykindsofvaccineatthesametime.Thecombinationvaccinesalsohavematuredtothepointatwhichaverylargenumberofcombinationvaccinesisavailableandothersremainindevelopment.However,thedevelopmentandevaluationofcombinationvaccinescanposenumerousissuesandtherearemultipletechnicalchallengesinmaintainingimmunogenicityandsafety.Someproblemsofconcernforcombinationvaccinesare:compatibility,effectivenessforthediseaseprotection,safety,interchangeability,theuseofcombinationvaccinesmorethanthetotaldosesrecommended,andcostofcombinationvaccines.

Continuingvaccinedevelopmentwillonlyincreasetheneedfortheuseofcombinationvaccines,andthefuturedevelopmentoflargercombinationsappearsinevitable.

Prof. Zulkifli Ismail, MD

Dr Zulkifli Ismail is a consultant paediatrician and paediatric cardiologist at KPJ Selangor Specialist Hospital and visiting paediatric cardiologist at the KPJ w Specialist Hospital. He was formerly Professor of Paediatrics and Paediatric Cardiology in Universiti Kebangsaan Malaysia (UKM). He has also served as the Head of the Paediatric Department and Director of Hospital Universiti Kebangsaan Malaysia (HUKM) as well as Medical Director of its private wing, UKM Specialist Centre, before opting for early retirement from the academic world. Dr Zulkifli has served as a Past President of the Malaysian Paediatric Association (MPA) and is currently the Editor of Berita MPA, a quarterly newsletter publication distributed to fellow members of the Association. He is also the Chairman of the Positive Parenting Management Committee and serves as the Chief Editor of the Positive Parenting Guide, a quarterly publication aimed to equip Malaysian parents with reliable and practical local information on maternal, child and family care since 2002. Dr Zulkifli is currently the President-Elect of the Asia Pacific Pediatric Association (APPA) and current Chairman of the Asian Strategic Alliance for Pneumococcal disease prevention (ASAP). He is also President of the Thalassaemia Association of Malaysia (TAM) from 2003. He serves as a board member of the National Population and Family Development Board (LPPKN), is a member of the Ministry of Health Unrelated Transplant Approval Committee (UTAC) and in the editorial board of the Malaysian Journal of Paediatrics & Child Health (MJPCH). He has also served as a reviewer for the Malaysian Journal of Medicine and the Philippines Pediatric Infectious Disease Journal. He has more than 35 publications in peer-reviewed international and local journals in addition to numerous abstracts and articles for the lay-public on various issues involving child health, paediatrics and vaccinology. He has authored or co-authored two books for parents, one for medical students and one for nurses. In 2008 he was conferred the Darjah Panglima Mahkota Wilayah by the Malaysian King that carries the honorific title of ‘Datuk’.

Dr. Musa Mohd Nordin DPMP

A 1982 graduate of Cardiff University (UK) , he obtained his Membership from the Royal College of Physician (UK) in 1985. He is a Fellow of the Royal College of Physicians Edinburgh, Royal College of Paediatrics & Child Health UK and the Academy of Medicine Malaysia. He is a Consultant Paediatrician & Neonatologist and an Adjunct Professor of Paediatrics at the Cyberjaya University College of Medical Sciences. Since 1999, he has served on various international advisory boards related to vaccines & immunisation. He is a founding member of the Asian Strategic Alliance on the Prevention of Pneumococcal Disease (ASAP). Currently, he serves on the Asia Pacific Expert Committee on Immunisation, Asia Pacific COMPAS Advisory Board, Asia Pacific PCV Expert Academy and Asia Pneumococcal Advisory Board.

MBBCh (Wales), MRCP (Paeds) (UK), FRCP (Edin.), FRCPCH, FAMM

Professor Lulu C. Bravo, MD

• APediatricianwhofinishedherM.D.(1972)Pediatricresidency(1976)andInfectiousDiseaseasa Subspecialty (1978), at the University of the Philippines, College of Medicine and Philippine General Hospital. She had further Pediatric Infectious Disease fellowship with Drs. George Mc Cracken and John Nelson at the University of Texas Southwestern Health Science Center at Dallas (1986). Due to the enormous burden of preventable infectious diseases in developing country compared to the developed world, child advocacy and disease prevention had been in the forefront of her career.• Asaresearcher,shestarteddoingstudiesonwell-babyvisitsandvaccinecomplianceduringherPediatricResidency proceeding to streptococcal infection, rheumatic fever and RHD during her Infectious Disease fellowship. Then she went on to doing studies on diarrhea, pneumonia ARI and in recent years to vaccine trials. To date, her published research papers totals over 75, 15 of which were given recognition awards by various medical societies.• AsateachershestartedasaresidentandassistantinstructorattheUPCollegeofMedicinein1976becoming a full professor in 1996. She has designed and published instructional modules, manuals and handbooks totaling over 20, together with colleagues from Pediatrics. Aside from this she has written Chapters in the Textbook of Pediatrics as well as helped produce teaching scientific videos on various infectious disease topics. She is a holder of various Professorial Chairs and prestigious faculty grants and centennial awards, a Senate Committee Health Award for Community-Oriented Medical Education and the Dr Jose P Rizal Memorial Award for Academics in 2011. • AsaCommunityWorker,OrganizerandMobilizershehastrainedhealthcareworkersandconductedhundreds of scientific conferences both local and international and participated in as chair or speaker in as many medical meetings. Among her involvements are with the International Congresses in Pediatrics and Infectious Diseases , Asian Society for Pediatric Infectious Diseases, International Society of Tropical Pediatrics in which she serves or has served as President and/or Executive Director. Better health and disease prevention are the main goals of all medical and vaccine missions that are undertaken by the Philippine Foundation of Vaccination of which she is the founding President. • AsChildAdvocateherworkwithWHOasTechnicalAdviserinthe90’sandmorerecentlyasmemberof the WHO Technical Steering Committee of the Child and Adolescent Department include the training of students, graduates and other stakeholders in the implementation of the appropriate management of diarrhea and pneumonia. This also entails disseminating the interventions and the strategy for Improving Child survival in the Philippines as part of the national health program to achieve MDG 4 of reducing infant and child mortality by 2/3 by the year 2015.

Convenor, Vaccine Study GroupNational Institutes of Health, University of the Philippines ManilaAddress: Room 112 ICHHD National Institutes of Health University of the Philippines Manila 632 Pedro Gil St, Ermita Manila, PhilippinesTelephone: 632-2545205 Mobile no.: +63918921599Email: [email protected]

CHAMPIONING VACCINATION: SHARING THE VISIONProfessor Lulu C. Bravo, MD

Networkingandpartnershipamongstakeholdersmakeforasuccessfulvaccineadvocacy.Howeveritisnotenoughthatasystemofnetworkingisinplace.Thebasicrequirementistheunderstandingofwhateachofthepartnersorstakeholdersorsectorshastoofferintermsofcommitment,responsibility,education,reforms,motivation,sacrifices,servicesandover-allpolicysystemchangetobenefitthepeople.Astheinformationandcalltoactiongetdisseminatedusingappropriatewaysandmeans,thelikelihoodofreachingthegoalorvisionsetoutbytheadvocatesbecomestronger.Thechallengescouldbeenormousbuteachchallengecanbeovercomewiththecooperationandcollaborationamongthevariouspartners.ThisiswheretheissueofSHAREDVISIONismostcrucialbecausenomatterhowandwhereeachpartnerundertakehis/heradvocacy,thereshouldbeaclearpictureanddescriptionofwhatwillbecreatedinsomefuturetime.

Tobeginwith,thissharedvisionusuallystemsfromapersonalvisionwhichinturncomesfromadeepcaringandwithpeoplecomingtogetherandrealizingthiscommonbond,avisionissharedwhicheveryonewillbewillingtocreate.Suchisthenaturalphenomenonthathappenswhensomeonehasthepassionandexcitement,therationaleandresourcefulness,andthecoordinationandcollaborationthatcomprisethebasictoolsforaproductiveoutcomeinadvocacy.TheestablishmentoforganizationsliketheGlobalAllianceforVaccineInitiativeorGAVI,ConfederationofMeningitisOrganizationorCoMO,thePhilippineFoundationforVaccination(PFV),theAsianStrategicAllianceforPneumococcalPrevention(ASAP),theImmunizationPartnersinAsiaPacificandmanyothersattesttothischainofevents.Whetherbigorsmall,itisnoteworthytosaythattheyshareacommonadvocacywhichcallsforbetterhealthforallwiththereductionofmorbidityandmortalityfromvariousconditionsparticularlyvaccine-preventablediseases.Thereareafterallmorethan2.4millionchildrenbelow5yearsstilldyingeveryyearfromvaccine–preventablediseases.Withvaccineadvocacyinplace,itisenvisionedthateverycountrywillbeabletoprioritizeimmunizationtowardstheachievementofMDG4intheverynearfuture.

