Background

Shortly after the May 1985 announcement of the regional goal to eradicate wild poliovirus by 1990, the Director of the Pan American Health Organization (PAHO) appointed a Technical Advisory Group (TAG) to provide evidence-based recommendations on strategies to achieve the goals set forth by the Expanded Programme on Immunization (EPI). The TAG's aims have expanded over the last few decades and now its current mandate is to advise on all efforts to achieve regional immunization goals, including eradication, elimination and control of vaccine-preventable diseases. TAG meetings serve as the leading regional forum to review and promote immunization progress in the Americas.

Functions

TAG is the principal technical advisory group for vaccines and immunization in the Americas. The committee is responsible for advising the PAHO Director and Secretariat on regional vaccination policies, strategies and tactics. TAG advises on a broad range of issues related to vaccines (e.g. research and development, safety, adoption and use, post-marketing surveillance) and immunization (e.g. delivery strategies, targets, health systems strengthening, linkages with other interventions, acceptability, communication and monitoring). TAG makes recommendations on vaccines and immunization for all populations, including children, adolescents and adults. TAG also reviews progress made and results achieved by national immunization programs. With the support of the Secretariat, TAG is also tasked with defining a regional research agenda and monitoring its implementation to drive immunization policy in the Americas.

Specifically, TAG advises the PAHO Director on:

  1. Optimal strategies and tactics to achieve the goals of the immunization program, in the context of the Regional Immunization Action Plan and beyond, including measles elimination, maintenance of polio and rubella free status and control of all other vaccine-preventable diseases;
  2. Major issues or program priorities that arise in the implementation of the Regional Immunization Action Plan;
  3. Immunization program response to relevant public health concerns and priorities in the Americas;
  4. Vaccine and immunization research agendas and implementation in the Americas to support evidence-based policy formulation;
  5. Engagement between PAHO and partners, including technical institutions, bilateral/multilateral and private agencies, and political leaders, to advance the regional immunization agenda and goals in the Americas;

In addition, the Director appoints TAG members to carry out the following activities:

  • Participate in missions at the regional and country level for progress reviews and technical update meetings;
  • Convene and chair working groups when necessary to inform TAG recommendations with the necessary evidence-based information; and
  • Promote activities geared towards National Immunization Technical Advisory Groups (NITAGs) strengthening, including encouraging the participation of NITAG members in TAG meetings and other PAHO Immunization Regional and Sub-Regional meetings.

Membership

TAG comprises nine independent experts, who shall serve in their individual capacity and represent a broad range of disciplines required for balanced immunization policy formulation. Members should refrain from promoting the policies and products of the institution for which they work.
 
TAG Members are identified, recruited and selected as recognized independent experts in the Americas from the fields of public health, epidemiology, vaccinology, immunology, pediatrics, internal medicine, infectious diseases, program management and/or health economics. The composition of the committee shall represent a broad range of expertise as well as professional affiliation, geographic representation and gender balance.
 
PAHO Director appoints all members including the Chair. PAHO Comprehensive Family Immunization Unit serves as the technical Secretariat for the TAG.
 
TAG Members receive appointments for an initial term of four years, with the possibility for one additional term renewal at the discretion of the PAHO Director. Exceptions to serving more than two terms are made for the TAG Chair to ensure continuity and smooth transition in Membership. TAG Chairs are required to serve as a TAG Member for one term before his or her selection and appointment and he or she must commit to fulfilling at least one term in the capacity of Chair, when selected. Additionally, the TAG Chair may be appointed to serve for an additional term as TAG Chair following their initial appointment for a maximum of three consecutive terms (one in regular Membership and two in the role of Chair).

Membership in TAG may be reexamined at the discretion of the PAHO Director for any of the following reasons:

  • Failure to attend two consecutive TAG meetings;
  • Change in affiliation resulting in a conflict of interest or involvement in activities resulting in conflict of interest incompatible with serving on TAG; or
  • A lack of professionalism, for example, breaching confidentiality agreement.
Existing TAG members shall be subject to the Terms of Reference upon their entry into effect.

Meetings and operational procedures

TAG meetings occur on a biennial basis and include participation from TAG Membership, PAHO Secretariat and PAHO Member States' National Immunization Programs. The PAHO Secretariat will work with the TAG Chair and Members to develop a work plan and research agenda that will guide the work of TAG and policy tasks. The biennial meetings shall normally be held in July every other year. Meeting agendas shall be circulated at a minimum one month in advance of meetings with the accompanying research and background materials to inform the policy discussion, recommendations and updates.

Ad hoc meetings may be called in the event of emergencies or as needed. In-person attendance by TAG Members at ad hoc meetings will not be required; participation may be via telephone, video conference, electronic meeting or other technology that permits real-time exchanges.

TAG Members will be asked to update their Declarations of Interest before each meeting. TAG Members with potentially conflicting interests will not participate in deliberations on specific topic(s) for which they would have a conflict of interest.

TAG recommendations will be made by consensus. The TAG Chair with the Immunization Unit Chief will brief the PAHO Director on the meeting outcomes. The record of the report, with the approval of the PAHO Director, will be made public within one month following the meeting.

All managers of national immunization programs in the Americas will be invited to the biennial TAG Meetings. Additionally, Chairs of the NITAGs may be invited to ensure rapid translation of regional technical recommendations to the local level. Other major regional immunization stakeholders, including UNICEF, Bill and Melinda Gates Foundation, Gavi, US CDC, among others, may be invited to contribute to discussions. Additional experts may be convened to participate in technical sessions, when relevant.

Ad-hoc working groups will be formed as deemed necessary by the TAG and the Secretariat. These working groups will work on specific topics by reviewing and providing evidence and options for recommendations to be discussed by TAG members at biennial meetings. The working groups will function for a limited period of time and should always be presided over a TAG member.


Roles and responsibilities of TAG

Members of TAG have a responsibility to provide PAHO with evidence-based, well considered advice and recommendations on matters described in these terms of reference. TAG has no executive or regulatory function. Its role is to provide advice and recommendations to the Director of PAHO. This may include providing advice and recommendations on urgent public health issues as needed.

TAG Members may be approached by non-PAHO entities for their views, comments and statements on particular matters of public health concern and asked to share the views of TAG. TAG members shall refer such enquiries to PAHO.

TAG Members will not be remunerated for their participation in TAG; however, reasonable expenses such as those related to travel and lodging incurred by attendance at TAG will be reimbursed.

TAG Members are expected to attend each biennial meeting. Further active participation will be expected from TAG Members throughout the year, which may require email communication, teleconferences and/or in-person meetings. PAHO Secretariat will work with TAG Members to identify opportunities for TAG Members to actively participate in annual regional immunization activities, where schedules, interest and expertise align, including participation in TAG Working Groups, sub-regional immunization meetings, regional trainings and/or subject matter specific technical updates (i.e. surveillance and laboratory, new vaccine introduction, program evaluation, evidence-based decision making, data quality and analysis, etc.)

The secretariat of TAG is organized by the PAHO Comprehensive Family Immunization Unit (IM) of the Department of Family, Health Promotion and Life Course (FPL). The function of Executive Secretary is carried out by the Unit Chief who directs this unit.

These Terms of Reference may be reviewed and adjusted as determined by the PAHO Director.