INTERNATIONAL ACCREDITATION ISO / IEC 17025 OFTHE …€¦ · AMR Antimicrobial Resistance CNCC...

INTERNATIONAL ACCREDITATION ISO / IEC 17025 OF THE NATIONAL CENTER FOR QUALITY CONTROL OF PERU

Lima, Peru

May 18 – 22, 2009

Amazon Malaria Initiative and South American Infectious Disease Initiative

Trip Report

Prepared by:

Anngie Caballero and Maria Recio June 2009

Links Media, LLC 707 Conservation Drive, Suite 300

Gaithersburg, MD 20878 USA Tel: (+1) 301-987-5495 Fax: (+1) 301-987-5498

Email: [email protected] This report was made possible through support provided by the U.S. Agency for International Development, under the terms of Contract No. GHS-I-01-03-00037-00. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the U.S. Agency for International Development.

AMI/SAIDI Trip Report • Links Media Page 1

About Links Media A full-service communications company, Links Media provides organizations with an array of technologies and methods to influence behavior, communicate risk, and mobilize resources to generate positive change. Links Media’s services include market research, strategic communications, multimedia production, partnership building and advocacy, and knowledge dissemination. Currently, Links Media is leading communication and advocacy efforts in support of multisector and multifactor antimicrobial resistance containment strategies in South America through the South American Infectious Diseases Initiative, funded by the U.S. Agency for International Development. Recommended Citation Links Media, LLC; 2009. Trip Report – International Accreditation ISO/IEC 17025 of the National Center for Quality Control of Peru. Lima, Peru, May 18–22, 2009. Submitted to the U.S. Agency for International Development by Links Media, LLC. Gaithersburg, MD: Links Media, LLC.


Acknowledgments

The authors of this report wish to express their sincere appreciation to all members of the Amazon Malaria Initiative (AMI) and the South America Infectious Disease Initiative (SAIDI), and particularly to the staff from the National Center for Quality Control of Peru [Centro Nacional de Control de Calidad (CNCC)]. Special thanks are offered to: - Ruben Tabuchi from CNCC and his fantastic staff for being so flexible, sharing, and willing to

make this achievement a turning point in the history of CNCC. - Jaime Chang from United States Agency for International Development (USAID), for his

constant guidance, support, and valuable contribution. - Roger Williams, Victor Pribluda, Adrian Barojas, and Laura Provan from the United States

Pharmacopeia (USP), for being so open and helpful to working together through the entire process.


Table of Contents Abbreviations and Acronyms .......................................................................................................... 4

Background ..................................................................................................................................... 5

Purpose of the Trip ......................................................................................................................... 7

Scope of Work ................................................................................................................................. 7

Source of Funding for the Trip ........................................................................................................ 7

Trip Activities .................................................................................................................................. 7

Conclusions and Recommendations ............................................................................................... 8

Next Steps ....................................................................................................................................... 9

Annex 1: Earned Media Report ..................................................................................................... 10

Annex 2: Press Release ................................................................................................................. 11


Abbreviations and Acronyms AMI Amazon Malaria Initiative AMR Antimicrobial Resistance CNCC International Accreditation ISO/IEC 17025 of the National Center for Quality

Control of Peru DIGEMID Dirección General de Medicamentos, Insumos y Drogas (General Directorate of

Medicines, Supplies and Drugs) DQI Program Information and Quality of Drugs INS Instituto Nacional de Salud LAC Latin America and Caribbean MOH Ministry of Health MSH Management Sciences for Health PAHO Pan American Health Organization SAIDI South American Infectious Diseases Initiative USAID United States Agency for International Development USP United States Pharmacopeia VNR Video News Release


Background On the Amazon Malaria Initiative The USAID Latin America and Caribbean Bureau, Office of Regional Sustainable Development launched the Amazon Malaria Initiative (AMI) in 2001 to improve the control and treatment of malaria in partner nations of the Amazon Basin. The initiative’s mission is to ensure that national malaria control programs in the Amazon Basin substantially incorporate selected best practices and promote lasting, evidence-based policy change in the partner countries. AMI began with the objectives of strengthening the partner countries’ systems of antimalarial drug resistance surveillance and encouraging the evidence-based formulation of drug policies that promote the adequate use of effective antimalarials. Over time, however, the initiative has expanded to address other related issues, including diagnostic accuracy and access, drug quality, access to treatment, and vector control.

USAID established AMI as a collaborative partnership among organizations (the AMI technical partners) that provide technical and scientific expertise and collaborate with the nations’ ministries of health and national malaria control programs to proactively address malaria prevention and control. The AMI partner countries take an active role, working closely with USAID and AMI’s technical partners at the regional and national levels, to ensure that positive impacts made in the reduction of malaria are sustained and sustainable. The partner countries also collaborate with one another and maintain an ongoing exchange of information and expertise (i.e., South–South collaboration).

