L. Privor-Dumm (IVAC) spoke about the additional trade-offs of primary container decisions in the context of vaccine wastage. She suggested that more than one container size may be needed within countries. Five dose vials may address issues for some products, but not all. The international community will need to provide improved container level forecasts to capture the varying needs by country to ensure production plans

for smaller vial sizes match with country needs and minimize risk of missed opportunities and/or contamination of vials if not handled appropriately. O. Mansoor summarized the activities of the Vaccine Presentation and Packaging Advisory Group (VPPAG) signaling pathway which is a forum for reaching consensus on vaccine product attributes established by the GAVI Alliance in 2007, in response to a query from industry on guidance about the optimal number of doses per vial for rotavirus and pneumococcal conjugate vaccines to be used in GAVI-eligible countries. The two leading child killers – pneumonia and diarrhea – can be largely prevented by new vaccines, and new technologies can help us to outreach to children in need Enzalutamide datasheet to deliver vaccines, in the optimal presentation. Subgroups were formed in 2013: one for

harmonization and the second to work on bar code, with support of GS1,4 a global organization that supports distribution of goods. Factors driving packaging choices include regulatory requirements, public sector preferences and guidelines, and manufacturers’ choices. Over the years, an increasing number of vaccines is available to children, from 6 in the 1970s to over 15 in the year 2010 (depending on regional schedules), challenging the delivery systems,

cold chain space, resources and immunization professionals. While the world is not on track to achieve its United Nations proposed Millennium Development Goal (MDG) commitment to a 67% reduction in child mortality by 2015, we believe that simple interventions like immunization can shift the balance from death to life for millions ALOX15 of children each year. D. Wood discussed existing initiatives for regulatory harmonization based on use of common set of written or measurement standards, and also on bi-lateral or multilateral legal agreements, such as European Medicines Agency (EMA), Association of Southeast Asian Nations (ASEAN), Asia Pacific Economic Cooperation (APEC), East African Community, among others. On the other hand, some decisions can be reached without a legally-binding obligation to do so, which he defined as regulatory convergence.