Note on the third meeting of the National Immunization Technical Advisory Groups (NITAGs) of the Americas

Ecuador, 2024, December (PAHO). Aligned with Panamerican Health Organization (PAHO) commitment and consistent with the Immunization Agenda 2030, which aims to sustainably and equitably reduce mortality and morbidity caused by vaccine-preventable diseases (VPEs), the Special Program on Integrated Immunization (CIM) organized the third Regional NITAG Network meeting of the Americas from December 2-4, 2024, in Quito, Ecuador.

The objectives of this meeting were to: update on the activities of the Regional NITAG Network of the Americas (RNA), hear the voice of the NITAGs in relation to the examination of priority immunization policy issues, share lessons learned on priority immunization issues, and discuss the roadmap for optimizing national immunization programs in the Americas.

More than 200 participants attended, including NITAG presidents and members, national immunization program managers, NITAG secretariat members, as well as partner representatives such as CDC, GAVI, UNICEF, Linked, Florida International University and WHO. The event was inaugurated by the Minister of Health of Ecuador, Dr. Antonio Naranjo Paz y Mino; the Executive Manager of CIM/PAHO, Daniel Salas; the President of the NITAG of Ecuador, Greta Muñoz; and the representative of PAHO Ecuador, Sonia Quezada Bolaños.

The meeting was key to making progress and fostering important discussions. The need for a strategic plan to strengthen the NITAGs was highlighted. The results of the self-assessment of the 23 NITAGs in the Region were analyzed, identifying areas to improve their performance and relevance in decision making. In shared learning, successful twinning programs were highlighted as models for strengthening technical capacities and fostering mutual growth. The limitations of vaccination legislation were also addressed, highlighting the need to adapt regulations to ensure equitable and universal access to vaccines. In addition, the importance of incorporating new frameworks and methodologies to prioritize new vaccines, using economic evidence and cost-effectiveness analysis, among others, was highlighted. The urgency of designing initiatives to make the impact of NITAGs visible and promote lessons learned through open platforms such as the RNA and the Global NITAG Network (GNN) was discussed.

Next steps include:

• Update NITAG Terms of Reference to ensure relevance and clarity in their roles;

• Implement conflict of interest policies;

• Improve transparency to promote credibility and trust;

• Use the RNA and GNN platforms;

• Attend trainings on prioritization of new vaccines to strengthen NITAG capacities;

• Formalize Standard Operating Procedures and regularly evaluate NITAGs to ensure efficient and effective operation;

• Use the Evidence to Recommendation framework to formulate recommendations and strategies in the field of immunization;

• Strengthen twinning programs and develop communication strategies to make visible and share best practices;

• Develop cost-effectiveness and public health impact studies to support evidence-based decision making;

• Develop a specific vaccinology course for NITAGs in the Americas;

• and compile evidence on immunization laws to guide policy decisions in the countries.