The initiative’s subregional approach benefits partner countries through (i) subregional training and technical assistance, (ii) the development of standardized guidelines and protocols across all partner countries, (iii) the comparability of research and monitoring results within and across countries, and (iv) coordinated approaches to addressing cross-border problems.

On the South American Infectious Disease Initiative The emergence and spread of antimicrobial resistance (AMR) increasingly threatens health improvements achieved through priority programs targeting diseases such as tuberculosis, malaria, acute respiratory infections, and sexually transmitted infections. AMR develops over time and is exacerbated by an increased exposure of the microorganisms associated with infectious diseases to antimicrobial medicines, and the subsequent evolution of survival mechanisms within these microorganisms. Although many factors contribute to the development of AMR, a major contributor, from a public health perspective, is the unnecessary use of antimicrobials to treat common conditions and/or the use of inappropriate doses of the drugs in cases where treatment is required. Health systems contribute to this factor through a lack of proper legal frameworks, regulations, and guidelines to insure the quality and appropriate use of antimicrobials, and the implementation of poor managerial mechanisms for proper selection, procurement, distribution, and use of these valuable medicines. Physicians, pharmacists, and drug vendors also contribute to the unnecessary use of these drugs by prescribing and selling inappropriate treatments. Likewise, patients who have experienced the


benefits of antimicrobials tend to self-medicate, even when they may have access to formal health care services. The implication is that new strategies and more resources for second-line drugs may be needed in the near future for these highly prevalent diseases as conventional treatments fail.

In response to this growing challenge, USAID Bureau for Latin America and the Caribbean (LAC) proposed a sub-regional strategy, the South American Infectious Disease Initiative (SAIDI), for the promotion of rational use of antimicrobials and AMR control in three LAC countries (Bolivia, Peru, and Paraguay). The initiative’s general objective is to contain the emergence and spread of AMR by improving the availability and use of high-quality antimicrobials. This initiative is managed through the USAID mission in Lima, Peru.

Without interfering with existing efforts in AMR surveillance and control, a new set of activities, focusing on the community through a multisector approach have been created through SAIDI. SAIDI-based efforts are interdisciplinary and holistic, approaching problems as systems rather than in isolation, seeking balance and long-term maintenance of structures and functions, and recognizing and leveraging interaction among stakeholders.

Through this holistic and interdisciplinary approach, organizations already working on rational drug use and AMR-related activities have collaborated to leverage their cumulative technical expertise in identifying the major determinants of inappropriate antimicrobial use. The goal is to explore underlying causes for these determinants, and document what is already known in each country. This information has been used to help national stakeholders find local approaches to contain AMR, tailored to meet each country’s specific needs. The international partners contributing to SAIDI activities are the Infectious Disease Division of the Pan American Health Organization, the Centers for Disease Control and Prevention, the Alliance for the Prudent Use of Antibiotics, the Rational Pharmaceutical Management Plus Program of Management Sciences for Health, the U.S. Pharmacopeia Drug Quality and Information Program, and Links Media.

The objectives of the initiative are to: (i) gather evidence regarding the management and use of antimicrobials in humans for improved decision-making; (ii) collaborate with countries in the development of effective approaches to address AMR, focusing on antimicrobial use; and, (iii) enhance information sharing and dissemination of lessons learned.

Achieving these objectives will contribute to the following overall Intermediate Results for USAID/LAC:

IR1: Evidence base for LAC Population, Health, and Nutrition priorities increased IR2: Evidence base for LAC PHN priorities communicated and used IR3: More inclusive and better informed policy process promoted

Peru’s National Center for Quality Control, or Centro Nacional de Control de Calidad (CNCC), which is part of Peru’s National Institute of Health, or Instituto Nacional de Salud (INS), achieved ISO/IEC 17025:2005 accreditation, an internationally recognized standard for testing


and calibration laboratories. CNCC attained the accreditation for five critical analytical tests. This important achievement by a laboratory responsible for the quality control of pharmaceutical products will have a significant impact on the distribution of good quality medicines. CNCC was awarded ISO/IEC 17025:2005 accreditation from ACLASS, an internationally recognized accrediting body based in Washington, D.C.; it ensures that CNCC’s technical operations and administrative systems are functioning at the highest quality levels by international standards.

Purpose of the Trip From May 18 through 22, 2009, Links Media project manager, Maria Recio, traveled to Lima, Peru, to provide technical support to CNCC to effectively disseminate its recently achieved ISO/IEC 17025:2005 accreditation, an internationally recognized standard for testing and calibration laboratories. The main objectives for this site visit were to: 1. Provide technical support to build CNCC’s capacity for informing and educating

professionals, providers, stakeholders, policymakers, news media, civil society, business community, and consumers in a timely manner about the value of this achievement; and,

2. Increase public appreciation and understanding of this accomplishment.

Scope of Work Coordinate and organize a press conference with relevant spokespersons and authorities, and support CNCC’s Communications Committee on the organization and execution of the accreditation event conducted on May 21, 2009.

