The Ethiopian National Immunization Technical Advisory Group
The Ethiopian National Immunization Technical Advisory Group is established to provide unbiased and evidence-based recommendations to the Ministry of Health. The Ministry of Health (MOH) makes final decisions on all recommendations provided by the E-NITAG. The Ethiopia NITAG was officially appointed in May 2016. The core members and invited non-core members received extensive orientation on the roles, procedures, and expectations. During that workshop, the E-NITAG developed its procedures and guidelines. The E-NITAG also elected Prof. Yemane Berhane as its first chairperson and Prof. Telahun Teka as vice-chairperson.
Photo: The E-NITAG Members at the orientation workshop, 16-18 May 2016. Bishoftu, Ethiopia
The E- NITAG reviews vaccine characteristics, vaccine-preventable disease epidemiology, and programmatic capacity to determine the optimal national policies on vaccines and immunization. The engagement includes reviewing evidence related to existing vaccination policies, the introduction of new vaccines, and strategies for the control of vaccine-preventable diseases through immunization. The E-NITAG recommendations shall be based on scientific evidence, the epidemiology of vaccine-preventable diseases, and the implementation capacity of the national immunization programme.
The E-NITAG mandate covers all vaccine-preventable diseases and therefore its recommendation will help the functionality of the existing technical working groups (Communication technical working group, Monitoring and evaluation technical working group, and logistics technical working group). The main EPI task force of the MoH will serve as entry point for the E-NITAG recommendations to the MoH for endorsement of the decisions. Issues within the mandate of the E-NITAG are channeled to the E-NITAG through the EPI case team of the Ministry of Health. All prior technical advisory responsibilities of the ICC devolve to the ENITAG. However, committees in charge of certification and eradication will remain independent from the E-NITAG.
The Core-Members of the E-NITAG are selected based on their individual merits and do not represent their home Institutions. The core members may include 10–15 experts working in their individual capacities. Members are selected to cover a broad range of experts. The E-NITAG membership is a voluntary unpaid contribution. However, costs related to the meeting and other related activities will be covered by the MoH. The service of the core members is limited to two terms, each term is three years. The E-NITAG can invite non-core members upon the recommendation of the MOH or by itself. Non-core members include key immunization stakeholders. The EPI relevant technical staff are Ex-officio members holding and the EPI manager is the secretary of the E-NITAG. The non-core and Ex-officio members are non-voting.
The E-NITAG routinely meets at the MoH, however, the E-NITAG may decide to meet elsewhere as deemed necessary for deliberations. The E-NITAG shall meet at least twice per year. Additional meetings can be called as necessary to expedite decisions on urgent or emergency conditions.
The chairperson ensures the quorum for the meeting is met for each meeting. A Conflict of Interest as well as a Confidentiality Agreement are signed by core E-NITAG members when accepting to become a member of the E-NITAG. The Conflict of Interest and the Confidentiality Agreement are inquired about and recorded in each meeting.
The E-NITAG receives requests for deliberations from the MOH with relevant documents. Usually, the documents are received at least one week in advance of the scheduled meetings. The E-NITAG adopted a procedure to address specific requests, as shown in the figure below. The E-NITAG also invites experts in the field or EPI experts to present the case and provide additional explanations.
The E-NITAG since the first year of its establishment has fulfilled the six functionality criteria; including the composition of core members (at least five areas), meeting frequency (at least one meeting in a year), declaration of conflict of interest by core members, agenda sent ahead of meeting with background document (at least a week prior to the meeting), the existence of legislative basis, and presence of a TOR. The E-NITAG has become a member of the Global Network of NITAGs in 2017. The E_NTIAG also attended several SAGE and RITAG meetings in-person and virtually.
The E-NITAG has deliberated and put forward recommendations on many critical immunization issues since its establishment including the introduction of additional vaccines into the routine vaccination programme and addressing emerging issues such as the COVID-19 vaccine introduction. The E-NITAG successfully completed its first term and continued into the second term. In the second term, membership has expanded to include relevant disciplines.