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COVID-19 highlights need for strengthening national regulatory authorities in Latin America and the Caribbean

PAHO report: COVID-19 highlights need for strengthening national regulatory authorities in Latin America and the Caribbean
Study draws lessons for the region from the six national regulatory authorities of reference in Argentina, Brazil, Chile, Colombia, Cuba, and Mexico.

Washington, D.C., April 26, 2021 (PAHO) The COVID-19 pandemic has demonstrated the urgent need for strengthening national regulatory authorities in Latin America and the Caribbean to ensure the safety and effectiveness of new medicines and medical products, a new report by the Pan American Health Organization (PAHO) asserts.

“During the pandemic, we have watched the rapid deployment of clinical trials, the introduction of new and repurposed treatments, and now the development and use of new vaccines, many based on innovative and groundbreaking technological platforms,” said PAHO Assistant Director Jarbas Barbosa. “Throughout these processes, the role of regulatory authorities as independent and science-based institutions has proven more critical than ever.”

The report shows that national regulatory authorities vary dramatically in their capacity to evaluate medicines and medical products. The report draws lessons for improvement from six national regulatory authorities in the region, which PAHO has designated as National Regulatory Authorities of Reference (NRAr). These authorities are ANMAT (Argentina), ANVISA (Brazil), ISP (Chile), INVIMA (Colombia), CECMED (Cuba), and COFEPRIS (Mexico).

Key findings include:

  • Robust regulatory capacities result from expansive legal and organizational frameworks, which give NRArs technical independence and strong mandates to supervise and sanction the pharmaceutical product approvals within their jurisdictions.
  • Recent reforms in national regulatory authorities have brought important improvement in access to medicines and transparency within the authorities.
  • Financial and human resources for national regulatory authorities have remained relatively static over the last five years in Latin America while the pharmaceutical market has increased both in value, volume and medical product complexity.
  • The manufacture of increasingly complex medical products requires stronger surveillance and control. Post-marketing surveillance and pharmacovigilance is a potential weakness of systems.
  • Advances in national regulatory authorities have helped catalyze improvements in other countries and regions. The creation of the Caribbean regulatory system and the Central American joint working system reflect an improvement of regulatory capacity.

The report raises concerns about the “limited or complete lack of legal and organizational frameworks for regulatory systems in a number of countries.”  It encourages countries with less capacity to rely, whenever possible, on evaluations and approvals already completed by one or more of the NRArs.

The report also highlights emergency measures that authorities have implemented since the beginning of the COVID-19 pandemic to improve access to health technologies essential for response and mitigation. “Yet the pursuit of accelerating access, while safeguarding the safety, effectiveness and quality of the products, created tensions and pressures within national regulatory authorities,” Dr. Barbosa said.

In 2010, PAHO member countries adopted a resolution calling for strengthening regulatory systems, which was the first of its kind for the World Health Organization (WHO).  The resolution established regulatory systems as a public health priority and underscored the need to ensure that medical products comply with international standards and are affordable and accessible.

“The Region of the Americas has made great progress in strengthening national regulatory authorities over the past decade, but work must continue,” Dr. Barbosa said.  “Strengthening regulatory systems takes time and commitment, and requires national leadership for sustainability.”

LINKS 
“Regulatory System Strengthening in the Americas” (English)
“Fortalecimiento del systema regulatorio en las Américas”  (Spanish)
Virtual launch of “Regulatory System Strengthening in the Americas” (Original audio)
Virtual launch of “Regulatory System Strengthening in the Americas” (English)
Lanzamiento virtual de “Fortalecimiento del sistema regulatorio en las Américas” (Spanish)

[Original press at PAHO’s website]

 
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WHO: Medical Product Alert N°2/2021: Falsified COVID-19 Vaccine BNT162b2

Falsified COVID-19 Vaccine BNT162b2 identified in the WHO region of the Americas

26 March 2021

Medical product alert
Geneva
Reading time: 2 min (443 words)

Alert Summary

This WHO Medical Product Alert refers to falsified COVID-19 Vaccine identified as “BNT162b2” detected in Mexico in February 2021 and recently confirmed as falsified to the WHO. The falsified product was supplied and administered to patients outside authorized vaccination programs.

This falsified COVID-19 Vaccine may still be in circulation in the region and may continue to be offered to patients outside authorized vaccination programs.

Laboratory analysis of the contents of the falsified products is pending and this Alert will be updated as soon as results are available.

Genuine COVID-19 Vaccine BNT162b2 is indicated for active immunization to prevent COVID-19 caused by the SARS-CoV-2 virus, in individuals 16 years of age and older. The use of genuine COVID-19 vaccines should be in accordance with official guidance from national regulatory authorities.