Dr. Sajid Maqbool

Dr Sajid Maqbool graduated from the K.E. medical College and trained in the USA in the field of Pediatrics. He worked as a faculty member at the K.E. medical college/ Mayo Hospital and then established the department of Pediatrics as Head of the department at the Shaikh Zayed Hospital, Lahore. He then took over as Dean of Institute of Child Health/Children’s Hospital in Lahore where he worked till 2005. His current designation is Professor Emeritus of Pediatrics. Professor Sajid Maqbool’s primary focus has been in teaching and training, a commitment he maintains even now. He is considered the pioneer of Neonatology in Lahore and retains a special interest in Infectious Diseases. He is an ardent supporter of the importance of prevention through immunization. He has taught extensively, participating in deliberations and lectures in Pediatrics both in Pakistan as well as abroad. He has conducted research in various fields of Pediatrics and has published numerous papers in the international and Pakistani medical journals, with a special focus on respiratory infections. He is the editor of the PPA Textbook of Pediatrics and has authored a Handbook of Neonatology, Manual of newborn care, Nursing Guidelines for nurses, booklets on Immunization and Ventilatory support. Dr. Maqbool is the past president of the Pakistan Pediatric Association and an active member of ASAP (Asian Strategic Alliance for Prevention of Pneumococcal Diseases). He is a dedicated worker and a leader in the cause of children’s health in general and neonatal care as well as respiratory infections in particular.

Professor of PediatricsMBBS, DABP (USA), FRCP (CANADA)FAAP (USA), FRCP (EDIN), FCPS (PAK)MPH (USA), FRCP (BANGLADESH)

PNEUMOCOCCAL VACCINES: TRANSCENDING AGE BARRIERSDr. Sajid Maqbool

Itisestimatedthat0.7-1millionoftheglobal1.6milliondeathsduetopneumococcalinfectionsperyearoccurinchildren.Amongelderlypatients,pneumococcusaccountsforatleast30%ofallcommunityacquiredpneumonia(CAP)cases.Despitetheuseofappropriateantibioticsandintensivecare,thecasefatalityrateofpneumococcalbacteremiahasremainedat15%to20%inchildrenandyoungadultsand30to40%intheelderly.

Inthequestforaneffectivepreventivepublichealthmeasure,the23-valentPolysaccharidevaccine(PPV23)wasthyefirstvaccinetobeapproved.Itwas,howeverthepoorimmunogenicityofPPV23intheelderlyandtheveryyoung,whichledtothedevelopmentofthePneumococcalconjugatevaccines(PCV).Thesevaccinesaresafeandeffective,inducingimmunologicalmemoryininfantsandyoungchildren<2yearsofage.Asaconsequence,theACIPcurrentlyrecommendsvaccinationwithPCV13forallchildren2-59monthsofage.AsingledoseofPCV13maybeadministeredforincreasedriskchildren6-18yearswhohavenotreceivedPCV13previously.AllchildrentwoyearsofageandolderathighriskforpneumococcaldiseaseshouldalsoreceivePPV23aftercompletingallrecommendeddosesofPCV13.ThisImmunizationstrategy,whereintroducedhasreducedtheincidenceofIPDsignificantly.

TomakeadentinIPDintheothervulnerablegroupi.e.,theelderly,itisrecommendedthatallindividuals≥65yearsofagereceivePPV23.OnDecember30,2011,theFDAalsoapprovedthePCV13foradults50years,thusfurtherstrengtheningmeasurestofurtherreduceIPDmortalityinallagegroups.

Bruce Langoulant

Bruce Langoulant has been President of the Confederation of Meningitis Organisations (CoMO) and the organisation’s Asia Pacific Regional Leader since 2008. Based in Perth Western Australia, CoMO is an international member organisation committed to preventing meningitis worldwide, because ‘we can and we should’. CoMO has experienced significant membership growth, and today represents 39 member organisations from 26 countries around the world, with more due to join soon. The organisation is dedicated to increasing global awareness of meningitis as well as influencing the policy decisions that relate to access to meningitis prevention and speedy treatment. As a member organisation, CoMO is also committed to supporting its members to be influential sources for information and support in their countries, as well as growing the membership network by helping to establish member organisations and welcoming existing organisations to CoMO. Bruce is also Chairman of the Meningitis Centre Australia, a position he has held since it was established in 1992. The Centre is a not-for-profit organisation established by a group of parents and health care professionals who recognised the need to raise public awareness of meningitis. For more than 20 years the Centre has worked to raise awareness of all types of meningitis, has promoted the need for and successfully lobbied the introduction of government funded vaccinations, provided family support services and supported meningitis research. The Meningitis Centre Australia was a founding member of CoMO in 2004. Bruce is also Chairman of the Disability Services Commission in Western Australia. His passion for meningitis awareness and prevention, and disability is drawn from personal experience when his daughter Ashleigh contracted pneumococcal meningitis in 1989 at just six months of age. She suffered significant intellectual and physical disabilities. Bruce is a seasoned parent and advocate. In his own words he is someone who has “been on the block for a while” and has something to contribute. Bruce’s sound business acumen and communications skills stem from his previous years working in marketing and owning his own financial planning business. These are all attributes he has brought with him during his tenure at CoMO and the Meningitis Centre Australia. Bruce is married to Jenni and has three daughters Jessica, Ashleigh and Courtney.

President and Asia Pacific Regional Leader Confederation of Meningitis Organisations

Enrique Amar Tayag MD,PHSAE,FPSMID,CESO III

For more than 20 years now, since graduating from UERMMCI, Dr. Enrique A. Tayag has focused on his career on public health, particularly in Epidemiology. His efforts 0n helping improve general knowledge and measures regarding disease control and prevention is immeasurable. Having earned his Medical degree from UERMMMCI in 1984, the Manila- born physician went to San Lazaro Hospital in Manila in 1988-1990 for Residency Training in Infectious Disease. He completed his training in Epidemiology in 1990-1992 through the Field Epidemiology Training Program (FETP) of the Department of Health and the US Centers for Disease Control and Prevention (CDC). During this time, he completed his study on the epidemiology of dengue fever, which was presented in various international conferences and was part of the team that established Firework-related injury Surveillance. He was also the co-investigator of Mt. Pinatubo Disease Surveillance, which won the prestigious John Snow Award from CDC in 1992. He stayed with San Lazaro Hospital until 1998 as its Chief Epidemiologist; his work then included setting of policies and standards for disease surveillance and hospital infection control, morbidity and mortality audit, and finalizing of what would become the nationally implemented guidelines for clinical management of dengue fever. He also remained to this day a member of the Acute Flaccid Paralysis (AFP) Expert Panel, an international requirement to keep the country’s Polio-free status intact. In 1994, Dr. Tayag, completed a short course on Management for International Public Health at Emory University in Atlanta, and has since become a resource speaker, facilitator and supervisor for the Field Management Training Program (FMTP) that was formally established in 2000. The FMTP has strengthened the capacity of LGUs foe evidence-based Public Health Decision Making and continuous Quality Improvement. He moved to Department of Health in 1998 and became the Officer-in-Charge of the Schistosomiasis Control Service and spearheaded the mass treatment with Praziquantel in larger areas of the country, particularly in CARAGA region. He became the first Director of the National Center for Infectious and Degenerative Diseases following the re-engineering of the DOH in 2000. During this time he was primarily responsible for establishing the program on emerging infectious diseases, antedating the explosion of SARS and bird flu. He became the Assistant Regional Director of the DOH Center for Health Development-Central Luzon in San Fernando, Pampanga. Dr. Tayag helped establish the Collaborating Center for Disease Prevention and Control of North Luzon, now becoming a strategic reference center for quality

An Outstanding Public Health Epidemiologist

assurance in malaria microscopy. During his term, he led Central Luzon to achieve the highest vaccine coverage in the Measles Elimination Campaign in 2003. In 2005, he became the Officer-In-Charge and later Director IV of the National Epidemiology Center (NEC), a post he holds to this day. The NEC is responsible for assessing the health status of Filipinos through disease surveillance and protecting the country from internal threats of epidemic via early warning and rapid response. From September 2010 to May 2011, he was the officer-in-charge of San Lazaro Hospital, concurrent to his position as Director of the NEC. He was the President of the Philippine Society for Microbiology and Infectious Diseases (1998) and also the President of the Philippine Foundation for Vaccination Inc. from 2006-2011. He is currently a member of the Executive Board of the Confederation of Meningitis Orgamizations, a global network of advocates for the prevention and care of sufferers of meningitis. His interviews in all media on public health issues have prepared him well in becoming the Official Spokesperson of the DOH. All these have certainly helped nurtured the steadfast epidemiologist that Dr. Tayag has become. Just 14 years after graduating from UERM, he also earned a national honor: the Secretary of Health Award for Outstanding Epidemiologist given to him in 1998. He also earned more honors as Most Outstanding Alumnus (PUBLIC SERVICE) 50th Year Anniversary UERMMMC, 2007 andMost Outstanding Alumnus (COMMUNITY LEADERSHIP), UERMMMC 2009 Alumni Homecoming. In 2012, he received the Award as Most Outstanding Alumnus in Medicine during the Centennial Celebration of St. Agnes Academy in Legaspi, where he finished his primary education. To Dr. Tayag, now 54, the nation owes a debt of gratitude for staying on guard against disease and outbreak-ever vigilant as he is ensuring that an epidemic will never trouble the country’s populace during his watch.

