EXPANDED PROGRAM IN IMMUNIZATION

Commodity, TA, training, and research support will help build a permanent institutional capability within the Government of Indonesia (GOI) to produce and distribute vaccines at an expanded level. The project will help P.N. Biofarma, the GOI"s pharmaceutical company, to expand its production facilities, train new personnel, and, eventually meet Indonesia"s demand for three vaccines against tuberculosis, diphtheria, pertussis, tetanus, and neonatal tetanus. Biofarma will receive both short-term TA and the heavy equipment needed to generate power for vaccine production. A major project thrust will be to establish a cold chain network for vaccine distribution. The project will support MOH procurement of vehicles (refrigerator trucks, jeeps, motorcycles, bicycles, and boats) and refrigerated storaged facilities. The U.S. Centers for Disease Control will provide long- and short-term TA and on-the-job training to Biofarma and GOI staff in managing the cold chain at all levels - from production to vaccination - while long- and short-term participant training in cold chain management will be provided to 15 Biofarma and 25 GOI staff. Cold chain R&D will be conducted at the Bandung Institute of Technology. One long-term and several short-term advisors will help the MOH establish a health management information system (to include surveillance, management reporting, and public information subsystems). Fifty Indonesians will receive long-term U.S. training in this area, 52 will receive short-term U.S. or third-country training, and others will benefit from seminars and on-the-job training. Amendment of 7/13/87 extends project to 9/30/90 and provides additional funds to: (1) reduce missed immunization opportunities (by reforming EPI guidelines, establishing a reference library and data base, fieldtesting new technologies, and including EPI services in public and private clinical facilities); (2) increase EPI demand (through social marketing and increased community support); (3) decentralize management (by introducing area-specific planning and local monitoring systems, and upgrading the training of health professionals responsible for supervision); and (4) enhance sustainability - through cost studies and advocacy efforts aimed at increasing GOI budgetary support, and through increased self-sufficiency in vaccine procurement. (PD-CAU-315)