Falsified COVID-19 vaccines pose a serious risk to global public health and place an additional burden on vulnerable populations and health systems. It is important to identify and remove these from circulation.

The product identified in this alert is confirmed falsified on the basis that it deliberately/fraudulently misrepresents identity, composition, or source:

  • The genuine manufacturer of COVID-19 Vaccine BNT162b2 confirmed they did not manufacture the product.
  • The batch number and expiry dates are falsified.
  • The glass vials and label are different from genuine COVID-19 Vaccine BNT162b2 vials.

 

Table 1: Products subject of WHO Medical Product Alert N°2/2021

Table 1. Falsified COVID-19 Vaccine details

Advice to regulatory authorities and the public

WHO requests increased vigilance within the supply chains of countries and regions likely to be affected by these falsified products. Increased vigilance should include hospitals, clinics, health centers, wholesalers, distributors, pharmacies, and any other suppliers of medical products.

All medical products must be obtained from authorized/licensed suppliers. The products’ authenticity and physical condition should be carefully checked. Seek advice from a healthcare professional in case of doubt.

If you are in possession of the above products, please do not use them.

If you have used these products, or you suffered an adverse reaction/event having used these products, you are advised to seek immediate medical advice from a qualified healthcare professional and to report the incident to the National Regulatory Authorities/National Pharmacovigilance Centre.

National regulatory/health authorities are advised to immediately notify WHO if these products are discovered in their country. If you have any information concerning the manufacture, distribution, or supply of these products, please contact the WHO Global Surveillance and Monitoring System via rapidalert@who.int

 

Table 2: Photographs of products subject of WHO Medical Product Alert N°2/2021

Table 2. Falsified COVID-19 Vaccine images

 

WHO Global Surveillance and Monitoring System

for Substandard and Falsified Medical Products

For more information, please visit the web pages of the WHO Global Surveillance and Monitoring System or Email: rapidalert@who.int

Source: https://www.who.int/news/item/26-03-2021-medical-product-alert-n-2-2021-falsified-covid-19-vaccine-bnt162b2

 
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55th Report – WHO Expert Committee on Specifications for Pharmaceutical Preparations

The 55th WHO Expert Committee on Specifications for Pharmaceutical Preparations (ECSPP) is now available at: https://apps.who.int/iris/bitstream/handle/10665/340323/9789240020900-eng.pdf. It will be included on the agenda and presented to the 149th session of the WHO Executive Board.

Important to mention that the chapter 9  “Regulatory guidance and model schemes”  of such document includes:

  • WHO Certification Scheme on the quality of pharmaceutical products moving in international commerce (page 205)
  • Good reliance practices in the regulation of medical products (page 237)
  • Good regulatory practices in the regulation of medical products (page 269)
  •  Update on WHO-listed authorities (page 40)

 

 

 
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31st edition of the RedETSA Webinars – Healthcare cost base

Dear all,

We are pleased to invite you to the 31st  edition of the RedETSA Webinars program, next Friday, March 19, at 2pm, Washington DC time.  

Alfredo Palacios, from the Institute for Clinical Effectiveness and Health Policy (IECS), Argentina,  will give a presentation on “Healthcare cost base.The session will take place in Spanish, without translation. 

The WebEx link that we will use is the following:

Please feel free to extend this invitation to all those who might be interested.

Best regards,

RedETSA Secretariat

 
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PAHO Director briefs PROSUR leaders on vaccine supply

25 Feb 2021

“We are still way behind where we should be as a Region”

Washington D.C. February 25 (PAHO) —  The Director Carissa F. Etienne today briefed leaders of PROSUR, the Forum for the Progress and Development of South America, on COVID-19 vaccine supply and procurement advances, saying, “PAHO shares your great concerns for equity of access to vaccines particularly for middle and low-income countries and we continue to advocate strongly for the LAC countries.” (…)

For more information go to https://www.paho.org/en/news/25-2-2021-paho-director-briefs-prosur-leaders-vaccine-supply

 
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WHO lists 2 additional COVID-19 vaccines for emergency use and COVAX roll-out: AstraZeneca/Oxford-developed vaccines to reach countries in the coming weeks

PRESS RELEASE

WHO lists 2 additional COVID-19 vaccines for emergency use and COVAX roll-out

 AstraZeneca/Oxford-developed vaccines to reach countries in the coming weeks

Geneva, 15 February 2021 – The World Health Organization (WHO) today listed two versions of the AstraZeneca/Oxford COVID-19 vaccine for emergency use, giving the green light for these vaccines to be rolled out globally through COVAX. The vaccines are produced by AstraZeneca-SKBio (Republic of Korea) and the Serum Institute of India.

WHO’s Emergency Use Listing (EUL) assesses the quality, safety and efficacy of COVID-19 vaccines and is a prerequisite for COVAX Facility vaccine supply. It also allows countries to expedite their own regulatory approval to import and administer COVID-19 vaccines.