Jess Langoulant

Jessica Langoulant is the Communications Officer for the Confederation of Meningitis Organisations (CoMO). Based in Perth Western Australia, CoMO is an international member organisation committed to preventing meningitis worldwide, because ‘we can and we should’. CoMO has experienced significant membership growth, and today represents 39 members from 26 countries around the world, with more due to join soon. The organisation is dedicated to increasing global awareness of meningitis as well as influencing the policy decisions that relate to access to meningitis prevention and speedy treatment. As a member organisation, CoMO is also committed to supporting its members to be influential sources for information and support in their countries, as well as growing the membership network by helping to establish member organisations and welcoming existing organisations to CoMO. Since 2005, Jess has also volunteered for the Meningitis Centre Australia, a not-for-profit organisation established in 1992 by a group of parents and healthcare professionals who recognised the need to raise public awareness of meningitis. In 2009 Jess joined the Centre’s Management Committee, a position she proudly held for three years. For more than 20 years the Centre has worked to raise awareness of meningitis, provide support to those affected by the disease, support meningitis research and promote the vaccines available to prevent the bacterial forms of the disease. The Meningitis Centre Australia was a founding member of CoMO in 2004. Jess’ passion for meningitis awareness and prevention comes through personal experience. Her sister Ashleigh contracted pneumococcal meningitis at just six months of age and suffered significant intellectual and physical disabilities. Jess, together with her family, have and will continue to provide Ashleigh with the full time care she needs for the rest of her life. Jess also has a Commerce degree, with majors in both Public Relations and Marketing. She has combined these skills with her passion for meningitis awareness and prevention with the hope that she can help ensure fewer families worldwide never suffer the devastation meningitis can cause.

Li Jin Chan

Li Jin CHAN, a mother of four, is a health writer/editor who has been actively involved in health-related advocacy work in Malaysia for more than a decade. In 2011, she founded a non-profit organization, MyHealth Outreach, which runs three core programmes - Parenting2u (building family-focused communities), SUBUR Community Gardens (community development through edible gardens) and Bulatan Biru (support group for diabetes patients). MyHealth Outreach aims to engage community stakeholders to drive changes in health attitudes and decisions. Her latest project is the YES to PnD Protection, a 6-month nationwide campaign involving two medical associations, 18 public hospitals, 16 private hospitals and 11 private paediatric clinics. The campaign works as a petition to urge the Malaysian government to include the pneumococcal vaccine into the National Immunisation Programme.

Dr. Charung Muangchana

Charung Muangchana is a graduate of Bloomberg School of Public Health, Johns Hopkins University (JHU), Baltimore, USA (2007)—International Health (Disease Prevention and Control; Vaccine Science and Policy as well as Economic Evaluation on Health) and of Siriraj Hospital, Mahidol University, Thailand (1990) for his PhD and MD, respectively. He is also a field epidemiologist by training from the Ministry of Public Health (Field Epidemiology Training Program: FETP). He got many publications on international and domestic peer review journals on variety of health issues, including vaccine and immunization. He has been a director of the National Vaccine Institute (NVI) Thailand, since 2007. The NVI is a new institute at national level to coordinate vaccine research and development as well as immunization of the country. Before joining the NVI he worked as a medical practitioner and directors of community hospitals in Southern Thailand.

Director National Vaccine Institute (NVI)Tiwanond Rd.Nonthaburi 11000ThailandTel: (66) 2590 3196-9Fax: (66) 2591 8425Email: [email protected]

IMMUNIZATION AND MDGSCharung Muangchana MD, Ph.D., National Vaccine Institute (NVI), Thailand

SubstantialprogresshasbeenmadetowardsachievingMDG4.Thenumberofunder-fivedeathsworldwidehasdeclinedfromnearly12millionin1990to6.9millionin2011.Theproportionofunder-fivedeathsthatoccurwithinthefirstmonthoflife(theneonatalperiod)hasincreased17percentsince1990,from36percenttoabout43percent,becausedeclinesintheneonatalmortalityrateareslowerthanthoseinthemortalityrateforolderchildren.Theleadingcausesofdeathamongchildrenunderagefivearepneumonia(18%ofallunder-fivedeaths);pretermbirthcomplications(14%);diarrhoea(11%);intrapartumrelatedcomplications(complicationsduringbirth;9%);andmalaria(7%).

WorldHealthOrganization(WHO)estimatesthatvaccinesagainsttuberculosis,diphtheria,tetanus,pertussis,polio,measles,hepatitisB,andHibdiseasearepreventing2.5milliondeathseachyear.However,80%oftheworldchildrenhaveaccesstovaccines,whichmeansoneinfiveiscurrentlybeyondthereachofvaccinationefforts.Therefore,everyyear24millionchildrendonothaveaccesstothevaccinestheyneedandasaresult,2.4millionchildrenundertheageoffivestilldieannuallyfrompreventablediseases.

Withverylarge,complex,heterogeneoussocieties,weseetremendousvariationintermsofcoverageofvaccinations,fromover80%tolessthan10%insomedifferentpartsofthosesamecountries.Disparitiesininterventioncoveragearemostacuteincountrieswiththelowestinterventioncoverageoverall.WHOhasestimatedthatifallthevaccinesnowavailableagainstchildhooddiseaseswerewidelyadopted,andifcountriescouldraisevaccinecoveragetoaglobalaverageof90percent,by2015,anadditionaltwomilliondeathsayearcouldbepreventedamongchildrenunderfiveyearsold.

Successfulimmunizationeffortsaretheresultofappropriate,effectivepartnershipsandthatallsectorsmustcometogethertomanagethetensionthatexistsbetweenprovidingandmaintainingasustainablemodel.Thechallengewillbeensuringthatthesupplyandlogisticssystemsneededtogetthesevaccinestothosewhoneedthemmostarestrengthenedandreadyforthetask.Immunization,togetherwithfamilyplanning,antenatalcare,andnutritioncounselingasapackage,isprovingtobemuchmoreefficientintermsofhowyoudeliverservices.Itisalsoimportantwestriveforbetterimmunizationcoverage,butwemustalsotrackthediseaseandtheimpactofthesevaccines.

Leilani Lee Tajanlangit-Sanchez,M.D.

Professional Experience:Regional Physician Jun 2011 – PresentClinical Research and DevelopmentNovartis Vaccines and Diagnostics Sub-Investigator May 2008 – April 2009A single-blind, randomized, monocentric Phase II trial to explore the safety and rabies-neutralizing activity of combined administration of CL 184 and rabies vaccine versus human rabies immune globulin plus rabies vaccine in simulated rabies post-exposure prophylaxis in children and adolescents.

Sub-Investigator April 2007- April 2009A phase IIb, open, randomized, controlled primary vaccination study to evaluate the non-inferiority and the persistence of the immune response of GSK Biologicals’ meningococcal serogroup ACWY conjugate vaccine given intramuscularly versus Mencevax ACWY given subcutaneously to healthy subjects aged 11 to 55 years of age

Graduate Training (medium of instruction: English)Masters in Vaccinology and Pharmaceutical Clinical DevelopmentUniversity of Siena, Siena, ItalyMay 2009 – April 2011Graduated with honors (Final grade 110/110)

Fellowship, Infectious and Tropical Diseases in Pediatrics, Department of Pediatrics, University of the Philippines-Philippine General HospitalJanuary 1, 2006-December 31, 2007Chief Fellow , January 1 – June 30, 2007

Other TrainingsCRO Management TrainingGiven by Dr. Laura Brown of Marcus Evans Training14-15 January 2013, Bangkok, Thailand

CRA Field Assessor’s TrainingGiven by Maureen Stannard and Dr. Thomas Lanzewizki22-23 October 2012, Manila, Philippines

GCP TrainingGiven by Maureen Stannard02-03 July 2012, Bangkok, Thailand

Alberta Di Pasquale, MD, PhD

Alberta Di Pasquale, is an MD with a post-doctoral degree in Internal Medicine from the University of Chieti (Italy) and a PhD in Vaccinology from the University of Genoa (Italy). In her current role (as from 2008), in the Global Medical Affairs Department at GlaxoSmithKline Vaccines, Belgium she is responsible for medical affairs activities on new Adjuvant Systems and alternative Delivery Technologies, she is in charge of setting-up and implementing the medical and scientific communication strategy and activities around understanding modern vaccine design and Adjuvant Systems to healthcare professionals, with publications, scientific meetings and experts forums. She joined what is today GlaxoSmithKline (GSK) Vaccines in 1997 as Medical Advisor for vaccines in Italy. In 2000 she moved to GSK Vaccines in Belgium as Associate Director Product Support and Medical Information in the Worldwide Medical Department, where she provided medical and scientific support to the registration and post-licensure strategies of GSK vaccines especially for pediatric combinations such as DTPa-IPV-HBV/Hib, MMR, Varicella, HAV-HBV, etc. From 2002 she was also in charge of the Central Medical Information Service for GSK Biologicals. From 2004 to 2006 she was assigned to GSK Italy as Vaccine Medical Leader to support the Italian vaccine team for the launch of Rotavirus and HPV vaccines. In 2006 she moved again to GSK Vaccines headquarters in Belgium as Director Medical Affairs Early Projects, where she focused on medical affairs and scientific communication on MMRV, and candidate vaccines containing Adjuvant Systems such as malaria, TB, HPV, etc. Before joining GSK she had spent 8 years in the Epidemiology and Clinical Pharmacology Department at Mario Negri South Institute, Italy, a no-profit Biomedical Research Centre, where she was involved in the design, coordination and analysis of epidemiological studies and clinical trials in cardiovascular diseases and hematological disorders.

Director, Global Medical Affairs, Global Adjuvants and Technologies Innovation Center, GlaxoSmithKline Vaccines, Wavre, BelgiumE-mail: [email protected]

ROLE OF NEW ADJUVANTS IN VACCINE ADVANCEMENTAlberta Di Pasquale, MD, PhD

Vaccinationremainsoneofthemostsuccessfulpreventivehealthmeasures;today29diseasesarepreventablebyvaccination.

Successfulvaccineshavebeenestablishedbasedontraditionaldesigns,whileremainingchallengesindiseasespreventionrequirenewandmorecomplexvaccinedesignandtechnologies.

