PAHO is conducting an external evaluation of the Immunization Program with the objective to strengthening the technical cooperation provided to countries and territories in the Region of the Americas.

 I. Description and Overall Purpose of the Evaluation

The aim of this evaluation is to assess the Regional Immunization Program's role in the context of the technical cooperation (TC) mandates of the Pan American Health Organization (PAHO), including its support to countries in the proper implementation of the Global and Regional mandates (Global and Regional Immunization Action Plan; the Pan American Health Organization, Strategic Plan 2014-2019; 2016-2017 Program Budget; and the 2016-2017 Biennial Work Plan). This evaluation will serve to identify strategic and practical elements to improve the Organization’s TC on immunization for the Region.

II. Main and Specific Objectives

Main Objective

To analyze the response of the RIP in meeting the needs of Member States as they strive to ensure universal vaccination coverage.

Specific Objectives
  • Assess the progress of the RIP in supporting countries to achieve the Global and Regional Mandates on immunization in the Region of the Americas.
  • Develop a conceptual map regarding the RIP’s current strategies, processes, interactions, results, and impact.
  • Assess the roles of and coordination between the RIP and the Revolving Fund in providing TC to immunization programs in countries, specifically related to annual vaccine forecasts and supplier engagement.
  • Examine the performance [the quality, timeliness, effectiveness, etc.] of the RIP in the Secretariat and at country level in the delivery of its TC to Member States.
  • Identify opportunities to maintain adequate vaccination coverage and quality epidemiological surveillance of vaccine preventable diseases (VPD), with specific emphasis on populations living in vulnerable situations.
  • Provide recommendations (opportunities for improvement) and lessons learned to direct future TC between the RIP and Member States.

III. Composition of the Independent Evaluator Group (established October 2018)

Dr Elizabeth Ferdinand (Barbados). Dr Ferdinand was born in Canje, New Amsterdam, Guyana. After attending secondary school in Guyana and in the UK, she completed her medical degree at the University of the West Indies, Mona, Jamaica. In December 1975 she came to Barbados and worked first with the Barbados Family Planning Clinic and then in the Casualty Department of the Queen Elizabeth Hospital. Following that she began working with malnourished children which led to her studying Public Health. After gaining her master's degree in Public Health from Harvard University she was appointed senior medical officer at the Ministry of Health, assuming greater responsibility for the national primary health care services. She was instrumental in leading the team which saw Barbados being certified polio free, the introduction of many new vaccine antigens and in 1999 she was seconded for three years to the Barbados office of the Pan American Health Organization (PAHO). On her return to the Ministry of Health she worked in many areas including immunization and disaster management. On retirement she became a part time lecturer at the University of the West Indies assisting in the undergraduate and post graduate courses in the medical faculty. She was awarded with the PAHO Immunization Award and the "Silver Crown of Merit" by Barbados for her work in medicine. 

Dr Jorge Bermudez (Brasil). Dr Jorge Bermudez graduated from the Faculty of Medicine of the Rio de Janeiro Federal University (UFRJ) in 1971 and earned his Master’s degree in Infectious and Parasitic Diseases (Tropical Medicine) from the same university in 1976. He received a Doctorate of Science in Public Health from the National School of Public Health (ENSP), Fiocruz, where he holds the position of Senior Researcher. Prior to returning to Fiocruz in 2011, he served as Unitaid Executive Director for a 4-year mandate from 2007 to 2011, based in Geneva and hosted by WHO. Between 2004 and 2007, Dr Bermudez was selected and served as Unit Chief for Medicines, Vaccines and Health Technologies Unit at PAHO/WHO, Washington DC, for the region of the Americas, after having been elected and served as Director for ENSP/Fiocruz (2001 to 2004) and previously Research Coordinator (1997 to 1998).

Dr Bermudez was President of the Institute Vital Brazil, Rio de Janeiro and linked to the State Government on two occasions (1999 to 2001 and 1987 to 1991), as well as President of the Association of Official Pharmaceutical Laboratories of Brazil (ALFOB). Additionally, he served as Deputy Executive Secretary of the Ministry of Health in 1993 and Director of Farmanguinhos (Fiocruz) between 1985 and 1987. He has published articles, books and book chapters on issues such as public health, pharmaceutical policies, access to medicines and intellectual property, while he also supervises students who undertake masters and doctoral degrees in these areas

Currently he is Head of the Department of Pharmaceutical Policies at the National School of Public Health/ Fiocruz, a PAHO/WHO Collaborating Centre for Pharmaceutical Policies. He was Vice-president of Health Production and Innovation at FIOCRUZ from 2011 to 2017 and a member of the UN Secretary-general High Level Panel on Access to Medicines.

Dr. Fernando De la Hoz (Colombia). Dr. Fernando de la Hoz Restrepo is full Professor at the Department of Public Health of the School of Medicine in Universidad Nacional de Colombia (Colombian National University. He is a Medical Doctor from the Universidad Libre de Colombia -Seccional Atlántico- and holds a PhD degree in Infectious Disease Epidemiology from the London School of Tropical Medicine and Hygiene. He has an MSc degree in Epidemiology from the Colombia´s University of the Valle and is a former trainee from the Colombian Field Epidemiology Training Program (FETP), which is sponsored by the Colombian National Institute of Health, USCDC, and TEPHINET (Training Programs in Epidemiology and Public Health Intervention Network).

He has worked for the Colombian National health Institute as General Director, Acting Director of Pubic Health Laboratories and Epidemiology, and scientific researcher. In addition, he led the National Program for Health Research and Technological Development at Colciencias, the Colombian agency for Research Development.  He has been part of editorial teams of Colombian medical journals such as: Biomedica (the Journal from the Colombian National Institute of Health), the Revista de Salud Publica (Journal of Public Health of the Colombian National University), and Infectio (Journal of the Colombian Association for Infectious Diseases).

His area of research includes economic and outcome evaluation of vaccination programs in Colombia and other countries. He has conducted field assessments of the effectiveness (Phase IV) of old and new vaccines in Colombia (pertussis, hepatitis B, rotavirus, Haemophilus influenza type b, and conjugated pneumococcal vaccines).   He has coauthored more than 100 papers published in national and international peer review journals and has served as academic supervisor for 11 PhD students and more than 30 MSc students.  Also, he was member of the Advisory Committee on Health Research for the Panamerican Health Organization (2006-2010), member of the WHO´s  Quantitative Immunization and Vaccines Related Research (QUIVER) Advisory Committee, and member of the WHO´s Immunization and vaccines related implementation research advisory committee (IVIR-AC) (2008-2014).  

IV. PAHO secretariat

  • Focal point: Andres De Francisco
  • Technical support: Cuauhtémoc Ruiz, Alba Maria Ropero, Martha Velandia


From left to right: Dr. Bermudez, Dr. Ferdinand, Dr. De la Hoz.

Declaration of interests

All members completed a declaration of interest and they declared no to have any interest that could affect their objectivity or independence in the performance of their duties in this evaluation.

According to PAHO's Guidelines for Declaration of Interests they have to declare any interest in (including association with) any entity with which they have may be required directly or indirectly or have official dealings on behalf of the Organization or which has a commercial inters in the work of PAHO or a common area of activity with PAHO. In addition as a result of PAHO’s strong stance against tobacco use, it is considered relevant for designated staff to disclose to the Organization whether they their supposes o depend children have any relationship with any part of what may be called “the tobacco industry”