Optimising procedure management for marketing authorisation of veterinary medicines in Eastern Africa

Timely and effective marketing authorisation of veterinary medicines requires a combination of rigorous scientific evaluation and efficient management of procedures.  In line with GALVmed’s role in implementing the AgResults Foot and Mouth Disease (FMD) Vaccine Challenge Project in Eastern Africa, GALVmed has worked with the Secretariat of the East African Community (EAC) to support National Regulatory Authorities (NRA) in the region to build capability in marketing authorisation of FMD and other vaccines.  A first workshop was organised in November 2020 that focussed on the technical requirements for authorisation.  A second workshop took place in November 2022, looking at measures that NRA could take to optimise the management of marketing authorisation procedures so that authorisations are evaluated and issued in a timely manner.  The Veterinary Medicines Directorate in the United Kingdom (UKVMD) provided expertise to both workshops based on their experience as an NRA that has extensive knowledge in authorisation of FMD and other vaccines, both at national level in the UK and in cooperation with other NRA.

Key workshop outcomes

This workshop focused on optimising procedure management for marketing authorisation of veterinary medicines in Eastern Africa.  Although the main focus of the workshop was on marketing authorisation of veterinary vaccines, the same principles of effective procedure management apply to all types of veterinary medicines, and so the conclusions and recommendations apply equally to both veterinary pharmaceuticals and vaccines. 

National marketing authorisation procedures operate in all countries within Eastern Africa that have a functional regulatory authority.  Member countries of the EAC also operate a mutual recognition (MR) procedure.  Ultimately, MR procedures rely on national procedures for issuing a national marketing authorisation certificate following agreement on a harmonised summary of product characteristics (SPC). The workshop therefore examined procedure management of both national and MR procedures and the interface between them.

Approach

Participants in the workshop consisted of experts from NRA responsible for managing marketing authorisation procedures, particularly MR procedures, for veterinary products within their agency.  Over the course of two days experts explored, with the organisers and invited experts, those aspects of procedure management that worked well within and between agencies in the region and aspects that could be improved.  A representative of the global animal health industry association HealthforAnimals gave a presentation that summarised feedback from local industry on their perceptions of procedure management in the region.

Key messages arising from the workshop

  • Companies that have used the MR procedure feel it generally works well and appreciate the ability to obtain marketing authorisation in multiple countries through a single procedure.  The role and activity of the MRP Coordinator was considered particularly helpful.
  • NRA are encouraged to make information on the technical and administrative requirements for marketing authorisation procedures more readily available to applicants, particularly in the case of the MRP.  It can be difficult for applicants to understand all of the requirements that apply in different countries, particularly where these differ between countries such as the arrangements for dossier submission, payment of fees and submitting samples for testing.  Where not already done, NRA should publish their requirements online and make use of the MRP ‘one-pager’ information sheet being prepared by the EAC Secretariat.
  • Adherence to timelines is frequently poor and delays may arise due to failure to adhere to deadlines by NRA, Local Technical Representatives (LTR), or applicants.  When accepting the role of Reference Country (RC) or Concerned Country (CC), NRA should ensure that they have sufficient resource to process applications in a timely manner.
  • Applicants currently find it difficult to obtain information on the previous experience, and performance, of NRA when performing the role of RC or CC.  NRA, possibly working the Coordination Group on Mutual Recognition (CGMR), should make this information public to allow applicants to make informed choices of NRA to act as RC or CC for their applications.
  • Communication with applicants on the progress of applications through the evaluation procedure is highly variable.  Some countries already have online systems allowing applicants to track their applications whilst applicants in other countries reported difficulty in monitoring progress of their applications.  NRA are encouraged to improve tracking of applications and communication with applicants.  NRA vary widely in the extent to which they rely on manual process or on IT solutions and on the resources available for management of procedures. Ways to promote exchange of experience and best practice between those agencies that already operate online tools and those that are developing them should be explored to accelerate the introduction of IT solutions and avoid unnecessary duplication of effort.
  • The LTR acts as the applicant’s representative with the NRA and plays a key role in the smooth functioning of the MR procedure.  The performance of LTR varies widely, and a poorly performing LTR can slow or halt an ongoing procedure.  Whilst managing LTR is the responsibility of the applicant, NRA need to consider ways to help applicants to improve or replace poorly performing LTR and to promote the use by applicants of LTR that are known to be effective.  Guidance from NRA on how LTR can best fulfil their role would be useful.
  • Participants were invited to explore the interest within their agency in trialling a self-assessment and evaluation tool developed by the UKVMD.  This tool provides a framework which agencies can use to evaluate the effectiveness of their regulatory functions and to develop action plans in areas identified for improvement.
  • Participants considered that a follow-up in-person workshop would help them develop action plans that address the areas for improvement identified by the current workshop.
  • The findings of the workshop should be brought to the attention of Heads of Agency to raise awareness of the benefits that the MR procedure is bringing to applicants and to agencies in the region, and of the areas that have been identified for further improvement.
  • The CGMR plays a key role in ensuring the smooth operation of MR procedures.  The group should be encouraged to play a greater role in fostering best practice among NRA by including process improvement as a standing item on their agenda and by promoting interchanges between agencies that increase sharing of work and knowledge.

