Conclusions & Recommendations
19.9.3 - ITI Supply Chain – 2
Conclusion/Recommendation:
TEC recommends that ITI Supply Chain review the Nigeria Zithromax® Accountability Action Plan and determine whether it would be applicable for other countries.
Action:
TEC recommends that ITI Supply Chain review the Nigeria Zithromax® Accountability Action Plan and determine whether it would be applicable for other countries.
TEC 19
2018
Nigeria
supply chain, recommendations for ITI management
18.1.1 - General Recommendations to ITI
Conclusion/Recommendation:
TEC notes that it would be useful to explore the impact of skipped treatments on trachoma outcomes by considering conducting early impact surveys rather than continued treatments. Information from such an exploration could advise future TEC decisions regarding requests in areas with skipped treatments, for reasons including insecurity, force majeure, etc.
Action:
There are not yet enough skipped treatments to complete this analysis but ITI will continue to monitor this.
TEC 18
2018
research, alternative treatment strategies, insecurity, recommendations for ITI management
18.1.2 - General Recommendations to ITI
Conclusion/Recommendation:
TEC recommends to ITI Supply Chain team to analyze treatments shipped versus distributed separated into POS and tablets to better understand average dosing by presentation and therefore the discrepancy between treatments shipped and distributed.
Action:
ITI Supply Chain Team is working on the analysis of treatments shipped versus distributed for countries with high variance and will report on this at TEC 20.
TEC 18
2018
supply chain, dosing, recommendations for ITI management
18.1.3 - General Recommendations to ITI
Conclusion/Recommendation:
TEC acknowledges the enormous progress of National Programs and the commitment of countries and their progress in reducing the burden of trachoma, resulting in lower Zithromax® requests for the first time.
Action:
This is noted, and ITI will seek input from TEC on if and how this affects ITI’s strategic direction for the coming years.
TEC 18
2018
end game
18.1.4 - General Recommendations to ITI
Conclusion/Recommendation:
TEC recommends that ITI send acknowledgements to National Programs where districts no longer warrant MDA and have not requested Zithromax®, while acknowledging that many still have TT goals that require further intervention. TEC further recommends that ITI offer technical assistance in dossier development.
Action:
ITI will send these communications with the 2019 MOUs in December. ITI will continue to offer assistance to countries for dossier development, as requested.
TEC 18
2018
end game, trichiasis, recommendations for ITI management
18.1.5 - General Recommendations to ITI
Conclusion/Recommendation:
TEC recommends that in the Zithromax® Applications, ITI:
-Color the font of TT prevalence greater than threshold in a different color;
-Include cumulative rounds of MDA count pre-2014 as a single column, but maintain the detailed annual breakdown in an electronic version available to TEC members;
-For TEC 19, print only Applications and provide electronic versions of the full TEC book (including detailed Applications);
-For TEC 19, include on the agenda a discussion on “persistent” TF, including:
-Clarity on geographical locations of the observed phenomenon;
-Details on current OR and program efforts already underway;
-Clarity on the questions and how TEC may advise countries
Action:
- Done
- This will be done for future applications as applicable
- Done for TEC 19, and we will seek feedback from TEC members
- Included on TEC 19 Agenda
TEC 18
2018
TEC meeting management
18.10.1 - Nigeria
Conclusion/Recommendation:
TEC recommends that in light of the Zamfara theft incident, the National Program review its security practices at all state-level drug storage facilities.
Action:
Since the first Zamfara incident, a new incident was uncovered involving the theft of 112 bottles of Zithromax® tablets. ITI Supply Chain has worked intensively with Pfizer, implementing partners, and the Ministry of Health to improve supply chain management. Following root cause analysis of the two incidents, the overall supply chain management system appears robust; however, there is need for continued vigilance.
TEC 18
2018
Africa - West
Nigeria
supply chain
18.11.1 - Ethiopia
Conclusion/Recommendation:
TEC recommends to the Federal Ministry of Health (FMOH) and Regional Health Bureaus (RHB) that:
In areas that have started as a single Evaluation Unit (EU)/woreda, and in accordance with WHO’s guidelines on population size for prevalence surveys, recently-split woredas be surveyed as a single EU (comprising the original “parent” district). Note that this does NOT apply to baseline “super districts”, in which multiple woredas were combined to comprise a single EU.
Action:
This recommendation was shared with the Ethiopia National Trachoma Task Force. All subsequent surveys are being planned and carried out taking this direction into consideration.
TEC 18
2018
Africa - East
Ethiopia
evaluation units
18.12.1 - Ethiopia-Oromia
Conclusion/Recommendation:
TEC recommends that the FMOH, RHB, and partners should consider including towns in future trachoma prevalence surveys.
Action:
This was communicated to the FMOH, Oromia Regional Health Bureau, and implementing partners. However, in the upcoming impact surveys, towns will not be included due to resource constraints.
TEC 18
2018
Africa - East
Ethiopia
evaluation units
18.13.1 - Kenya
Conclusion/Recommendation:
In regards to the 2017 Zithromax® shipment being held since October 2017 pending large demurrage charges, TEC recommends and concludes that:
– ITI work with Sightsavers to support The Trust in sending a letter to the President of Kenya, with copy to the Ministry of Health (MOH), Ministry of Finance, and Ministry of Foreign Affairs;
– ITI and Sightsavers consider sending a high-level delegation to follow up in person;
– Additional drug (2018 shipment) is not sent until the clearance issues of the 2017 shipment are resolved (2018 approvals are now in “RS”);
– They will defer consideration of the 2019 Zithromax® Application pending resolution of the 2017 clearance issues.
Action:
TEC’s recommendations were shared with the National Program in person. ITI and Sightsavers sent a letter to Her Excellency Siciliy Kariuki, Cabinet Secretary for Health, MOH. Following a leak to the national media, and prominent news articles on broadcast television and in a national circulation newspaper, the Ministry of Health agreed to make a settlement with the clearing agent, obviating the need for further intervention. However, only a proportion of the Zithromax® was released in spite of weekly assurances that the balance will be released imminently. Complete details will be given in a separate presentation at TEC 19.
TEC 18
2018
Africa - East
Kenya
supply chain, recommendations for ITI management