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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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C01EB10 CARDESINE G Adenosine - 6mg/2ml 6mg/2ml Injectable solution 563,070 L.L
J01CR02 CURAM G Amoxicillin (trihydrate) - 500mg, Clavulanic Acid (potassium) - 125mg 625mg Tablet, film coated 402,189 L.L
L01EX07 CABOMETYX B Cabozantinib - 60mg 60mg Tablet, film coated 440,893,501 L.L
M01AH05 CONSORT G Etoricoxib - 60mg 60mg Tablet, film coated 338,648 L.L
M01AH05 COXIFLAM G Etoricoxib - 60mg 60mg Tablet, film coated 1,109,630 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 60mg 60mg Tablet, coated, scored 16,494,074 L.L
J01FF01 CLINDAMYCIN VIANEX BA FREE G Clindamycin (phosphate) - 600mg/4ml 600mg/4ml Injectable solution 201,576 L.L
A12AA04 CALTRATE 600 B Calcium (carbonate) - 600mg 600mg Tablet 618,168 L.L
C07AG02 CARVEDILOL ARROW G Carvedilol - 6.25mg 6.25mg Tablet, film coated, scored 364,181 L.L
R06AE07 CETIMED G Cetirizine (dihydrochloride) - 5mg/5ml 5mg/5ml Solution 415,951 L.L
R06AX13 CLARITINE B Loratadine (micronised) - 5mg/5ml 5mg/5ml Syrup 430,030 L.L
R06AX13 CLARA G Loratadine (micronised) - 5mg/5ml 5mg/5ml Syrup 215,015 L.L
H01AC01 CINNATROPIN BioTech Somatropin recombinant - 5mg/1.5ml 5mg/1.5ml Injectable solution 4,699,417 L.L
R06AE09 CALIVIDA G Levocetirizine dihydrochloride - 5mg 5mg Tablet, film coated 447,948 L.L
G04BE08 CIALIS B Tadalafil - 5mg 5mg Tablet, film coated 6,512,261 L.L
L01EJ01 CELEZON G Ruxolitinib - 5mg 5mg Tablet L.L
L01EJ01 CELEZON G Ruxolitinib - 5mg 5mg Tablet 95,532,998 L.L
N06AB10 CITOXAL G Escitalopram (oxalate) - 5mg 5mg Tablet, film coated 895,895 L.L
C10AA07 CRESTOR B Rosuvastatin (calcium) - 5mg 5mg Tablet 589,947 L.L
D10BA01 CURACNE G Isotretinoin - 5mg 5mg Capsule, soft gelatin 856,028 L.L
D10BA01 CURACNE G Isotretinoin - 5mg 5mg Capsule, soft gelatin 856,028 L.L
D10BA01 CURACNE G Isotretinoin - 5mg 5mg Capsule, soft 856,028 L.L
C07AB07 CONCOR B Bisoprolol fumarate - 5mg 5mg Tablet, film coated 870,164 L.L
C07AB07 CARDIOSAFE 5 G Bisoprolol fumarate - 5mg 5mg Tablet, coated 330,585 L.L
C09AA04 COVERSYL ARGININE B Perindopril arginine - 5mg 5mg Tablet, film coated 452,875 L.L
J06BA02 CLAIRYG BioHuman Human normal immunoglobulin G - 50mg/ml 5g/100ml Injectable solution L.L
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S02D CERULYSE B Xylene - 5g/100g 5g/100g Drops solution 339,992 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 54mg 54mg Tablet, extended release 6,049,979 L.L
N03AG01 CONVULEX G Sodium Valproate - 50mg/ml 50mg/ml Syrup 213,671 L.L
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