This blog was written by the AgResults FMD Vaccine Challenge Project team.

Developing a Public Private Partnership Framework for FMD in Eastern Africa

Although Public Private Partnerships (PPPs) have been implemented in Eastern Africa, they have largely been for infrastructural development in the road, water, and energy sectors. Applying PPP approaches in the veterinary sector is still an emerging concept. But now, thanks to the AgResults Foot and Mouth Disease (FMD) Vaccine Challenge Project, there is a new standardised PPP Framework that highlights the landscape, challenges, and opportunities of PPPs in the FMD vaccine value chain.

The FMD Vaccine Challenge Project is an eight-year, US$17.68 million Pay-for-Results prize competition that encourages the development and uptake of high-quality FMD vaccines tailored to meet the needs of Eastern Africa in six target countries: Burundi, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda. One of the project’s goals is to develop a private sector model for buying and distributing FMD vaccines to complement public sector efforts in the region. PPP Frameworks can be crucial tools for communicating and raising awareness among key stakeholders. The team knew that creating such a framework for the FMD vaccine value chain could attract private sector investments into the veterinary domain to effectively and efficiently control FMD in the region.

To develop the PPP Framework, the FMD Vaccine Challenge Project team customized aspects of the OIE PPP Handbook into a practical framework, aimed at sparking commitments between partners to strengthen the FMD vaccine value chain in Eastern Africa. Although the OIE PPP Handbook is the single most comprehensive resource on PPP development in the veterinary sector, it only offers general guidelines.

The development process involved seeking views and inputs from the groups in Eastern Africa that would use the tool: veterinarians, para-veterinarians, and representatives from vaccine manufacturers, importers, distributors, livestock enterprises, and farmer organizations. From October 2020 to August 2021, the team engaged these key public and private sector stakeholders to collate feedback on their perspectives and interests in PPPs.  

Although COVID-19 restrictions forced these meetings to be virtual, the discussions were dynamic, and participants provided enthusiastic comments that are summarized and validated in the PPP Framework. To create a stronger enabling environment, participants overwhelmingly identified the need to establish PPPs as well as link existing PPP units with their respective Departments of Veterinary Services. Responding to this feedback, the framework points out key challenges to the establishment of PPPs: lack of awareness of their benefits, trust issues between the public and private sector, and lack of financing. In addition, it identifies and prioritises opportunities for PPPs in vaccine production, purchasing, distribution, delivery, vaccinations, and post-vaccination monitoring for each of the six target countries.

Now that the PPP Framework is finalized, the FMD Vaccine Challenge Project team is focused on promoting its use in manufacturing, purchasing, distribution, and vaccination campaigns. This involves (1) identifying partnerships to promote the PPP Framework in target countries and (2) facilitating PPP MOUs, contracts, and/or informal partnership agreements in those countries.

Making the framework relevant and accessible will hopefully catalyze future PPP arrangements in the FMD vaccine value chain and trigger PPPs in the general veterinary domain.

The full PPP framework is available here. For more information on the AgResults FMD Vaccine Challenge Project, visit the GALVmed and AgResults websites.

Written by Badi Maulidi