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إجتماع اللجنة الفنيّة للبرنامج الوطني للتحصين في 18/10/2018

 
Purpose:
 
The EPI technical committee convened on the 18th of October 2018, at the Director General office at the MoPH.

The committee welcomed the new members who were added to the already existing experts list, based on the amendment 1/1877 to the EPI technical committee decree 1/124.

The meeting objective was to suggest a working plan for the newly formed committee and to discuss what was raised during last meeting regarding revisiting PCV introduction to the vaccination calendar. In addition the MoPH decision to provide all EPI vaccines to the private sector was highlighted. 
 
Proceedings:

Prof. Ammar welcomed the committee to this meeeting, reminding of the purpose of the EPI technical committee, and stressed that all the decisions taken are based on evidence and expertise of the members.

Dr.Bizri mentioned that the Lebanon report on the Polio Free Status has been accepted by the regional certification committee, with minor needed amendments. Thanking all members of the EPI committee, the MoPH team and Dr Randa Hamade for their instrumental input in achieving this status.

To initiate the discussion on the inclusion of the PCV vaccine in the National Immunization calendar a brief about the decision making process and the role of the committee were summarized by Dr Bizri. Based on the findings of three missions by the WHO and a visit by an international expert, MoPH was adviced to include the PCV in the national immunization calendar. The technical committee has advised the inclusion of PCV either type 10 or 13, since both cover the most common serotypes of pneumococcus circulating in Lebanon.

Supported by UNICEF pooled vaccine procurement process, Lebanon was able to purchase the more comprehensive vaccine (PCV13), hence it was chosen to be introduced to the calendar. All vaccines a procured by UNICEF through the pooled process by the UNICEF Copenhagen supply department.
 
The issue of cost benefit of the PCV 13 vaccine was raised by Dr.Adib, to make sure that the limited funds allocated for the Ministry of Health, are well allocated. According to Dr Adib to perform the cost benefit evaluation of the vaccine, pneumonia caused by pneumococcus should be included in the surveillance system. This has initiated a discussion of how to determine whether a pneumonia case was caused by pneumococcus, since no consensus was reached it was proposed to set a meeting for the technical committee to discuss this issue. In addition there is a need to have a clear evidence based procedure, to be followed before adding a new vaccine to the EPI calendar, including initiating surveillance for the disease.
 
Dr Ammar clarified that the procedure followed by the MoPH prior to introducing new vaccines, is to take the opinion of experts in the field and allocate the funds for introduction.
 
It was mentioned that there is an ongoing national study on the prevalent serotypes of pneumococci, performed by Dr. Dbaibo of AUB, it was suggested that he be invited to present his finding in the upcoming EPI technical committee meetings.
The committee was reminded that The MoPH in collaboration with the LPS has set in place a process that will allow pediatricians from the public sector to receive all the EPI vaccines, provided that they commit to abide by the regulations pertinent to the cold chain, vaccine administration free of charge, except for the consultation fee, and reporting on the names of the vaccinated children.
 
Dr Hamadeh announced that the MoPH is planning to launch a national media campaign on immunization starting with lighting the National Museum with the memorable Polio stamp, open day for universities, rally paper….etc.
The official launching will be held on November 27, 2018.
 
Recommendations:

The members of the committee agreed to set a follow up technical meeting to discuss on the way forward regarding PCV13 and what needs to be included in the surveillance.
Dr Mansour will compile all the WHO mission reports pertinent to the introduction of the PCV13 vaccine introduction and present them to the committee.
Dr Dbeibo to be invited to present his findings during the mentioned meeting.
All decisions by the technical committee meetings should be adopted and endorsed by all members, discussions initiated not to be shared with media or in outside discussions.
 
 
List of attendees:
 
Dr. Walid Ammar
Dr. Randa Hamadeh
Dr.Genevieve Begkoyian
Dr. Abdul Rahman Bizri
Dr.Salim Adib
Dr.Myrna Doumit
Dr.Assaad Kadhum
Dr.George Araj
Dr. Bassem Abou Merhi
Dr.Gaby Falakha
Dr.Bernard Gerbeka
Dr. Joseph Rachkidi
Dr. Ziad Mansour
Dr.David Amaneddine
Dr. Hannan Masri
Wafaa Kanaan
Rima Shayya
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D07CC02 GENTACORT-FC G Fluocinolone acetonide - 0.01%, Clotrimazole - 1%, Gentamicin (sulfate) - 0.1% Cream 302,365 L.L
R02AA05 GOLASEPTINE-LIDOCAINE G Chlorhexidine HCl - 5mg, Lidocaine HCl - 1mg Tablet, chewable 736,426 L.L
J07BM03 GARDASIL 9 HUMAN PAPILLOMAVIRUS 9- VALENT VACCINE RECOMBINANT B Papillomavirus (human type 6) - 30mcg/0.5ml, Papillomavirus (human type 11) - 40mcg/0.5ml, Papillomavirus (human type 16) - 60mcg/0.5ml, Papillomavirus (human type 18) - 40mcg/0.5ml, Papillomavirus (human type 31) - 20mcg/0.5ml, Papillomavirus (human type 33) - 20mcg/0.5ml, Papillomavirus (human type 45) - 20mcg/0.5ml, Papillomavirus (human type 52) - 20mcg/0.5ml, Papillomavirus (human type 58) - 20mcg/0.5ml Injectable suspension 14,139,396 L.L
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A02BX13 GAVISCON B Sodium alginate - 500mg/10ml, Sodium bicarbonate - 267mg/10ml, Calcium (carbonate) - 160mg/10ml Liquid 295,645 L.L
A02BX13 GAVISCON INFANT B Sodium alginate - 225mg, Magnesium alginate - 87.5mg Powder for suspension 710,893 L.L
C09DA04 GIZLAN-PLUS G Irbesartan - 150mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 395,090 L.L
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A02BX13 GAVISCON DOUBLE ACTION MINT B Sodium alginate - 500mg/10ml, Sodium bicarbonate - 213mg/10ml, Calcium (carbonate) - 325mg/10ml Suspension 542,912 L.L
A02BX13 GAVISCON DOUBLE ACTION B Sodium alginate - 500mg, Sodium bicarbonate - 213mg, Calcium (carbonate) - 325mg Suspension 517,379 L.L
G01AA51 GYNAMEND G Nystatin - 100,000IU, Neomycin (sulfate) - 35,000IU, Polymyxin B sulfate - 35,000IU Capsule, soft 345,560 L.L
C09DA04 GIZLAN-PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 395,090 L.L
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N02BE51 GENTLE RELIEF G Paracetamol - 325mg, Ibuprofen - 400mg, Famotidine - 20mg Tablet 184,106 L.L
S01ED51 GANFORT B Timolol maleate - 5mg/ml, Bimatoprost - 300mcg/ml Drops solution 950,097 L.L
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A10BD02 GLUCOVANCE B Metformin HCl - 500mg, Glibenclamide - 5mg Tablet, film coated 775,971 L.L
A10BD02 GLYSTOR PLUS G Metformin HCl - 500mg, Glibenclamide - 5mg Tablet, film-scored 691,119 L.L
A10BD02 GLUCOVANCE B Metformin HCl - 1000mg, Glibenclamide - 5mg Tablet, film coated 1,006,220 L.L
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