Inthelasttwodecades,progressesinmolecularbiology,immunologyandmicrobiologyhaveallowedabetterunderstandingofhost/pathogeninteractions,ofhowpathogensareabletotriggeranimmuneresponseandarefurtherelucidatingtheimmunologicalmechanismsofprotection.Thisknowledgehaspavedthewaytothediscoveryofnewtargetantigens,newwaysofdeliveringtheantigensandtheroleofadjuvantsassubstancesabletoenhancetheimmuneresponsetotheantigen.

Newadjuvantandadjuvantcombinationshavebeenintroducedinrecentlylicensedvaccinesandothersareinlatestageclinicaldevelopmentandtheyrepresenttodayoneofthemostadvancedapproachinmodernvaccinology.

Severalsubstanceshavebeencharacterizedandusedasadjuvantinhumanvaccines,researchhasdemonstratedthatforadjuvants“onesizedoesnotfitall”;itiskeytofindtheappropriatematchbetweentheselectedantigensandoneoracombinationofadjuvantsthatarecompatible,stableandabletoinducethedesiredimmuneresponsewithanacceptablesafetyprofile.

Theexperienceandfastgrowingresearchonnewadjuvantedvaccinescanhelpaddresssomeoftheremainingvaccinechallengessuchasmalaria,HIV,tuberculosisandtoimprovetheimmuneresponsetovaccinesinhighriskpopulations,suchastheelderlyorimmunocompromised.

Somsak Lolekha

Degrees and Qualifications:• M.D.(Hon),FacultyofMedicineSirirajHospital,MahidolUniversity,Bangkok,Thailand1964.• CertificateinBiochemistry,TulaneUniversitySchoolofMedicine,NewOrleans,La,USA1967• DoctorofPhilosophy(Ph.D.)inmicrobiologyandimmunology,UniversityofIllinoisatthe Medical Center, Chicago, Illinois, U.S.A. 1971.• DiplomateoftheAmericanBoardofPediatrics,1973.• DiplomateoftheThaiBoardofPediatrics,1975.• Fellow,InfectiousDiseasesSocietyofAmerica,1983.• DiplomateoftheThaiBoardofFamilyMedicine2001• DiplomateoftheThaiSubspecialtyBoardonPediatricInfectiousDiseases2004

Professional and Administrative Activities:Present Position• President,theMedicalCouncilofThailand(2000–2011)(2013-2015)• President,theRoyalCollegeofPediatriciansofThailand(2001-2005)(2007-present)• President,PediatricSocietyofThailand(1994-1998)(2008-present)• EmeritusProfessorofPediatrics,FacultyofMedicine,RamathibodiHospital,MahidolUniversity (2002-present)• NationalAdvisoryCommitteeonImmunizationPractice(1978-present)• HonoraryAdvisorofCommitteeonHealth,SenateofThailand(2002-2006)(2008-present)• MemberoftheStandardandQualityControlBoardofNationalHealthSecurityOffice (2012-present)• Chairman,BoardofDirectorLadpraoGeneral Hospital (1991-present), and Ladprao Bilingual School (2000-present)

Address: 35/322 Phayathai Road Ratchathewi, Bangkok 10400Telephone Home: 662 640 0003, Fax: 662 640 1529Mobile Phone +6689 810 3833E-mail: [email protected], [email protected]

• Chairman,Expertcommitteeonpediatricinfectiousdiseases,RoyalCollegeofPediatriciansof Thailand (1991-present)• ExecutiveCommitteeofAsiaPacificSocietyofClinicalMicrobiologyandInfection (2012-present)• EditorialBoardoftheJournalofPaediatrics,Obstetrics&Gynaecology(1997-present)• EditorialAdvisoryBoard-MIMsAsia(1994-present)• Member,ExecutiveCommitteeofMedicalAssociationofThailand(2000-present)• AdvisorycommitteeofCMEandMedicalTimes,MIMSCME,HealthTodayThailand (2002-present)• ChairmanofJuristicpersonofNobleHousePhayathai(2002-present)

Past position• President,WorldSocietyofPediatricInfectiousDiseases(1999-2003)• President,AsianSocietyforPediatricInfectiousDiseases(1992-2002)• President,InfectiousDiseaseAssociationofThailand(1991-1995)• President,PediatricInfectiousDiseaseSocietyofThailand(1995-2009)• ProfessorofPediatrics,ChiefDivisionofInfectiousDiseases,RamathibodiHospital,Mahidol University, Bangkok (1982-2002)• Vice-President,MedicalCouncilofThailand(1997-2000)• BoardMemberofNationalHealthSecurityOffice(2003-2011)• ExecutivecommitteeofNationalHealthSystemReform(2005-2007)• President,FederationofProfessionalCouncilofThailand(2005-2011)• BoardMember,MahidolUniversityCouncil(1989-1998)• AssociateDeanforEducation,FacultyofMedicineRamathibodiHospital Mahidol University (1995-1998)• AssociateDeanforPost-graduatestudy,FacultyofMedicine,RamathibodiHospital,Mahidol University (1986-1990)• CommitteeofBasicEducationCommission,MinistryofEducation.(2004-2012)• CommitteeofNationalHealth(2007-2012)• Chairman,CommitteeonNationalMedicalLicenseExamination(1988-1997)• Chairman,CommitteeonStandardrequirementofmedicalgraduates(1991-2005)• Chairman,Subcommitteeonaccreditationof residency training center (2001-2005)• Chairman,SubcommitteeonTrainingand Examination for Thai Board of Pediatrics (1997-2001)

• Editor,RamathibodiMedicalJournal(1984-1990)andThaiJournalofPediatrics(1982-1987,1990- 1991)• Editor,CMEPlus,DNA(2002-2012)• ExecutiveCommittee,WesternPacificSocietyforChemotherapyandInfectiousDiseases(1988- 2012)• Chairman,Localscientificcommitteeofthe5thWorldCongressofPediatricInfectiousDisease, Bangkok 2007• Chairman,HospitalInfectionCommitteeRamathibodiHospital(1976-1978,1982-1986)• Chairman,ScientificCommitteeoftheRoyalCollegeofPediatricianofThailandandPediatric Society of Thailand (1988-1994)• President,9thWesternPacificCongressofChemotherapyandInfectiousDiseases(2004)• President,theFirstAsianCongressofPediatricInfectiousDiseases(2002)• ChairmanofNobleHousePhayathaiManagementControlBoard.(2001-2010)• FounderofInfectiousDiseaseAssociationofThailand,AsianSocietyofPediatricInfectious Diseases, Pediatric Infectious Disease Society of Thailand, Royal College of Pediatricians of Thailand

Publication More than 200 scientific articles in English and Thai

Research interest New vaccines, new antibiotics, nosocomial infection. immunologic deficiency diseases, epidemiology of infectious diseases

Prof. Cecilia Ladines-Llave, MD. PhD

Dr. Cecilia Llave is the UP-PGH National Cancer Institute Initiative Coordinator. She also coordinates the International Activity for Health collaborative network with the Kobe University Graduate School of Medicine, were she got her PhD, and the collaborative work with Aijinkai Corporation. She is the chief of the Gynecologic Oncocolgy Unit of the Asian Hospital and Medical Center and Secretary of the Medical Marketing Team . From 2001-March 2010 she was the first woman Chair of the Cancer Institute. In 2004 she was awarded Most Outstanding Oncologic Researcher by the PSO, in 2009, Most Outstanding Faculty for Extension Services of the University. She is the Past President of the PSCPC, President elect of SGOP, Board Member of the Philippine Cancer Society Inc., immediate past President of AOGIN Philippines. She is the program Director of the Cancer Institute Foundation (CIF), Chair of the CECAP (Cervical Cancer Prevention Network) and Co - Investigator for Mother Daughter Initiative (MDI), of JHPIEGO an affiliate of Johns Hopkins University. Her international memberships include the International Gynecologic Cancer Society, ISCPC and AOGIN Asia.

UP-PGH National Cancer Institute Initiative Coordinator Gynecologic Oncologist Department of OB-Gyne and Cancer Institute University of the Philippines College of Medicine Philippine General Hospital Asian Hospital and Medical Center

HPV: THE ADOLESCENT VACCINATIONCecilia A. Ladines-Llave, MD, PhD

Thispresentationfocusesonthehumanpapillomavirus(HPV),thenecessarycauseofcervicalcancer.Theburdenofcervicalcancerwillbediscussedthatwillemphasizeontheneedforpreventionthroughscreening,healthylifestyleandvaccinationtoboosterone’simmunity.TheWorldHealthOrganization’s(WHO)recommendationsandUnionforInternationalCancerControl’s(UICC)worlddeclarationencourageimplementationofHPVvaccinationtoadolescents(9-13yearsold)inordertosavewomen’slives.Thevaccine’seffect,delivery,safety,andsideeffectswillbepresented.Recommendationsforimplementationnationwidewithsustainabilitywillalsobedemonstrated.

