Conclusions & Recommendations

TEC noted the progress made by MISAU in addressing the corrective actions outlined in the program assessment and reiterated that all supply chain and program corrective actions must be fully addressed and verified by an external supply chain assessment before Zithromax® shipments can resume. TEC also commends USAID Mozambique for their support in addressing this issue.

TEC recommends that before the in-country Zithromax® inventory can be used, MISAU should:
- Provide ITI and TEC with a full report on completion of corrective actions
- Present to ITI and TEC a plan for MDA using the in-country stock of Zithromax® before it expires
- Support a supply chain and MDA training

TEC noted the actions taken in Guinea following the diversion of donated drug to the open market and recommends to ITI continued vigilance and intensive follow-up. TEC recommends that ITI follow up with USAID and RTI to brief them on the issue and request assistance from USAID Guinea. TEC recommends that the 2018 approved treatments be shipped as planned.

TEC noted Pfizer’s recent safety review and is looking into modifying the Zithromax® label to ensure that tablets and POS are administered to the appropriate age and height groups. ITI is revising the Zithromax® Management Guide, including new recommendations around dosing, and will communicate changes to partners upon finalization.

TEC notes that azithromycin eye drops are now available, are well tolerated, and are easily administered (one drop twice daily for three days). These could be considered for programmatic use in place of tetracycline eye ointment among infants 1-6 months of age.

TEC congratulated WHO’s Eastern Mediterranean Region for their development of a comprehensive trachoma regional plan of action and budget, and looks forward to its timely implementation. TEC awaits with interest future reports on regional progress.

TEC thanks ITI for its contribution in the development of the regional plan and recommends continued active engagement.

TEC acknowledges Iain Jones for his tremendous support, encouragement, and personal commitment to trachoma elimination during his tenure with the DFID health services team. Iain has been an active observer at TEC meetings and a strong advocate for coordination within the donor community and on the broader agenda of integration. TEC wishes Iain well as he leaves the team, and requests continued DFID participation at future TEC meetings.

TEC observed the reduction of mid-year requests, and notes that this is an indication of strong support by ITI, collaboration with WHO, streamlined application process, and confirmation by partners that donor support is available earlier in the year.

TEC congratulates the Nigerian trachoma program on their recent baseline, impact, and surveillance surveys, noting the significant decrease in prevalence across several previously-highly endemic areas, and appreciates their enthusiasm for geographic scale-up. TEC approved the mid-year request for additional districts to be treated in 2018.