ARCHIVED: Appendix 1: The Management of the National Antiviral Stockpile: Options Report - AVSMTG Terms of reference

APPENDIX 1:  AVSMTG TERMS OF REFERENCE

(December 2008)

1.0 Background

In 2006, the federal provincial and territorial governments set a target of 55 million doses of antiviral medications for the National Antiviral Stockpile (NAS) to be used for treatment purposes during a pandemic.  An initial purchase of 16 M doses was made primarily in early 2005, although some provincial/territorial governments (P/Ts) did purchase small stocks in 2004.  Following the decision to increase the stockpile to 55 M doses, additional purchases were made throughout 2006, 2007 and early 2008 and as of April 2008, 53 million doses have been delivered.  The final component of the stockpile (paediatric oseltamivir capsules) will be delivered in late 2008 or early 2009 at which time the stockpile will have reached the target of 55 million doses. The stockpile is comprised of approximately 90 % oseltamavir and 10 % zanamivir.  
 
There is currently no amantadine product in the NAS however some jurisdictions may hold small  amounts outside of the NAS.

The federal government supported the early treatment stockpile strategy through funding of 60% of the cost of the 55 million doses for a total of $80.54 million through a Treasury Board Submission.  There was no agreement at time the NAS was created as to whether or not the initial stockpile would be replenished or possible funding options. 

There is also a National Emergency Stockpile System (NESS) stockpile consisting of 8 M doses of oseltamivir and 4 M doses of zanamivir. Initial stocks for NESS were purchased in early 2004 and early 2006 although the bulk of the NESS stockpile (5 M doses of oseltamivir and 4 M doses of zanamivir) was delivered in early 2008.  The NESS also consists of a small quantity (70,000 capsules) of amantadine.

The Department of National Defence also maintains its own antiviral stockpile for military personnel consisting of 3 M doses of oseltamivir and 2.8M doses of zanamivir.

Both oseltamivir and zanamivir have an approved shelf-life of 5 years from the date of manufacture and most of the contracts covering the procurement for the NAS and the NESS required that the antivirals carry a shelf-life of at least 4.25 years from date of delivery.

2.0 Mandate

The mandate of the Antiviral Stockpile Management Task Group is to review and recommend options for a sustainable stockpile management strategy including short term (eg shelf-life extension) and long term (in terms of mix and turn over) options.

3.0  Roles and Responsibilities

Key activities of the task group are to:

• Develop recommendations to address expiring antiviral stock and shelf-life
• Develop options for changing composition based on new developments
• Consider cost and other implications (such as legal and regulatory) for both short term and long term options.

The duration of the task group is currently expected up to March 31, 2009 with the possible re-configuration or extension of the group in the new fiscal year.

The task group will be established early June 2008 with initial deliverables to be completed by the end of August 2008.

4.0  Governance

4.1 Recommendations will be brought forward through the:

• Council of Chief Medical Officers of Health
• Pandemic Preparedness Oversight Committee (PHAC)
• Public Health Network Council (PHNC) for endorsement/approval of recommendations (Pandemic Influenza Committee (PIC) or other groups may be requested to provide comments before submitting to PHNC), Deputy Ministers (if required)

5.0   Decision Making

To the extent possible, recommendations will be made through consensus.

6.0   Resources and Support

Scientific, research, policy, monitoring, secretariat functions and administrative support to the task group is provided and/or funded by the Public Health Agency of Canada (PHAC), Centre for Infectious Disease Prevention and Control (CIDPC).

The Public Health Agency of Canada (PHAC) is responsible for the travel costs of the members, and at the discretion of the chair, for guests and liaison members to attending meetings.  Travel, accommodation and per diem (meal and incidental) expenses will be reimbursed by the PHAC within Treasury Board Guidelines.

7.0   Meetings

Teleconferences and meetings will be held as needed.  Meeting material will be circulated by email to members prior to meetings and teleconferences.

7.1 Record of Decisions

Records of Decision of meetings and teleconferences will be prepared and distributed for review and comments as soon as possible.  The record of decisions is to be considered final upon approval by Members at the next meeting or teleconference.  Records of Decision should reflect consensus and non-consensus discussions.  The Records of Decision can be shared within jurisdictions for their internal use only and are not to be broadly disseminated.

8.0 Professional Ethics

Matters discussed at meetings and teleconferences are confidential.

9.0  Communication

Communication of progress and recommendations will be made to the Public Health Network.

A communication plan will be developed to further ensure provinces and territories are made aware of recommendations once final approval has been received.

MEMBERSHIP

Co-Chairs
Clint Shingler, Ontario Ministry of Health and Long-Term Care
Patricia Huston, Public Health Agency of Canada

Provincial & Territorial Representatives
Lorraine Adam, Manitoba Health and Healthy Living
Dominic Bélanger, Province of Quebec
Andre Corriveau, Government of North West Territories
Cathy Goodfellow, Province of New Brunswick
Sue Kessler, Alberta Health and Wellness
Fawziah Marra, BC Centre for Disease Control
Moira McKinnon, Government of Saskatchewan
Corinne Rowswell, Government of Prince Edward Island
Isaac Sobol, Government of Nunavut
Robert Strang, Government of Nova Scotia
Faith Stratton, Government of Newfoundland

Public Health Agency of Canada, Centre for Immunization and Respiratory Infectious Diseases
Lisa Paddle, Public Health Agency of Canada
Alan Thom, Public Health Agency of Canada
Secretariat:  Pamela Clarke, Public Health Agency of Canada
Secretariat:  Carolyn Lacaille, Public Health Agency of Canada

Public Health Agency of Canada, Centre for Emergency Preparedness and Response
Frank Smith, Public Health Agency of Canada

Departmental Legal Services
Mara Pollock, Health Canada

Health Canada, Therapeutics Products Directorate and Inspectorate
Shiv Brar, Health Canada
Kun Cao, Health Canada
Ian MacKay, Health Canada
Krishnan Tirunellai, Health Canada

DND
Brad Blanchard, DND

PWGSC
Isabelle Cantin, PWGSC
Henry Kreker, PWGSC

Other Government Departments
Poovadan Anoop, Health Canada
Nadia Giancaspro, Health Canada
Pauline Lacroix, Health Canada
Eric Turner, Public Health Agency of Canada