Dr. Hans Bock

Dr Bock, Chief Medical Officer, Region International, Novartis Vaccines, obtained his MD and doctorate from the Johannes Gutenberg University of Mainz, Germany in 1978. He conducted his postgraduate training in internal, family and tropical medicine. More recently, he completed advanced management programs at the Wharton Business School, University of Pennsylvania, USA. In 1985, he joined Behringwerke/Hoechst in Marburg, Germany, managing drug safety on a global scale, focusing on pharmacovigilance of vaccines and other biological products. He went on to conduct and coordinate clinical trials in the development of anti-infectives and a wide range of candidate vaccines. He remained in his field of interest after joining SmithKline Beecham in Munich, Germany, in 1989. Since 1996, he has redirected his focus on both vaccine development and medical affairs in the international area in particular Asia Pacific region. During the last four years, he has concentrated his efforts in vaccine development in the International Region of Novartis Vaccines while serving as Chief Medical Officer for Region International. In addition he held the position of Head of Global Program Team for Emerging Diseases from November 2009 to May 2011 while establishing this function and evaluating several new vaccines projects. Dr Bock has authored over 200 original papers and has given more than 300 scientific presentations at national and international congresses and symposia worldwide and served on academic and non-governmental organizations’ advisory boards

Novartis Vaccines

INNOVATIVE APPROACHES IN CLINICAL DEVELOPMENT

Hans Bock MD

TheaimofVaccineClinicalResearchandDevelopmentistopreventinfectiousdiseasesinindividualsandsocieties.

Examplesofinnovationsinvaccinologyincludeusingnewtechnologiesfortheprovisionofantigensornewtargetgroups,bothresultinginnewindicationsandultimatelybenefitingpublichealth.

Real-worldexamplesoftheapplicationofsuchinnovativeapproachesarepresented:reversetechnologyidentifiednewantigens,whichpavedthewaytoatotallynovelanduniquevaccineagainstmeningococcalserotypeBdisease;targetingnewpopulationgroupssuchaspregnantwomenpotentiallyallowsprotectionofbothmotherandinfantbyimmunizationwithawiderrangeofoldandnewantigensinonesessionwiththeadditionalbenefitofprotectingthenewborninamostvulnerablephaseoflife.

Dr. Emilio Ledesma MD

Dr. Emilio Ledesma is currently Vice President and Head of Vaccine Value Health Science in GSK Vaccines Asia Pacific, based in Singapore. His main responsibilities include Clinical, Epidemiological and Health Economics research, Safety and Pharmacovigilance, Quality and Risk Management, as well as Medical Affairs for GSK vaccines in Asia Pacific. Dr. Ledesma obtained his MD in the Complutense University and Clinico San Carlos Hospital in Madrid (Spain) and after completing Immunology training, he started the research in the HIV and Infectious Diseases fields. He completed his training at Yale University School of Medicine, on Clinical Trial design and Methodology, and at Vanderbilt University (Owen Graduate School of Management) in Management. Dr. Ledesma has collaborated with local and European organizations in defense of the health rights of people living with HIV/AIDS. Dr. Ledesma has held many professional posts, dedicating most of his 14+ years of Pharmaceutical Industry career to Research & Development and Medical Affairs. His key areas of expertise are anti-infectives, specifically HIV and viral hepatitis therapies, and vaccines. He has worked with different Pharmaceutical companies including Bristol-Myers Squibb, Sanofi Pasteur & Merck, and Glaxo SmithKline. Dr. Ledesma is committed to join forces with other stakeholders to develop the best vaccines and generate the necessary data for the best decision making for the prevention and treatment of diseases in the population in Asia Pacific.

NEW VACCINES ON THE HORIZONDr. Emilio Ledesma

Vaccinologyisprogressingfast,andneweffectiveandsafevaccinesarebecomingavailableeveryyear.Buttheremainingbiginfectiousdiseasetargets(dengue,malaria,HIV,etc)areprovingtobebigchallengesandrequireadditionalefforts,includinginnovativeapproaches.Inparallel,astheunderstandingofimmunologyincreases,adjuvantsystemsarebeingdevelopedtomatchupwithspecificantigensandprovideacustomizedenhancementoftheimmunologicresponse,aimingatreducingtheantigendoseneeded,increasingtheimmuneresponseforanearlier,higher,moresustainedimmuneresponse,leadingtoincreasedprotection.Developmentinareasbeyondtheantigen,includingadjuvantsystemsanddeliverysystemswillbringgreatprogressinvaccinedevelopment.Inthemeantime,vaccinesareenteringintothetherapeuticarena.Preliminaryevidencethataseriesofvaccineinjectionscancomplimentchemotherapy/radiotherapyinthetreatmentofNSCLCormelanomahavebeenpresentedandphaseIIIclinicaltrialsareongoingtofurthervalidatetheseresults.OthertypesofdiseaseslikeAlzheimer,Parkinson’sdiseaseorCOPDexacerbationsareadditionalcurrentvaccinetargets.WeshouldhoweverrememberthattheuseofcurrentlyavailablevaccinesanduniversalaccesstothemremainsthebiggestchallengeinAsiaPacificandshouldremainthefirstpriority.NewVaccinesintheHorizonareimportant,butnewpopulationsbenefitingfromwellresearched,wellknownvaccinespreventingmajorpathogensanddiseaseslikeinvasivepneumococcaldiseasearealsointheHorizonandweallhopetoseethatcomealivesoon.

Prof. Miguel Luis O’Ryan

Miguel O’Ryan is Full Professor at the Microbiology and Mycology Program at the Faculty of Medicine, University of Chile where he also holds the current position of Associated Director for Innovation for the Faculty of Medicine. He was Vice President for Research and Development of the University of Chile until August 2012 and previously Director of the Microbiology and Mycology Program. Professor O’Ryan qualified at the Catholic University of Chile and studied paediatric infectious diseases at the University of Texas Health Sciences Center, Houston, Texas. He served as the President of the Chilean Infectious Disease Society from 1998–1999. His research has focused in three main areas: a) molecular and clinical aspects of enteric disease (mainly rotavirus, norovirus and more recently Helicobacter pylori), b) new pediatric vaccines, and c) infection in the immunecompromised host. He was the principle investigator for the multinational trial of the human rotavirus vaccine (NEJM January 2006). Professor O’Ryan’s research and expert reviews and editorials have been widely published in 80 Pubmed indexed articles. He has co-authored 19 book chapters on topics that include enteric viruses, parasitic diseases in children, and medications used in paediatrics. Professor O’Ryan is an active member of the Pediatric Infectious Disease Society of America, the Sociedad Chilena de Infectologia and the Sociedad Latinoamericana de Infectologia Pediatrica. He has been/is International Editor of the Journal of Pediatrics and the Pediatric Infectious Disease Journal and he chaired the III World Congress of Pediatric Infectious Diseases. Dr. O’Ryan was elected member of the Chilean National Academy of Medicine in 2012.

A NEW VACCINE FOR THE PREVENTION OF MENINGOCOCCAL SEROGROUP B DISEASE: CLINICAL AND SAFETY DATAProf. Miguel Luis O’Ryan

ThedevelopmentofabroadlyeffectivevaccineagainstmeningococcalserogroupB(MenB)diseaseisanimportantadvanceintheglobalefforttopreventinvasivemeningococcaldisease(IMD).4CMenBisanovel,multicomponentmeningococcalserogroupBvaccineforactiveimmunisationofindividualsfrom2monthsofageandolderagainstinvasivemeningococcalserogroupBdisease.

4CMenBcontains4majorantigencomponents,fHbp,NadA,NHBAandPorA1.4,whichwerechosentoachievebroadprotectionagainstmeningococcalserogroupBstrains.Theimmunogenicityandsafetyof4CMenBhasbeendeterminedinclinicaltrialsof7803individuals2monthsofageandolder.

4CMenBelicitedrobustprotectiveimmuneresponseagainstreferencestrainsinabroadagerangeofsubjects,includinginfants(vaccinatedfrom2monthsofage)andadolescents(vaccinatedat11–17yearsofage)—theagegroupsatgreatestriskofdisease.Thetolerabilityprofileof4CMenBwasalsoestablishedintheseclinicaltrialsandfoundtobeacceptable.

4CMenBisthefirstmeningococcalserogroupBvaccinewiththepotentialtoprovidebroadprotectionagainstserogroupBdisease.Anevaluationofcoverageof4CMenBforseveralcountriesgloballyfoundthat4CMenBwaspredictedtocover66%to91%ofserogroupBcirculatingdisease-causingstrains,representingapotentialpublichealthbenefit.Thedefinitiveeffectivenessandsubsequentpublichealthbenefitof4CMenBwillonlybecomeknownwhenthisvaccineisusedinbroad-coverage,population-basedvaccinationprogramsworldwide

Pornthep Chanthavanich, M.D.

