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Introduction
The National Immunization Technical Advisory Group (NITAG) in the Republic of South Africa is the National Advisory Group on Immunization (NAGI). This committee was established in 1993 to advise the Department of Health (DoH) on issues related to vaccination. Prior to that time no committee had existed, so decisions concerning vaccines and immunization had been taken on the basis of ad hoc consultations or discussions with local experts and WHO.
The first NAGI was established in the dying days of the apartheid government when the country was largely isolated from the international community and when scientific and academic contacts were substantially restricted. Following on the first democratically elected government, NAGI enjoyed greatly enhanced access to international expertise during the rest of its first 5-year term as well as seeing a strengthening of the immunization program.
The South African NAGI consists of 9 regular members representing disciplines of paediatrics, vaccinology, community health, virology, microbiology, infectious diseases, neurology, pulmonology and medicines regulation. In addition there is also ex officio representation from the DoH and the country offices of the WHO and UNICEF - making a total of 14 participants (Table 1 ).
Terms of reference and process of meetings
NAGI was established by a letter of appointment from the Ministry of Health (MoH) that included a brief outline of the committee's mission. There are terms of reference [1] that were attached to the letter of appointment. These spell out clearly what inputs the MoH expects from NAGI and the process through which NAGI recommendations should be communicated to the ministry.
The documents produced by the committee are not public. Recommendations and other documents such as rationales for introducing new vaccines (including assessments of disease burdens and cost-benefit analyses) are sent to the DoH. NAGI minutes are sent to the Director General of Health for perusal who liaises with the MoH on a need basis, or vice versa.
The MoH appoints all the members to the committee, based on expertise and merit. Appointment to NAGI is made via a letter from the MoH. No contract is drawn up since members serve in honorary, non-remunerative capacities and each member is appointed to a five-year term that is renewable. Vacancies created by resignation may be filled by the...