1. IMMUNIZATION CORE PIPELINE Health Cluster Meeting 5 th April 2016 JUBA, SOUTH SUDAN

2. UNICEF ROLE IN IMMUNIZATION CORE PIPELINE 1.Procurement of Immunization Supplies:  All vaccines except the Pentavalent (DTP-HepB-Hib) and Inactivated Polio Vaccine (IPV) which are GAVI supported These include: Bacillus Calmette–Guérin (BCG) – for routine immunization (RI) Oral Polio Vaccine (OPV) – for RI and supplementary immunization activities (SIAs) Measles Conjucate Vaccine (MCV) – for RI and SIAs Tetanus Toxoid (TT) Vaccine – for RI and SIAs  Vaccination injection materials and related accessories (syringes, safety boxes, cotton wool)  All cold chain equipment: solar and electric fridges, deep freezers, cold boxes, vaccine carriers, temperature monitoring equipment and generators. 2. Storage of injection materials and related accessories at UNICEF warehouses at national and regional levels. 3. Distribution of immunization supplies to State capitals and hard to reach counties. 4. Support to the Ministry of Health in the installation, maintenance and repair of cold chain equipment.

3. VACCINES N˚AntigensDoses availableDoses in PipelineDoses in fund-raising proposal 1Measles1,127,400910,072 2Penta875,500 3TT2,230,0100 4tOPV2,434,0000 5bOPV1,240,00032500 6IPV3,910 114,200 7Men A349,3400 8BCG147,600 890,400 18,600

4. COLD CHAIN EQUIPMENT N˚DescriptionAvailablePipelineDoses in fund-raising proposal 1Solar Fridges01824 2Electric Fridge1900 3Electric Freezers100 4Cold Boxes27210060 5Vaccines carriers7482500517 6Ice Pack30002000030000

5. INJECTION MATERIALS AND ACCESSORIES N˚DescriptionAvailableIn PipelineDoses in fund- raising proposal 1Syringes 5ml00172,900 2Syringes 0.5ml683,3000851,900 3Syringes 0.05ml98,1007,500 4Syringes 2 ml3,7007,500 5Safety Boxes16,2502,000 6Cotton W3,961790

6. Approved and commonly used cold chain equipment TFW 800 icepacks freezer only MF314 Vest frost freezer vaccine storage and icepack freezing (264lts) MK304 vestfrost iceliner vaccine storage only (108lts) VC150 solar that use batteries vaccine storage and icepack freezing TCW2000/2043 SDD solar without batteries for vaccine storage and icepack freezing (85ltrs) TCW3000/3043 SDD solar without batteries for vaccine storage and icepack freezing (120lts)

7. 7 Electric freezers/ iceliners

8. Vaccine and Cold Chain Request Process

9. Unicef discuss with the partner the suitable delivery mode ( air,road, boat ) and any support needed in the process According to the partner capacity : - The partner can pass to collect items to the National Cold chain and bring the to the field. - Unicef can transport items from Juba to the final destination. Maintenance system: - The partners is in charge of follow up and alert UNICEF any damage or additional need identified. - Unicef will send the technician according the availability and security clearance given by the SS Government

10. Established county vaccine stores with solar direct driven fridges SDD 10 Installation of solar direct driven fridges SDD in health facilities replacing aged solar, kerosene fridges or new immunization service facilities

11. Continue supporting counties generators in vaccine stores that are also used for freezing icepacks for SIAs Continue supporting generators maintenance

12. 12 EPI Standard Cold boxes

13. 13 EPI standard vaccine carriers

14. CHALLENGES Lack of funds for cold chain equipment. The December 2013 crisis caused many damage to the cold chain system (looted, vandalized). Shortage of qualified staff at all level. Lack of infrastructures in the country leading to high cost of program implementation. Poor maintenance of equipment installed. The last comprehensive cold chain inventory was carried out in 2012. Proposal submitted in 2016 were approved by donor but no fund received yet. Poor infrastructure resulting into expensive logistics for delivery of vaccines and supplies.

15. Transport barriers What the roads become during the rainy season Where roads don’t exist

16. Other Essential Commodities Subject to funding, other commodities procured – Malaria Commodities Anti-malarial drugs (Artemisinin-based Combination Therapy – ACTs) Rapid Diagnostic Tests Bed Nets (LLITNs) – IMCI/iCCM commodities Amoxicillin Oral Rehydration Salts Antimalarial