Appointment: Associate ProfessorSpecialty: Pediatric Infectious DiseasesPosition: Staff, Department of Tropical Pediatrics

Qualification & Education:M.D., Siriraj Hospital, Mahidol University D.T.M. & H., Faculty of Tropical Medicine, Mahidol University M.Sc., M.C.H., Institute of Child Health, University of London D.T.C.H., Liverpool School of Tropical Medicine, University of Liverpool Fellow of the Royal College of Pediatricians of ThailandDiploma Thai Board of Pediatric Infectious DiseasesDiploma Thai Board of Family Medicine

Areas of Interest: infectious diseases, vaccines, malaria, parasitic infection

On going project: Dengue burden, Dengue vaccine phase 2

Office: Department of Tropical Pediatrics, Faculty of Tropical Medicine Mahidol University, 420/6 Ratchawithi Rd., Bangkok 10400, THAILAND Tel: +66-3549161, Fax: +662-3549163 Email: [email protected]

DENGUE: GETTING STRONGER IN TIMEPornthep Chanthavanich

SincetheepidemicofdenguehemorrhagicfeverinAsiain1953andthere-emergenceofdenguefeverinLatinAmericain1968,thenumberofdenguecaseshaverisencontinuously.Overthelastdecade,denguehasspreadmorerapidlythanothermajorinfectiousdiseases.In2012,denguerankedasthefastestspreadingvector-borneviraldiseasewithanepidemicpotentialintheworld,registeringa30-foldincreasedincidenceoverthepast50years.Anestimated3.5billionpeopleareatriskin124endemiccountries;35millionsymptomaticcasesoccurannually,with20,000deaths.Vectorcontrolhasachievedonlylimitedsuccessinreducingthetransmissionofdengue.Theprimaryvector,theurban-adaptedAedesaegypti,hasbecomewidelydistributedacrosstropicalandsubtropicallatitudes.Ithasspreadgloballywiththeadventofincreasedtravelandtradeinthepast50years.Asecondaryvector,Aedesalbopictus,hasexpandeddramaticallyinrecentyears.Thereasonsforcontinuedtransmissionarepopulationgrowth,rapidurbanization,environmentalchange,climatechange,moderntransportation,inadequatewaterstorage,lackofpoliticalcommitment,andlackofintersectoralcollaboration.Fortunately,asdenguehasbecomestrongerovertime,ourpotentialtocombatdengueisalsogettingstronger.Modernscientificknowledgeandtechniquesinpathophysiology,drugandvaccinediscovery,socialandbehavioralsciences,andvectorbiologyandcontrolofferusgreatpromiseoftangibleandsubstantialimpactsondengueoverthenextdecade.However,aneffectivetetravalentdenguevaccinemaybethemajormeantoeffectivelycontroldengue.

Alain Bouckenooghe

Alain Bouckenooghe obtained his MD at the Catholic University of Leuven, Belgium, before leaving on assignment with the Ministry of Health in Zambia, where he worked as General and District Medical Officer for several years. Subsequently, Dr Bouckenooghe moved to the US and completed his residency at the University of Texas, Houston. He obtained his Master of Public Health degree at the UT School of Public Health and completed a fellowship in adult Infectious Diseases at Baylor College of Medicine. Alain held several academic positions during this time in the Department of Medicine at Baylor College. He joined Sanofi Pasteur in December 2006 in Swiftwater, PA, USA, coming from GlaxoSmithKline Biologicals, where he had been leading the rotavirus vaccine clinical development program. Prior to his appointment at GSK, he held the position of Director, Regulatory Affairs with MSD Europe. Alain is currently located in Singapore as Associate VP and Regional Head of Clinical R&D and Medical Affairs of Sanofi Pasteur Asia.

Associate Vice President and Regional Head of Clinical R&D and Medical Affairs, Sanofi Pasteur Asia

DENGUE VACCINE: IS IT WORTH THE WAIT? Alain Bouckenooghe

Denguerangesinseverityfrommildfevertoseveredenguecharacterizedbyhaemorrhage,shock,andsometimesdeath.Globally,anestimated2.5billionpeopleareatriskofdengueand75%ofthesepeopleliveintheAsiaPacificregionwheremostreportedcasesarechildrenhospitalizedwith,oratriskfor,severedengue.Thetrueburdenofdengueremainsunrecognized.Someaspectsoftheregionalepidemiologywillbediscussed.

Dengueaffectspeoplefromallsociallevels.Nationalhealthauthoritiesworkhardtocontroloutbreaksandminimizemorbidityandmortalitythroughvectorcontrolmeasures,seasonaldengueawarenesscampaigns,andstandardizingtreatmentregimens.Deathsstilloccurandthesearemostcommonwhereaccesstomedicalcareisdifficultorwheretreatmentisnotoptimal.Inmostcountries,thecasefatalityrateisnowlowerthan1%forallreporteddengue,duetomajorimprovementsinmedicalcare.Yetduetosignificantincreasesinthesizeofthepopulationtheabsolutenumberoffatalitiesremainshigh.ThetotalnumberofdenguefatalitiesinAsiais29timeshigherthanintheAmericas(Shepard,2012submitted)andtheincidenceofseveredengueis18timeshigher(Halstead,2006).ThepublichealthburdenonmanysocietiesinAsiaduetodengueremainsverylarge.

Themosteffectivewaytocontrolthisdiseaseinthefuturewillbethroughtheuseofasafeandeffectivevaccine.RecentlytheresultsfromSanofiPasteur’sleadcandidatedenguevaccineefficacystudy,averyfirstofitskind,wentpublic.Thesedatashowforthefirsttimethatasafeandefficaciousvaccineagainstdengueispossible.Thiscandidatevaccinewasimmunogenicforallfourserotypesandprotectedagainstthreeofthefourserotypes(1,3,and4)intherangeof60to90%.ResultsofthisstudyincontextofthewiderSanofiPasteurdenguevaccinedevelopmentwillbediscussed.

Georges Thiry, PhDDirector of DVI, IVI, Seoul, South Korea

Dr. Georges Thiry, Ph. D. is Deputy Director-General, Portfolio Management at IVI and acting Director for the Dengue Vaccine Initiative (DVI). Dr. Thiry obtained his PhD in Science, Microbiology and Genetics, in 1984 at the University of Liège, Belgium and became Project Manager Professional from PMI in 2005. He started his career as Team Leader, Genetic Engineering, in Solvay Central Laboratory (Brussels) in 1984, in discovery of new veterinary vaccines, then in the manufacturing facility of Solvay Animal Health (Minneapolis, USA) in development and licensure of veterinary vaccines for EU and US. Dr. Thiry worked at GlaxoSmithKline Biologicals (Belgium) from 1996 to 2000 as Project Manager and led the development of human vaccine candidates against Rotavirus (became RotaRix), MenB, RSV, EBV, Influenza as well as new adjuvants and delivering technologies. At the International AIDS Vaccine Initiative (IAVI, New York till 2007) as Director of Project Management, and of Process, Manufacturing and Quality Assurance, he participated to the development and evaluation of vaccine candidates against HIV in Uganda, Kenya and India. Finally, before joining IVI, he was Director, Portfolio and Project Management at PATH, Vaccine Development, and also Director of Advancing new Rotavirus vaccines (ARVAC). In that later responsibility, he led public private partnerships on the development of Rotavirus vaccine candidates with manufacturers in India, China, Brazil and Indonesia/Australia.

STRATEGY OF DVI IN ACCELERATING INTRODUCTION OF DENGUE VACCINESGeorges Thiry, PhD, Director of DVI, IVI, Seoul, South Korea

Dengueposesamajorhealthburdenintropicalandsub-tropicalpartsoftheworld,asasourceofsignificantsocialandeconomiccostinmanydevelopingcountrieswhileoutbreaksstraintheirhealthcaresystems.Denguecausesmainlymorbiditywithanestimated100Msystematiccasesandatleast500,000severecasesrequiringhospitalizationsannually.Thediseaseisamosquito-borneandfastlyspreadingdisease..Therearenolicensedvaccinesorantiviraldrugstopreventortreatthedisease.FivedifferentvaccinecandidatesarecurrentlyinclinicalevaluationincludingoneinlargePhase3efficacy,withexpectationsthatvaccineswillbeavailableinthefivecomingyears.

TheDengueVaccineInitiativeisaconsortiumofIVI,WHOInitiativeofVaccineResearch,JohnHopkinsUniversity’sInternationalVaccineAccessCenter,andSabinInstitute.Ouraimistosupportdevelopmentandintroductionofsafe,effectiveandaffordabledenguevaccinesintoendemiccountries.Ouractivitiesare(1)togeneratedataondengueepidemiology,evidenceofhealtheconomicsandpredictedimpactofvaccinationthroughmodeling;(2)toprovidesupportandtrainingtofirst-to-introducecountriesontechnicalandregulatoryaspectsofdenguevaccineintroduction.

POSTER ABSTRACTS

TYPHOID FEVER IN BANGLADESH :ENDEMIC DISEASE (?SILENT EPIDEMIC DISEASE ), WIDESPREAD DRUG RESISTANCE & LACK OF EFFECTIVE DIAGNOSTICS HIGHLIGHT NEED FOR PREVENTIONMESBAH UDDIN AHMEDAssociate ProfessorDept. Child Health, Gonoshasthya Samaj Vittik Medical College.Immediate Past Secretary GeneralBangladesh Paediatric Association

Theemergenceofantibiotic-resistanttyphoidstrainsandthelackofearlydiagnostictoolshavebecomemajorstumblingblocksinthefightagainsttyphoidinBangladesh.AlthoughtyphoidfeverishighlyendemicinBangladeshandisknowntoaffectallages,includingadolescentsandadults,recentepidemiologicstudieshavedemonstratedthatpre-schoolagedchildrenandinfantsareincreasinglyafflictedwithtyphoid,especiallyinruralareasandurbanslumcommunitieswithoutaccesstosafewaterandbasicsanitation.TheoverallincidenceoftyphoidfeverinBangladeshisestimatedtobe2episodesper1000person-years,withanotablyhigherincidenceof10.5episodes/1000person-yearsinchildrenlessthan5yearsofage.Moreover,anongoingtyphoidsurveillanceprojectbasedinurbanslumsofDhakareportsthatover51%ofisolatesampleswerefoundtoberesistantto3commonlyusedantibiotics,b-lactams,chloramphenicol,cotrimoxazoleand49%werealsoresistanttonalidixicacid.ThehighratesofMDRtyphoidinBangladesharealarming,andmybepartiallyattributabletotheindiscriminateuseofantibiotics.TheoverwhelmingdiseaseburdenandrisingincidenceofMDRtyphoiddemonstratetheneedforvaccinationinadditiontootherpreventionstrategies,suchaswaterandsanitationimprovement.Whilenextgenerationtyphoidvaccinesareindevelopment,currentlyavailablepolysaccharidevaccinesshouldbeevaluatedforuseinchildrenlessthan2yearsinordertoaddressthehighestburdenofdisease.OnestateofIndia(Delhi)hasbeenusingTyphoidPolysaccharideVaccineintheirEPIProgramme,wheathervulnerablechildrenofBangladeshcanbeprotectedfromtyphoidbythesamewayasDelhiisprotectingtheirchildrenthroughtyphoidvaccinationbyEPI.

