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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
    4
ATC Name B/G Ingredients Dosage Form Price
A10BD20 FLORIMET 5/1000 G Metformin - 1000mg, Empagliflozin - 5mg Tablet, film coated 1,836,585 L.L
S01AE01 FLOXEDOL G Ofloxacin - 3mg/ml 3mg/ml Gel 339,992 L.L
S01AE01 FLOXIGEN G Ofloxacin - 3mg/ml 3mg/ml Drops solution 358,806 L.L
J01MA14 FLOXIMOX G Moxifloxacin (HCl) - 400mg 400mg Tablet, film coated 1,062,276 L.L
J01MA12 FLOXIN-L 500 G Levofloxacin (hemihydrate) - 500mg 500mg Tablet, film coated 831,903 L.L
J02AC01 FLUCOKEY G Fluconazole - 150mg 150mg Capsule 81,974 L.L
J02AC01 FLUCONAZOLE PANPHARMA G Fluconazole - 200mg/100ml 200mg/100ml Injectable solution 11,256,652 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 100mcg Capsule, inhalation 1,777,706 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 250mcg Capsule, inhalation 2,487,891 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 500mcg Capsule, inhalation 3,169,668 L.L
L01BB05 FLUDARABIN EBEWE G Fludarabine Dihydrogenophosphate - 50mg/2ml 50mg/2ml Injectable solution 3,567,902 L.L
L01BB05 FLUDARABINE PHOSPHATE NEAPOLIS G Fludarabine Dihydrogenophosphate - 50mg/2ml 50mg/2ml Injectable solution 4,031,528 L.L
C03BA11 FLUDEX B Indapamide - 1.5mg 1.5mg Tablet, sustained release 517,379 L.L
A03CA02 FLUDINIUM G Clidinium bromide - 2.5mg, Trifluoperazine HCl - 1mg Capsule 386,515 L.L
R05CB06 FLUIBRON G Ambroxol - 15mg/5ml 15mg/5ml Syrup 459,594 L.L
R05CB01 FLUIMUCIL B N-acetylcysteine - 600mg 600mg Tablet, effervescent 567,102 L.L
R05CB01 FLUIMUCIL MUCOLYTIC B N-acetylcysteine - 2% 2% Syrup 595,322 L.L
R06AD52 FLUISEDAL G Promethazine HCl - 2.5g/5ml, Meglumine benzoate - 130mg/5ml, Polysorbate 20 - 15mg/5ml Syrup 572,634 L.L
R06AD52 FLUISEDAL G Promethazine HCl - 2.5g/5ml, Meglumine benzoate - 130mg/5ml, Polysorbate 20 - 15mg/5ml Syrup 393,746 L.L
J05AH02 FLUMIVIR G Oseltamivir - 75mg 75mg Capsule 1,384,158 L.L
M01AE51 FLUMIX BENTA G Ibuprofen - 200mg, Guaifenesin - 200mg, Chlorpheniramine maleate - 2mg, Phenylephrine HCl - 5mg Tablet, film coated 875,417 L.L
M01AE51 FLUMIX BENTA G Ibuprofen - 200mg, Guaifenesin - 200mg, Chlorpheniramine maleate - 2mg, Phenylephrine HCl - 5mg Tablet, film coated 460,746 L.L
J01CR50 FLUMOX G Flucloxacillin (monohydrate) - 250mg, Amoxicillin (trihydrate) - 250mg Capsule 348,055 L.L
J02AC01 FLUNAZOL G Fluconazole - 50mg/5ml 50mg/5ml Powder for suspension 756,391 L.L
J02AC01 FLUNAZOL G Fluconazole - 50mg 50mg Capsule 534,465 L.L
J02AC01 FLUNAZOL G Fluconazole - 150mg 150mg Capsule 149,742 L.L
D07AC04 FLUOCINOLONE ACETONIDE G Fluocinolone acetonide - 0.25mg/g 0.25mg/g Cream 296,925 L.L
G01AC05 FLUOMIZIN B Dequalinium chloride - 10mg 10mg Tablet 775,397 L.L
J02AC01 FLUORES G Fluconazole - 150mg 150mg Capsule, hard 428,686 L.L
S01JA01 FLUORESCEIN SODIUM USP IV G Fluorescein sodium - 10% 10% Injectable solution 1,198,595 L.L
    4
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