The role of National Immunisation Technical Advisory Groups (NITAGs) in strengthening national vaccine decision-making: A comparative case study of Armenia, Ghana, Indonesia, Nigeria, Senegal and Uganda.

INTRODUCTION: Improving evidence informed decision-making in immunisation is a global health priority and many low and middle-income countries have established National Immunisation Technical Advisory Groups (NITAGs) as independent technical advisory bodies for this purpose. NITAG development and strengthening has received financial and technical support over the past decade, but relatively little evaluation. This study examined NITAGs in six low and middle-income countries (i.e. Armenia, Ghana, Indonesia, Nigeria, Senegal, Uganda), to examine functionality, quality of recommendation development, and integration with national decision-making bodies and processes. METHODS: A mixed-method case-series design, used semi-structured interviews, NITAG meeting observations, and document review. Data were analysed thematically. RESULTS: Five NITAGs had been legally established with terms of reference and appeared well functioning, with Ghana's in development. All NITAGs had standard operating procedures and nomination procedures to ensure a range of expertise, generally comprising 10-15 core, 1-5 secretariat, and several ex-officio members. Aside from economics, NITAGs reported a wide range of member expertise. Newer NITAGs had particular concerns about funding. Four used formal conflict of interest procedures, although some commented that implications were not always understood. NITAGs valued local data, and limited evidence suggested NITAG presence might reinforce data production through surveillance and local research studies. All observed meetings demonstrated due process and evidence-based decision-making processes were generally followed, with a critical role played by working-group data syntheses and assessments. NITAGs were seen as well integrated with ministry of health (MoH) decision-making and MoH interviewees were positive about NITAG contributions, indicating NITAGs had an important role. Collaboration with other bodies was more limited, but mitigated by NITAG members' cross-membership in other bodies. CONCLUSIONS: NITAGs have an important and valued role within national immunisation decision-making. However, their position remains insecure, with the need for sustainable technical and financial support

Human Rights Beyond Borders at the World Court: The Significance of the International Court of Justice's Jurisprudence on the Extraterritorial Application of International Human Rights Law Treaties

This article uses the case study of the question of whether human rights treaty law applies extraterritorially as a means of exploring the general theme of the value of the International Court of Justice's involvement in human rights, when compared to such involvement by specialist human rights bodies. The Court's express pronouncements on the issue, in the Wall Advisory Opinion, the DRC v. Uganda judgment, and the Provisional Measures Order in Georgia v. Russia, as well as an earlier more general statement in the Namibia Advisory Opinion, are compared to determinations on the issue by specialist courts and tribunals. The article begins by setting out the broader historical context of the ICJ's involvement in human rights issues. It then analyses the different ways in which this involvement can be critically appraised, in the process making the case for the focus adopted herein, on a comparison between the role of the Court and that of specialist human rights tribunals on issues of meaning/interpretation rather than application/enforcement, and, within this, on comparative analysis concerned with the generalist/specialist distinction itself rather than the relative merits of positions taken on the substantive law. Such a focus is then deployed through a detailed critical evaluation of the Court's statements in the decisions indicated. Finally, the article summarizes the significance of the Court's determinations on the extraterritorial application of human rights law, and the broader relevance of these determinations for understanding the role of the ICJ in the field of human rights more generally

Science advice to governments: diverse systems, common challenges

This briefing paper formed the basis of discussions at the 'Science Advice to Governments' summit, which took place in Auckland, New Zealand from 28-29 August 2014, and was attended by science advisors and policymakers from 48 countries

The process of setting micronutrient recommendations: a cross-European comparison of nutrition-related scientific advisory bodies

