How a Training the Trainer program delivers education to fight the deadly illness.

Dr. Téné-Alima Essoh, Director, Agence de Médecine Préventive and Caroline Forte, Vaccines Corporate Affairs Lead, Pfizer

An innovative Training of Trainers program has empowered more than 44,000 healthcare workers across 24 Gavi-supported countries to administer a novel presentation for a vaccine for pneumococcal disease.


Diseases caused by Streptococcus pneumoniae are a critically important global public health problem as infection with S. pneumoniae continues to be a major cause of death and disease worldwide.

In 2005, the World Health Organization estimated that 1.6 million people die from pneumococcal disease each year, roughly one million of whom are children under the age of five in developing countries.

In 2000, prior to widespread introduction of pneumococcal conjugate vaccines, there were approximately 14.5 million episodes of serious pneumococcal disease, which resulted in around 826,000 deaths in children under the age of five.

Conditions associated with immune deficiency – such as HIV infection – can greatly increase the likelihood of contracting pneumococcal disease. Additionally, pneumococci bacteria are increasingly becoming resistant to conventional antibiotics, which underlies the urgent need to focus on administering vaccines to help control pneumococcal disease.

Source: Gavi, the Vaccine Alliance

Thankfully, there are vaccines available that can help prevent this dangerous disease. However, delivering these vaccines to the far reaches of developing countries can be difficult, which is why the multi-dose vial, a novel vaccine presentation developed by Pfizer for one of its vaccines, is critically important. It helps organisations deliver the vaccine more efficiently through the last mile to people that need it the most.

But in order for multi-dose vaccine vials to be successfully delivered and administered in Gavi countries across the globe, thousands of health care workers needed training. That’s where the Training of Trainers program stepped in, armed with training workshops and documents that were accessible to healthcare workers involved in the vaccine delivery process.

The Training of Trainers program works in the form of cascade training:

  1. The Agence de Médecine Préventive (AMP) Services implement the training;
  2. The Expanded Programme on Immunization (EPI) managers train;
  3. Local health professionals also known as “master trainers” then work in their respective countries to disseminate the knowledge to various district health personnel.

“Two key areas the trained healthcare workers (HCWs) mention as desperately needed, which the training provided, are the improvements in the immunization communication skills and adverse event identification and management. A HCW I interviewed said the training has helped improve her customer care; that since she received the training, she now communicates more effectively with mothers/caregivers who take their children for vaccination” – Dr. Dennis Marke, EPI Manager from Sierra Leone.

The goal of this program is to strengthen the capacity of the EPI managers, regional health system managers, national pharmacovigilance managers, and disease control officers to be able to train country-level health care providers on how to successfully administer these this vaccine. Each new individual we train is an opportunity to strengthen the way vaccines are delivered and ultimately prevent morbidity and mortality caused by pneumococcal diseases worldwide.

Gavi is proud to partner with Agence de Médecine Préventive, Pfizer, the EPI managers and all other health care providers involved to implement the Training of Trainers program in Gavi countries across the globe, which has been able to train thousands of healthcare workers on how to efficiently and effectively deliver multi-dose pneumococcal vaccines in the hopes of protecting millions of individuals from this deadly disease.