CLINICAL CHARACTERISTICS AND COSTS OF CHICKENPOX HOSPITALIZATION IN THAI CHILDREN

Introduction:CosteffectivenessanalysisofincludingvaricellavaccinationintheThaiNationalImmunizationProgramhasnotbeenavailable.ThisisprobablyduetolackofrelevantinformationondiseaseseverityandimpactonhealthcareresourcesincurredbysevereprimaryvaricellainfectionrequiringhospitalizationofThaichildren.

Objective:Todetermineclinicalcharacteristicsofhospitalizedprimaryvaricellazosterinfection;particularly,diseaseseverity,prevalenceofcomplications,anduseofhealthcareresourcesintermsoflengthofstayandhospitalcharges.

Studydesigns:Retrospectivedescriptivestudy

Studypopulation:Childrenagedonemonthto18yearswhowerehospitalizedwithchickenpoxbetween2007and2011inanurbanmedicalcenterinBangkok,Thailand.

Methods:Informationonclinicalmanifestations,complications,outcomes,andhospitalchargeswereobtainedbymedicalrecordabstractionanddescriptivelyanalyzed.

Results:Atotalof101casesofchickenpoxwereidentified,withamedian(interquartilerange/IQR)ageof4(0.8,7.25)years.Underlyingpredisposingconditionsforseverevaricellainfectionwereidentifiedin35cases(34.7%).Seventyfourof101(73.3%)patientsdevelopedcertaincomplications,withskinandsofttissueinfectionsbeingthemostcommon(50.5%),followedbypneumonia(12.7%)andneurologicalcomplications(6.4%).Therewerenofatalcases.Median(IQR)durationofhospitalizationandhospitalchargeswere6(3,9)daysandUS$330.2($139.3,$1013.5),respectively.Childrenwithpredisposingconditionsforseverevaricellaweresignificantlyolder,incurring6-foldhigherhospitalchargesand2-foldlongerhospitalizationdurationcomparedtotheircounterparts.

Conclusions:Thehighrateofcomplicatedvaricellaandfinancialburdenreportedinthisstudysuggestedthattheseverityofvaricellacomplicationsinhealthychildrenmighthavebeenpreviouslyunderestimated.

IMPROVING CHILD SURVIVAL THROUGH VACCINATION & PREVENTION OF DISABILITIES IN BANGLADESH - AN OVERVIEW.

Dr. Mesbah Uddin Ahmed, Gonoshasthya Samaj Vittik Medical College & Hospital, [email protected]

Dr. Afroza Akhter Munnu Medical College

Introduction:

Bangladeshisahighlypopulouscountryof160millionpeopleonaareaof1,47,570sq.kmandthebirthcohortis4millioneachyear..BangladeshhasstartedEPIwith6antigensin1979anditscoveragewasonly2%by1985bythevigorouseffortofGOB,NGOs,civilsocietiesandthecontinuoussupportofBangladeshpediatricsassociation(BPA).In2004HepatitisBVaccine,in2009Hib,in2012MRhavebeenincorporatedinourEPI.TheintroductionofMRvaccinewasfundedbytheGovernmentofBangladesh.MCV2isprovidedthroughGAVIfunds.VeryshortlyPCV,RotavirusvaccinewillbeincorporatedinourEPI.Vaccinationhasgreatlyreducedtheburdenofinfectiousdiseasesanddiseaserelateddeathanddisability.

Objectives:

Theobjectiveofourstudyistoreviewdifferentstudyandtoseetheachievementofimmunizationinaspectofchildsurvivalanddisability.

Studydesign:

ItisadescriptivetypeofstudyusingdatafromseveralEPIrelatedpapers.

Methodology:

ThestudyuseddatafromEPIFactSheetBangladesh2011,BangladeshDemographicandHealthStatistics(BDHS)2011,WHObulletinbyFEAndreetal.andEPIsurveillancebulletinbyWHO.

Results:

Upto40%ofchildrenwhosurvivemeningitisduetoHibmayhavelife-longneurologicaldefects.Around13%oftotalpopulationshavebeensomeshortofdisabilityanditwasincreasingdaybyday,halfofthemduetopostpolioparesis,meningitisduetoTB,Hibandothervaccinepreventabledisease.Therehasbeennotableimprovementinvaccinationcoverageinrecentyears.Theproportionofchildrenage12-23monthswhoarefullyvaccinatedincreasedfrom73percentin2004,to82percentin2007,andto86percentin2011.Theproportionofchildrenfullyvaccinatedby12monthsofagealsoincreasedfrom68percentto83percentbetween2004and2011.PolioandneonataltetanusissuccessfullyeradicatedfromourcountrythroughEPIvaccination.Under5pneumoniadeathhasdecreasedto20,000whichwas50,000twoyearsback.Measlesvaccination

protectsagainstmultiplecomplicationssuchasdysentery,bacterialpneumonia,keratomalaciaandmalnutrition.Complicationssuchascongenitalrubellasyndrome,livercirrhosisandcancercausedbychronichepatitisBinfectionorneurologicallesionssecondarytomeaslesormumpscanhaveagreaterlong-termimpactthantheacutedisease.Infieldtrials,mortalityandmorbidityreductionswereseenforpneumococcaldiseaseinsub-SaharanAfricaandrotavirusinLatinAmerica.

Conclusion:

Vaccinescanincreaselifeexpectancybyprotectingagainstdiseasesagainstwhichonewouldnotexpectbenefit.ThereareseveralvaccineinthepipelineofEPIinBangladeshliketyphoid,cholera,rotaviralvaccine.Vaccinesagainsttyphoidcanpreventprimaryinfectionandthespreadofantibiotic-sensitiveaswellasmultidrug-resistantstrains.Thedevelopmentofnewvaccinesagainstinfectiouspathogenswhereantibioticresistanceisaglobalthreat(e.g.Staphylococcusaureus)isviewedasabetterlong-termoptiontocontroltheproblemofincreasingresistance.

ACUTE FLACCID PARALYSIS AFTER ADMINISTRATION OF ORAL POLIO VACCINE

Author: Judith N. Quijardo, MDCo-Author: Adolfo D. Solis, MD, DPPS, FPCS, FPSPS

Thisreportdescribesacaseofacuteflaccidparalysisafteradministrationoforalpoliovaccine(OPV).A3montholdmalewithadecreasedmovementoftheupperandlowerextremitiesforoneweekwasadmittedatourinstitution.HereceivedthefirstdoseofOPVat2monthsofage.Flaccidparalysiswasobserved4weeksafterOPVimmunization.Poliovirustype2andtype3wasisolatedinthetwostoolculture.StoolwasthensenttoVictorianInfectiousDiseaseReferenceLaboratoryinAustraliawherethepolioviruswasidentifiedasSabin-like,thestrainresponsibleforVaccineAssociatedParalyticPoliomyelitis(VAPP).Recoveryofmotorfunctionoftheupperandlowerrightextremitieswasnotedupondischarge;however,hisleftlegstillappearsflaccid,hypotonicandhyporeflexive,butwithintactsensation.Theweaknessandatrophyoftheleftlegpersisteduptothepresentdespitecontinuousrehabilitationtherapy.BasedonDOHcensus,thisisthefirstprovencaseofrecipientVaccineAssociatedParalyticPoliomyelitis(VAPP)isolatedinourprovince.

CLINICAL CHARACTERISTICS AND OUTCOME OF PERTUSSIS: A CASE SERIES

Rosalia Belen F. Bonus, MDUniversity of the Philippines-Philippine General HospitalDepartment of PediatricsSection of Infectious and Tropical Diseases in Pediatrics (INTROP)

Cleo Anna Marie Dy, MDUniversity of the Philippines-Philippine General HospitalDepartment of PediatricsSection of Infectious and Tropical Diseases in Pediatrics (INTROP)

Carmina de los Reyes, MDUniversity of the Philippines-Philippine General HospitalDepartment of PediatricsSection of Infectious and Tropical Diseases in Pediatrics (INTROP)

Ruth Alma A. Ramos, MD, MPH National Epidemiology Center, Department of Health

Introduction

Pertussisisahighlycontagiousbutvaccinepreventablediseasecausingfatalillnesstovulnerableandincompletelyvaccinatedchildren.Philippinesreported57casesofpertussis(CFR5.3%)with80%DTP3coveragein2011.

Objective

Todescribetheclinicalprofile,symptoms,DTwPvaccination,exposure,laboratory(WBCcount,absolutelymphocytecountandplateletcount),complicationsandoutcomeofpertussisPCRpositivecases.

StudyDesign

Caseseriesanalysis

Methodology

Retrospectivechartreviewofpatientsbelow5yearsoldwithpertussisPCRpositiveadmittedinatertiaryhospitalfromSeptember1,2012toApril10,2013.DatawereobtainedusingstandardizedformandenteredintoanExceldatabase.