“Countries with no access to vaccines to date will finally be able to start vaccinating their health workers and populations at risk, contributing to the COVAX Facility’s goal of equitable vaccine distribution,” said Dr Mariângela Simão, WHO Assistant-Director General for Access to Medicines and Health Products.

‘But we must keep up the pressure to meet the needs of priority populations everywhere and facilitate global access. To do that, we need two things – a scale-up of manufacturing capacity, and developers’ early submission of their vaccines for WHO review.”

The WHO EUL process can be carried out quickly when vaccine developers submit the full data required by WHO in a timely manner. Once those data are submitted, WHO can rapidly assemble its evaluation team and regulators from around the world to assess the information and, when necessary, carry out inspections of manufacturing sites.

In the case of the two AstraZeneca/Oxford vaccines, WHO assessed the quality, safety and efficacy data, risk management plans and programmatic suitability, such as cold chain requirements. The process took under four weeks.

The vaccine was reviewed on 8 February by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE), which makes recommendations for vaccines’ use in populations (i.e. recommended age groups, intervals between shots, advice for specific groups such as pregnant and lactating women). The SAGE recommended the vaccine for all age groups 18 and above.

The AstraZeneca/Oxford product is a viral vectored vaccine called ChAdOx1-S [recombinant]. It is being produced at several manufacturing sites, as well as in the Republic of Korea and India. ChAdOx1-S has been found to have 63.09% efficacy and is suitable for low- and middle-income countries due to easy storage requirements.

WHO emergency use listing

The emergency use listing (EUL) procedure assesses the suitability of novel health products during public health emergencies. The objective is to make medicines, vaccines and diagnostics available as rapidly as possible to address the emergency, while adhering to stringent criteria of safety, efficacy and quality. The assessment weighs the threat posed by the emergency as well as the benefit that would accrue from the use of the product against any potential risks.

The EUL pathway involves a rigorous assessment of late phase II and phase III clinical trial data as well as substantial additional data on safety, efficacy, quality and a risk management plan. These data are reviewed by independent experts and WHO teams who consider the current body of evidence on the vaccine under consideration, the plans for monitoring its use, and plans for further studies.

As part of the EUL process, the company producing the vaccine must commit to continue to generate data to enable full licensure and WHO prequalification of the vaccine. The WHO prequalification process will assess additional clinical data generated from vaccine trials and deployment on a rolling basis to ensure the vaccine meets the necessary standards of quality, safety and efficacy for broader availability.

WHO also listed the Pfizer/BioNTech vaccine for emergency use on 31 December 2020.

See more on EUL

See SAGE recommendations

Media contacts:

mediainquiries@who.int

Source: https://worldhealthorganization.cmail19.com/t/ViewEmail/d/5B68A476D68F6C052540EF23F30FEDED/B6510F5CB331C02F9E794568BD214575

 

 
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PAHO Director says COVID-19 vaccines for the Americas still recommended despite new variants

10 Feb 2021

“PAHO’s surveillance network is keeping a close watch on today’s variants of concern.”

Washington, D.C., February 10, 2021 (PAHO) Pan American Health Organization (PAHO) Director Carissa F. Etienne said the COVID-19 vaccines soon to be available from COVAX in the Americas are still recommended for the region, despite new variants of the SARS-CoV-2 virus that causes the disease.

Based on the evidence we have now on the variants of concern, we are confident that our growing portfolio of COVID-19 vaccines remains useful and will guide us through the end of this pandemic.”

PAHO Director Carissa F. Etienne

For more information go to https://www.paho.org/en/news/10-2-2021-paho-director-says-covid-19-vaccines-americas-still-recommended-despite-new-variants

 
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Episode #25 – Vaccines explained

Vismita Gupta-Smith Hello and welcome to Science in 5. I'm Vismita Gupta-Smith and this is WHO's conversations in science. We're going to continue our conversation on COVID-19 vaccines and explaining the science and evidence behind it is WHO's Chief Scientist Dr. Soumya Swaminathan. Welcome, Soumya. https://youtu.be/ihi55JzTCqU https://youtu.be/ihi55JzTCqU

 
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The United States Pharmacopeia (USP): Global Seminar Series, Ensuring Quality Hand Sanitizer Production During COVID-19

USP is hosting a Global Seminar Series, Ensuring Quality Hand Sanitizer Production During COVID-19, to help ensure quality alcohol-based hand sanitizer production and support the safe use of alcohol-based hand sanitizer, February 25th, 2021.

For more information go to: USP Global Seminar Series: Ensuring Quality Hand Sanitizer Production During COVID-19 for Manufacturers and Healthcare Providers in Latin America – Event Summary | Online Registration by Cvent