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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
D07AB02 LOCOID B Hydrocortisone butyrate - 1mg/g 0.1% Cream 215,015 L.L
D07AB02 LOCOID CRELO 0.1% B Hydrocortisone butyrate - 1mg/g 0.1% Emulsion 177,387 L.L
D07AB02 LOCOID CRELO 0.1% B Hydrocortisone butyrate - 1mg/g 0.1% Emulsion 177,387 L.L
A10AE04 LANTUS SOLOSTAR BioTech Insulin glargine - 100IU/ml 100IU/ml Injectable solution 4,992,375 L.L
A10AE04 LANTUS BioTech Insulin glargine - 100IU/ml 100IU/ml Injectable solution 3,327,354 L.L
C07AG01 LABETALOL HYDROCHLORIDE INJECTION G Labetalol HCl - 100mg/20ml 100mg/20ml Injectable solution 2,955,110 L.L
N03AX18 LACOSAMIDE/GENEPHARM G Lacosamide - 100mg 100mg Tablet 4,856,647 L.L
N03AX18 LACOSAMIDE/GENEPHARM G Lacosamide - 200mg 200mg Tablet 8,284,105 L.L
N03AX18 LACOSAMIDE/GENEPHARM G Lacosamide - 50mg 50mg Tablet 614,136 L.L
J05AF05 LAMIVUDINE ARROW G Lamivudine - 150mg 150mg Tablet, coated, scored 7,850,907 L.L
J05AR01 LAMIVUDINE/ ZIDOVUDINE ARROW G Lamivudine - 150mg, Zidovudine - 300mg Tablet, coated, scored 15,643,319 L.L
J05AF05 LAMIVUDINE ARROW G Lamivudine - 300mg 300mg Tablet, coated 7,850,907 L.L
N03AX09 LAMOTRIGINE ARROW LAB G Lamotrigine - 100mg 100mg Tablet, dispersible/ chewable 1,050,885 L.L
N03AX09 LAMOTRIGINE BIOGARAN G Lamotrigine - 100mg 100mg Tablet, dispersible 1,233,647 L.L
N03AX09 LAMOTRIGINE NORMON G Lamotrigine - 100mg 100mg Tablet, dispersible/ chewable 2,284,532 L.L
N03AX09 LAMICTAL B Lamotrigine - 100mg 100mg Tablet 2,741,209 L.L
N03AX09 LEPIGINE G Lamotrigine - 100mg 100mg Tablet, scored 1,163,768 L.L
N03AX09 LAMICTAL B Lamotrigine - 25mg 25mg Tablet 1,088,270 L.L
N03AX09 LAMOTRIGINE ARROW LAB G Lamotrigine - 25mg 25mg Tablet, dispersible/ chewable 556,351 L.L
N03AX09 LAMOTRIGINE BIOGARAN G Lamotrigine - 25mg 25mg Tablet, dispersible 595,322 L.L
N03AX09 LAMOTRIGINE ARROW LAB G Lamotrigine - 50mg 50mg Tablet, dispersible/ chewable 1,052,229 L.L
N03AX09 LAMOTRIGINE BIOGARAN G Lamotrigine - 50mg 50mg Tablet, dispersible 985,037 L.L
N03AX09 LAMOTRIGINE NORMON G Lamotrigine - 50mg 50mg Tablet, dispersible/ chewable 1,643,519 L.L
N03AX09 LAMICTAL B Lamotrigine - 50mg 50mg Tablet 1,753,895 L.L
N03AX09 LAMICTAL LIQUI-TABS B Lamotrigine - 5mg 5mg Tablet 361,046 L.L
A02BC03 LPZ-30 G Lansoprazole - 30mg 30mg Capsule, delayed release 360,150 L.L
L04AX04 LENOMA G Lenalidomide - 10mg 10mg Capsule, hard L.L
L04AX04 LEDOBOOK 10 G Lenalidomide - 10mg 10mg Capsule 62,230,245 L.L
L04AX04 LENALIDOMIDE NEAPOLIS G Lenalidomide - 10mg 10mg Capsule 72,248,183 L.L
L04AX04 LENALIDOMIDE OHRE PHARMA G Lenalidomide - 10mg 10mg Capsule 33,314,752 L.L
    4
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