Yellow fever causes an estimated 200,000 cases and 30,000 deaths each year, primarily in sub-Saharan Africa. In order to protect at-risk populations, the World Health Organization (WHO) recommends routine infant immunization, and mass vaccination campaigns in high-risk areas and control of the mosquito Aedes aegypti in urban centers.
Since 2007, the GAVI Alliance has provided support to increase vaccination coverage. A condition of funding is the implementation of AEFI (adverse events following immunization) surveillance. However, many poor countries do not have functional national pharmacovigilance (PV) systems in place, capable of providing accurate surveillance data. This is due primarily to a lack of resources, infrastructure, and local PV expertise.
In this context, AMP is supporting WHO and ministries of health in several African countries (Togo, Mali, Burkina Faso, Cameroun, Benin, Guinea) to establish AEFI surveillance by:
- Developing surveillance tools (e.g., operational guides, notification and investigation forms, standard operating procedures for taking and transporting biological samples)
- Introducing active case-finding methods
- Creating and training national expert committees to review and classify suspected serious AEFIs
In support of AMP's work, local, and international reference laboratories—including the Institut Pasteur in Cameroon and the Robert Koch Institute in Germany—have provided diagnostic test results to facilitate the yellow fever AEFI classification process. Best practices have been shared between different countries and African-based consultants have been trained to become local experts. Their expertise is now being requested for AEFI surveillance of additional vaccines such as the meningococcal A conjugate vaccine.