Copyright @ The Authors 2010Objective: To examine the workings of the nutrition-related scientific advisory bodies in Europe, paying particular attention to the internal and external contexts within which they operate. Design: Desk research based on two data collection strategies: a questionnaire completed by key informants in the field of micronutrient recommendations and a case study that focused on mandatory folic acid (FA) fortification. Setting: Questionnaire-based data were collected across thirty-five European countries. The FA fortification case study was conducted in the UK, Norway, Denmark, Germany, Spain, Czech Republic and Hungary. Results: Varied bodies are responsible for setting micronutrient recommendations, each with different statutory and legal models of operation. Transparency is highest where there are standing scientific advisory committees (SAC). Where the standing SAC is created, the range of expertise and the terms of reference for the SAC are determined by the government. Where there is no dedicated SAC, the impetus for the development of micronutrient recommendations and the associated policies comes from interested specialists in the area. This is typically linked with an ad hoc selection of a problem area to consider, lack of openness and transparency in the decisions and over-reliance on international recommendations. Conclusions: Even when there is consensus about the science behind micronutrient recommendations, there is a range of other influences that will affect decisions about the policy approaches to nutrition-related public health. This indicates the need to document the evidence that is drawn upon in the decisions about nutrition policy related to micronutrient intake.This work has been carried out within the EURRECA Network of Excellence (www.eurreca.org) which is financially supported by the Commission of the European Communities, specific Research, Technology and Development (RTD) Programme Quality of Life and Management of Living Resources, within the Sixth Framework Programme, contract no. 036196

Better community engagement: a framework for learning

Because different needs and priorities call for different approaches, the document does not present a single curriculum. Instead it provides a statement of the purpose, elements and competences for community engagement practice that should enable training providers to develop their own curricula to address the needs of practitioners operating in different settings. We hope that this approach can make a significant contribution to establishing a range of learning opportunities that will deliver the best practice needed to deliver on policy commitments and to put communities first

Value and effectiveness of National Immunization Technical Advisory Groups in low- and middle-income countries : A qualitative study of global and national perspectives

© The Author(s) 2019. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.The Global Vaccine Action Plan proposes that every country establish or have access to a National Immunization Technical Advisory Group (NITAG) by 2020. The NITAG role is to produce evidence-informed recommendations that incorporate local context, to guide national immunization policies and practice. This study aimed to explore the value and effectiveness of NITAGs in low- and middle-income countries (LMICs), identifying areas in which NITAGs may require further support to improve their functionality and potential barriers to global investment. A multi-methods study design was used, comprising 134 semi-structured interviews and 82 literature review sources that included 38 countries. Interviews were conducted with 53 global/regional and 81 country-level participants able to provide insight into NITAG effectiveness, including NITAG members, national immunization programme staff, and global agency representatives (e.g. the World Health Organisation, the Bill and Melinda Gates Foundation, Gavi the Vaccine Alliance). The review, including published and unpublished sources on NITAGs in LMICs, was conducted to supplement and corroborate interview findings. Data were analysed thematically. NITAGs were described as valuable in promoting evidence-informed vaccination decision-making, with NITAG involvement enhancing national immunization programme strength and sustainability. Challenges to NITAG effectiveness included: (1) unreliable funding; (2) insufficient diversity of member expertise; (3) inadequate conflicts of interest management procedures; (4) insufficient capacity to access and use evidence; (5) lack of transparency; and (6) limited integration with national decision-making processes that reduced the recognition and incorporation of NITAG recommendations. LMIC NITAGs have developed significantly in the past decade. Well-functioning NITAGs were trusted national resources that enhanced country ownership of immunization provision. However, many LMIC NITAGs require additional technical and funding support to strengthen quality and effectiveness, while maintaining impartiality and ensuring sufficient integration with national decision-making processes. Barriers to sustainable global support need to be addressed for LMIC NITAGs to both continue and develop further.Peer reviewedFinal Published versio

Building the System: Follow-up, monitoring & adaptive management

Does impact assessment (IA) end when the license has been granted? While societal resources tend to focus on rigorous project approvals, what happens to the project, to the public and to the environment once approval is granted? Follow up and monitoring are often an afterthought for legislators, public servants and proponents. But they are critical to public confidence and to ensuring that proponents live up to their commitments in a rapidly changing world."This report draws from research funded by the Impact Assessment Agency as part of the Social Sciences and Humanities Research Council of Canada Knowledge Mobilization Grant on Informing Best Practice in Environmental and Impact Assessment.