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EPI Techical Committee Meeting 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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ATC Name B/G Ingredients Dosage Form Price
D01AC03 ECONAZ G Econazole nitrate - 1% 1% Cream 307,164 L.L
N02BE51 EXTRA STRENGTH HEADACHE RELIEF G Acetaminophen - 250mg, Acetylsalicylic acid - 250mg, Caffeine - 65mg Tablet 353,431 L.L
N06DA52 EXENTAZIL G Donepezil - 10mg, Memantine - 28mg Capsule 4,363,009 L.L
N06DA52 EXENTAZIL G Donepezil - 10mg, Memantine - 14mg Capsule 3,117,715 L.L
L04AX03 EBETREXAT G Methotrexate - 5mg 5mg Tablet, scored 2,488,796 L.L
L04AX03 EBETREXAT G Methotrexate - 15mg/1.5ml 15mg/1.5ml Injectable solution 2,135,366 L.L
N06DX01 EXENTA G Memantine HCl - 10mg 10mg Tablet, film coated 1,057,156 L.L
L01CA04 EBERELBIN G Vinorelbine (tartrate) - 50mg/5ml 50mg/5ml Injectable concentrated solution 6,834,783 L.L
A03FA01 ELITAN G Metoclopramide HCl - 10mg/2ml 10mg/2ml Injectable solution 252,642 L.L
L01CB01 ETOPOSIDE EBEWE G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution 768,678 L.L
L01CB01 ETOPOSIDE VIATRIS 20MG/ML G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution 1,544,466 L.L
R05 EXALL FORTE G Chlorpheniramine maleate - 2.5mg, Guaifenesin - 100mg, Acetaminophen - 100mg, Diprophylline - 25mg Syrup 501,701 L.L
L01CD01 EBETAXEL G Paclitaxel - 30mg/5ml 30mg/5ml Injectable concentrated solution 2,983,330 L.L
G03AD02 ECINQ G Ulipristal acetate - 30mg 30mg Tablet, film coated 1,302,183 L.L
L01CD01 EBETAXEL G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrated solution 15,457,059 L.L
S01XA18 ESTAPORIN G Ciclosporin - 0.05% 0.05% Emulsion 2,815,798 L.L
C01CA03 EPINORD G Noradrenaline (tartrate) - 8mg/4ml 8mg/4ml Injectable solution 2,751,678 L.L
J05AF10 ENTECAVIR ARROW G Entecavir - 1mg 1mg Tablet, coated 18,701,506 L.L
M01AB05 EPARDEX G Diclofenac sodium - 50mg 50mg Tablet, enteric coated 223,974 L.L
J01DH03 ERTANZ G Ertapenem - 1g 1g Injectable powder 2,521,049 L.L
J05AF10 ENTECAVIR BIOGARAN G Entecavir - 1mg 1mg Tablet, coated 19,080,319 L.L
M01AB05 EPARDEX G Diclofenac sodium - 50mg 50mg Tablet, enteric coated 3,246,979 L.L
J01DH03 ERTAPENEM INJECTION G Ertapenem - 1g 1g Injectable concentrate for solution 26,153,163 L.L
J05AF10 ENTRILIV G Entecavir - 1mg 1mg Tablet, film coated 19,165,898 L.L
C01CA26 EPHEDRINE AGUETTANT G Ephedrine HCl - 30mg/ml 30mg/ml Injectable solution 614,136 L.L
L01DB03 EPIRUBICINE VIATRIS 2MG/ML G Epirubicin HCl - 10mg/5ml 10mg/5ml Injectable solution 855,212 L.L
C01CA26 EPHEDRINE RENAUDIN G Ephedrine HCl - 30mg/ml 3% Injectable solution 693,423 L.L
J05AF10 ENTECAVIR ARROW G Entecavir - 0.5mg 0.5mg Tablet, coated 18,701,506 L.L
L01DB03 EPIRUBICINE VIATRIS 2MG/ML G Epirubicin HCl - 50mg/25ml 50mg/25ml Injectable solution 3,914,242 L.L
C01CA26 EPHEDRINE AGUETTANT G Ephedrine HCl - 3mg/ml 3mg/ml Injectable solution 7,827,491 L.L
    ...
    9
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