Results

Atotalof16pertussisPCRpositivepatients,majoritycamefromregions4-A(9,56%)andNCR(6,37%).Medianageof1.8months;mostarefemales(10,62%).Patientshadparoxysmalcough,cyanosis(16,100%),posttussivevomiting(4,25%),afebrile(12,62%)andwithoutawhoopwith14meandaysofillness.13(81%)wereeligibleforDTwPvaccination,only4(31%)werevaccinatedanddeferredin9(69%)patientsbecauseofcough(5,55%)andtemperature37.5C(2,22%).14(88%)hadcontacttohouseholdmember,usuallythemother(7,41%)withoutboosterdoseofTdap.Allhadleukocytosis(24.5-111.5;median64x109/L)withabsolutelymphocytecountof3,259.6andthrombocytosis(269-823;median634x109/L).12(75%)necessitatedventilatorsupport,pneumoniaprogressedtoARDS(7,41%)anddevelopednosocomialinfection(3,17%)secondarytoprolongedhospitalstay(averagehospitalstay,7days).10deathsaccountedfor62%casefatalityrate.

Conclusion/recommendations

Pertussisishighlysuspectedinachildlessthan2monthswithorwithoutDTwPvaccinationwithparoxysmalcough,cyanosis,withoutfeverandwhoopwithfindingsofleucocytosis,lymphocytosisandthrombocytosisexposedtosickindividualstopreventcomplicationswhichcontributestohighcasefatalityrate.

Keywords:Casefatalityrate(CFR),pertussis,DTwPvaccination

LONG-TERM NEUTRALIZING ANTIBODY FOLLOWING A BOOSTER DOSE OF JE CV (IMOJEV®), A NOVEL LIVE ATTENUATED JAPANESE ENCEPHALITIS VACCINE, IN CHILDREN PREVIOUSLY PRIMED WITH A JE VACCINE.*

Emmanuel Feroldi, MDSanofi [email protected] Pasteur1541 avenue Marcel MerieuxBat X Sud69280 Marcy l’EtoileFrance+33 4 37 37 78 88+33 6 32 55 13 17

Kulkanya Chokephaibulkit MD,Division of Infectious Diseases, Siriraj Hospital, 2 Prannok Road, Bangkoknoi, Bangkok 10700, Thailand

Arunee Sabchareon MD,Department of Tropical Pediatrics, Faculty of Tropical Medicine, 420/6 Rajvithi Road, Rajthevi, Bangkok 10400, Thailand

Usa Thisyakorn MD,9th Floor Infectious Unit, Department of Pediatrics, Chulalongkorn Hospital, Bangkok 10330, Thailand;

Chitsanu Pancharoen MD,9th Floor Infectious Unit, Department of Pediatrics, Chulalongkorn Hospital, Bangkok 10330, Thailand;

Maria R Capeding, MD,Research Institute for Tropical Medicine, Mutinlupa City, Philippines;

Claude Meric, Ph D,Sanofi Pasteur, France

Mark Boaz, PhD,Sanofi Pasteur, USA;

Alain Bouckenooghe, MDSanofi Pasteur, Singapore

*Industry-initiated paper

Introduction

Pertussisisahighlycontagiousbutvaccinepreventablediseasecausingfatalillnesstovulnerableandincompletelyvaccinatedchildren.Philippinesreported57casesofpertussis(CFR5.3%)with80%DTP3coveragein2011.

Objective

Todescribetheclinicalprofile,symptoms,DTwPvaccination,exposure,laboratory(WBCcount,absolutelymphocytecountandplateletcount),complicationsandoutcomeofpertussisPCRpositivecases.

StudyDesign

Caseseriesanalysis

Methodology

Retrospectivechartreviewofpatientsbelow5yearsoldwithpertussisPCRpositiveadmittedinatertiaryhospitalfromSeptember1,2012toApril10,2013.DatawereobtainedusingstandardizedformandenteredintoanExceldatabase.

Results

Atotalof16pertussisPCRpositivepatients,majoritycamefromregions4-A(9,56%)andNCR(6,37%).Medianageof1.8months;mostarefemales(10,62%).Patientshadparoxysmalcough,cyanosis(16,100%),posttussivevomiting(4,25%),afebrile(12,62%)andwithoutawhoopwith14meandaysofillness.13(81%)wereeligibleforDTwPvaccination,only4(31%)werevaccinatedanddeferredin9(69%)patientsbecauseofcough(5,55%)andtemperature37.5C(2,22%).14(88%)hadcontacttohouseholdmember,usuallythemother(7,41%)withoutboosterdoseofTdap.Allhadleukocytosis(24.5-111.5;median64x109/L)withabsolutelymphocytecountof3,259.6andthrombocytosis(269-823;median634x109/L).12(75%)necessitatedventilatorsupport,pneumoniaprogressedtoARDS(7,41%)anddevelopednosocomialinfection(3,17%)secondarytoprolongedhospitalstay(averagehospitalstay,7days).10deathsaccountedfor62%casefatalityrate.

Conclusion/recommendations

Pertussisishighlysuspectedinachildlessthan2monthswithorwithoutDTwPvaccinationwithparoxysmalcough,cyanosis,withoutfeverandwhoopwithfindingsofleucocytosis,lymphocytosisandthrombocytosisexposedtosickindividualstopreventcomplicationswhichcontributestohighcasefatalityrate.

Keywords:Casefatalityrate(CFR),pertussis,DTwPvaccination

IPAPVISION - MISISON

STATEMENT

IPAP Immunization Partners in Asia-Pacific, Inc.

Suite 17D University Towers, 728 Pedro Gil St., Ermita 1000 Manila, Philippines Telefax: +6322545205 Mobile Phone: +639178912462

www.ip-ap.net IPAP responds to –

1. the Siem Reap Declaration 2009 calling for “greater efforts to be undertaken by governments, non-governmental agencies, international organizations, academia and the private sector to ensure that each child is provided protection, as is his/her RIGHT,” and

2. an understanding reached during a meeting on July 29, 2011 at the 3rd Asian Vaccine Conference (ASVAC) in Jakarta among different stakeholders about the need for a heterogeneous group of partners which will study and implement advocacy programs focusing on all vaccine preventable diseases.

IPAP believes that –

1. the enjoyment of a healthy existence is a basic human right; 2. the protection of the right to health is imperative for the enjoyment of other fundamental

human rights as health is integrated and closely intertwined with the rights to survival, education, freedom from poverty and environmental protection; and

3. a human rights-based approach shall be the foundation of all IPAP’S advocacy, programs, projects and activities in ensuring that the right to health shall be the paramount consideration in the conduct of advocacy and adoption of policies in both the public and private sectors.

IPAP seeks to –

1. engender collaboration, cooperation and partnerships among governments, international agencies, non-governmental organizations, United Nations agencies, key opinion leaders, donors, health authorities, health providers, business stakeholders, patient groups and professionals, and

2. develop dynamic, reliable and effective advocacy campaigns to increase, expand and improve the immunization coverage in the region for all preventable diseases.

Thus, IPAP envisions a world where no person shall suffer from preventable diseases. It foresees a society where public health is at the forefront of every governmental program and policy. It visualizes a regional cooperation among multi-sectoral associations and organizations working towards ensuring that every person’s basic rights to survival, development and protection are guaranteed and realized. Henceforth, IPAP commits itself to the development of a strong, progressive and dynamic movement that engages all stakeholders such as government, key opinion leaders, NGOs, international organizations, business stakeholders, patient groups and professionals, to liberate the people from death and suffering from preventable diseases and put an emphasis on the key messages of “Prevention, Protection and Treatment”. To fulfill this, IPAP shall effectively advocate and campaign for the widest coverage of immunization in the region and beyond.

ORGANIZINGCOMMITTEE

Lulu Bravo PresidentCynthia Aguirre Vice PresidentSalvacion Gatchalian SecretaryMa. Rosario Capeding TreasurerCharissa Fay Tabora Business ManagerEnrique Tayag MemberTony Nelson Chairman, Steering Committee

Jonathan Lim Overall chairArlene Macabaya Member, Scientific CommitteeMitzi Marie Chua Member, Scientific CommitteeElizabeth Gallardo Emcee, Scientific ProgramBelle Ranile Chair, Registration CommitteeMa. Antonette Madrid Member, Registration CommitteeMarjorie Cang Member, Registration CommitteeAnabelle Laranjo Member, Registration CommitteeFidji Tambago Member, Registration CommitteeBenson Lim Member, Registration CommitteeCorazon Meneses Treasurer, Registration CommitteeXenia Catherine Fabay Chair, Poster CommitteeVirginia Mesola Co-chair, Poster CommitteeDeborah Sussana Limchiu Chair, Exhibits CommitteeLydia Chang Member, Exhibits CommitteeHelen Tudtud Member, Exhibits CommitteeMontoya Melfer Member, Exhibits CommitteeMarilou Viray In-charge, Physical ArrangementsArcelin Piramide Chair, Souvenir ProgramGladdys dela Torre Member, Souvenir ProgramJoey Alberto Event Coordinator

Ma. Divina Carandang Project CoordinatorRamil Sanchez CommunicationsGemma Asistin LogisticsMel Fortus LogisticsMiguel Canino Logistics

Francis Kwong ASAP Business Meetings and SymposiumKatherine Wong ASAP Business Meetings and Symposium

ASAP STAFF

ASVAC 2013 ORGANIZING COMMITTEE

IPAP OFFICERS

LOCAL ORGANIZING COMMITTEE

IPAP SUPPORT STAFF

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