Dili, October 25: A team of national and international experts has successfully concluded a comprehensive two-week review of Timor-Leste’s Expanded Programme on Immunization (EPI) and Vaccine-Preventable Disease (VPD) surveillance systems. The review, conducted from October 14 to 25, marks the first such exercise in nearly nine years and was the result of months of planning and coordination.
The review team, comprising 12 experts from the US CDC, the University of Sydney, WHO Headquarters, WHO SEARO, WHO Bangladesh, UNICEF EAPRO, NCIRS Australia and the Ministry of Health of Indonesia, alongside national officials and WHO and UNICEF in country officials visited 13 municipalities covering 73 health facilities, and conducted 14 interviews with national officials involved in immunization policy and planning in the country.
On Friday, the exercise concluded with a debriefing session attended by Dr Élia A. A. dos Reis Amaral, Minister of Health; Dr Arvind Mathur, WHO Representative; and Ms Ainhoa Jaureguibeitia, UNICEF Deputy Representative, officials from Ministry of Health, municipalities, partner agencies, as well as both national and international reviewers.
Prof Julie Leask, professor at the University of Sydney’s School of Public Health, presented a summary of the review team’s findings, noting that the experts would submit more detailed observations in a forthcoming comprehensive report.
Dr Amaral said that vaccination has reshaped public health, boosting life expectancy for Timorese citizens by more than 10 years; besides playing a major role in elimination of polio, maternal and neonatal tetanus, measles and more recently rubella. She affirmed that the Ministry of Health will thoughtfully review and act on the committee’s findings to strengthen “immunization services, making them more robust and responsive”.
Dr Mathur commended the team of experts for their tireless efforts in gathering data and insights across national, municipal, and community levels. He explained that the review aimed to assess the program's current status and examine all facets of vaccination—ranging from vaccination modalities, storage, waste disposal and documentation to the training of healthcare staff. He highlighted that the review comes at a significant time, with the country having successfully achieved a 96% HPV vaccination rate among targeted girls.
“As we move forward, it is essential to translate the lessons from this review into actionable strategies,” he stated.
Ms Jaureguibeitia expressed her gratitude to frontline health workers and partners for their dedication to expanding immunization efforts. Calling the review timely, she said, “Since the last review, Timor-Leste has enhanced its routine immunization program by introducing three new vaccines for children under five and COVID-19 vaccines for those over 12”. She emphasized that the findings would contribute to the development of the 2025-2030 National Immunization Strategy.
Prof Leask said that the review was timely, as the last assessment of Timor-Leste’s immunization program took place in 2015. She explained that the team primarily focused on examining the overall implementation of EPI and VPD systems as well as conducting post-introduction evaluations for the pneumococcal conjugate vaccine (PCV), which was introduced last year, and the COVID-19 vaccines.
Key areas of focus included program management and financing, human resource management, vaccine supply, quality and logistics, service delivery, adverse effects following immunization (AEFI) surveillance, vaccine-preventable disease surveillance and demand generation among others.
Presenting the team’s preliminary findings, Prof Leask emphasized the need for the program to evaluate and strengthen several areas: securing dedicated local funding, enhancing coverage monitoring, expanding health personnel training, implementing effective waste management, improving AEFI detection and appropriate response and ensuring timely reporting and response on outbreak investigation, among other priorities. “There is a strong commitment to immunization in Timo-Leste,” Leask summed up.