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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
    ...
    6
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ATC Name B/G Ingredients Dosage Form Price
C07AG02 DILATREND B Carvedilol - 25mg 25mg Tablet, scored 598,010 L.L
C09CA03 DIOVAN B Valsartan - 80mg 80mg Tablet, film coated 602,041 L.L
C09CA03 DIOVAN B Valsartan - 160mg 160mg Tablet, film coated 846,621 L.L
D01AC02 DAKTARIN B Miconazole nitrate - 20mg/g 20mg/g Cream 231,141 L.L
D01AC14 DERMOFIX B Sertaconazole nitrate - 20mg/g 2% Cream 382,995 L.L
D04AA32 DERMAMINE ITCH STOPPING G Diphenhydramine HCl - 1%, Zinc acetete - 0.1% Cream 560,382 L.L
D04AX01 DOXIDERM G Doxepin (HCl) - 5% 5% Cream 1,037,958 L.L
D05AX52 DAIVOBET B Calcipotriol - 50mcg/g, Betamethasone - 0.5mg/g Gel 2,100,426 L.L
D06AX DERMOTRACIN G Neomycin sulfate - 165.000IU/150ml, Bacitracin - 15.500IU/150ml Powder 737,770 L.L
D06AX01 DERMICIN G Fusidic acid - 20mg/g 20mg/g Cream 175,339 L.L
D06AX01 DERMOFUCIN G Fusidic acid - 2% 2% Cream 290,270 L.L
D07AC01 DIPROSONE B Betamethasone (dipropionate) - 0.5mg/g 0.05% Cream 291,614 L.L
D07AD01 DERMOVATE B Clobetasol (propionate) - 0.5mg/g 0.05% w/w Cream 290,270 L.L
D07AD01 DECLOBAN G Clobetasol (propionate) - 0.05% 0.05% Cream 302,045 L.L
D07AD01 DERMASONE G Clobetasol (propionate) - 0.05% 0.05% Cream 119,026 L.L
D07AD01 DERMOVATE B Clobetasol (propionate) - 0.5mg/g 0.05% w/w Ointment 290,270 L.L
D07AD01 DECLOBAN G Clobetasol (propionate) - 0.05% 0.05% Ointment 302,045 L.L
D07XA01 DAKTACORT B Hydrocortisone - 10mg/g, Miconazole nitrate - 20mg/g Cream 208,296 L.L
D07XC01 DIPROSALIC B Salicylic acid - 30mg/g, Betamethasone (dipropionate) - 0.5mg/g Ointment 352,087 L.L
D10AD03 DIFFERIN B Adapalene - 0.1g/100g 0.1% Cream 521,411 L.L
D10AD03 DIFADERM G Adapalene - 0.1% 0.1% Gel 414,671 L.L
D10AD03 DIFFERIN B Adapalene - 0.1g/100g 0.1% Gel 503,941 L.L
D10AD03 DIFADERM G Adapalene - 0.3% 0.3% Gel 952,208 L.L
D10AF51 DUAC ONCE DAILY B Clindamycin (phosphate) - 1%, Benzoyl peroxide - 5% Gel 1,658,302 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 300mg 300mg Injectable solution 123,001,362 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 300mg 300mg Injectable solution 123,001,362 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 200mg 200mg Injectable solution 123,001,362 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 200mg 200mg Injectable solution 123,001,362 L.L
D11AX18 DILO G Diclofenac sodium - 8% 8% Spray 502,981 L.L
G01AF DERMOFIX GYNO OVULE G Sertaconazole nitrate - 300mg 300mg Ovule 822,320 L.L
    ...
    6
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