The Advisory Panel on Azithromycin for Child Survival (APACS) convened for the first time on 29 August 2025, bringing together country representatives, global health experts, donors, and partners in person, in Milan, Italy, and online.
This milestone meeting marked the beginning of APACS’s role as the independent advisory body on azithromycin stewardship, which will seek to ensure that donated and procured medicines for child survival are allocated fairly, transparently, and responsibly.
APACS was jointly established by the REACH Network and the International Trachoma Initiative (ITI) to provide expert guidance as azithromycin interventions expand across West Africa and potentially beyond.
A clear mandate
The APACS panel’s mandate and purview were set out by APACS Vice-chair, Dr David Addiss, who chaired the inaugural session.
APACS will:
- Provide independent advice on the allocation of azithromycin donated to and procured by the REACH Network
- Offer guidance in evidence-based decision-making on when to start and stop mass drug administration in REACH countries
- Ensure safety, antimicrobial resistance (AMR), and mortality data are taken into account when considering requests for azithromycin allocation
- Strengthen alignment across countries through recommendations for standardized and transparent processes.
The inaugural meeting laid the emphasis firmly on transparency and rigour, in order to maintain confidence among partners and to create a platform for meaningful exchange and mutual learning between countries.
Niger allocation request
The first meeting of the APACS committee reviewed Niger’s request for azithromycin allocation in 2026. The REACH AVENIR intervention in Niger has expanded rapidly since 2024, and programme representatives requested nearly 10 million doses to cover all seven regions in Niger next year.
APACS members provisionally recommended approval, while also noting challenges associated with the request, including data gaps, differences in mortality estimates, and the need to balance supply constraints with programmatic ambitions.
A resource for members
As APACS begins its work in earnest, the APACS.africa website will become a resource for panel members and all interested parties and stakeholders. It will include a password-protected members’ area where APACS meeting reports, allocation recommendations, and supporting documents will be published in a repository for panellists.
Work in progress
The first APACS meeting was an important first step and while much remains to be refined, one thing is clear: the Advisory Panel on Azithromycin for Child Survival is already a cornerstone of its founding partners’ commitments to equity, transparency, and responsible stewardship, as the International Trachoma Initiative and the REACH Network work together across West Africa to save young lives.
Logged-in members can read the first report of the Advisory Panel on Azithromycin for Child Survival here.