Source of Funding for the Trip This trip was supported through the respective AMI and SAIDI budgets.

Trip Activities During the visit, Links Media conducted various activities which can be summarized as follows: Developed and disseminated three press releases to Peruvian and international media

about the CNCC accomplishment, and scheduled interviews with CNCC’s director, Dr. Ruben Tabuchi.

Worked closely with USP and USAID to properly communicate this significant achievement to target audiences.

Worked with the members of the CNCC Communications Committee to review and finalize the organization and execution of the accreditation event and press conference conducted on May 21, 2009.

Coordinated and led the film crew to obtain video footage of the CNCC facilities and interviews with Jaime Chang and Ruben Tabuchi.

Edited and produced a video news release (VNR) that covered the accreditation event and the press conference, including providing guidance on the structure of the video and its script.


Met with Jorge Alania, Director of Communications from Peru’s Ministry of Health (MOH), and his team to ensure attendance by local media at both the accreditation event and the press conference. This meeting also was used to discuss the need to closely collaborate with the MOH Communications Office to strengthen Peru’s network of communicators for the promotion of AMI.

Met with local and national SAIDI coordinators, Dr. Malqui and Dr. Vasquez, to discuss the purpose and agenda of the virtual information sharing meeting, being planned to promote south-to-south collaboration. The meeting is scheduled to take place in August 2009.

Worked with in-country staff, Anngie Caballero, to coordinate future steps and strategies for the implementation of AMI and SAIDI activities.

Debriefed with Jaime Chang.

Debriefed with Ruben Tabuchi and his team to evaluate the overall execution and organization of the accreditation event and press conference.

Distributed VNR to local and international media outlets.

Prepared an earned media report and disseminated among AMI and SAIDI national and international partners.

Conclusions and Recommendations The work provided Links Media the opportunity to further strengthen the collaboration among AMI and SAIDI national and international partners. The Links Media team obtained valuable information regarding the communication needs of local partners, and considered ideas for addressing these needs. One such idea was to provide a workshop with the MOH’s network of communicators in Peru to support the institutionalization of AMI and SAIDI lines of work at country and regional level. Based on the work conducted during this trip, Links Media recommends the following:

Strengthen the alliance with CNCC by continuing to disseminate news of specific achievements in drug quality and control supported by AMI and SAIDI. Maintain communication with CNCC to further support timely communication of achievements and success stories, such as CNCC preparations to obtain the World Health Organization´s international certification through technical assistance supported by the initiatives.

Encourage collaborative work among AMI and SAIDI national and international partners. Use AMI and SAIDI project Web sites, regular partner conference calls, partner meetings, etc., to disseminate the results of activities conducted through shared partner efforts in AMI and SAIDI lines of intervention.

Use CNCC as an example to inspire AMI and SAIDI countries to pursue a higher level of achievement. Assist AMI/SAIDI partner, USP-DQI, to develop and disseminate a comprehensive document describing the results and impact of CNCC’s success story to key authorities within MOHs, national drug quality control laboratories, and related government institutions in the region.


Next Steps Continue discussions with Jorge Alania, Director of Communications for Peru’s MOH,

regarding the technical assistance needed to strengthen in-country dissemination of AMI’s lines of work through the national network of communicators in the country’s 15 regions.

Continue to disseminate the CNCC VNR through key local and international media, such as the main national television and radio networks (Panamericana Televisión, Frecuencia Latina, Andina de Televisión, Radio Programas del Perú), major newspapers (El Comercio, La República), and other outlets (CNCC, Efe News Agency, The Washington Post, News Public Radio, etc.). Additionally, disseminate the VNR through the AMI and SAIDI project Web sites and malaria and antimicrobial resistance-related organizations in the region.

Work with USP-DQI to finalize the development and dissemination of an official communication describing the results and impact of CNCC’s success story to key authorities within partner country MOHs, national drug quality control laboratories, and related government institutions in the region.


Annex 1: Earned Media Report

Table 1. Pre-Ceremony Press Release Source Media Type Coverage Reach

Latin America

Agencia Orbita Digital News 1 story N/A

AguasDigital Digital News 1 story 23,779

Sendero del Peje (SDP Noticias) Digital News 1 story 6,197

Web Diarios Blog 1 story; 1 spot 1,855

Radio Nacional Web Radio 1 story 952

Terra Noticias Internet Services 1 story 359,243

Yahoo! Mexico Internet Services 1 story 3,704,601

International

Soitu Internet Services 1 story 30,970

Terra España Digital News 1 story 1,637,253

Vive Lo Hoy Newspaper 1 story 29,358

ADN Newspaper 1 story 913,556

AguasDigital Digital News 1 story See above

Sendero del Peje (SDP Noticias) Digital News 1 story See above

AOL Noticias Internet Services 1 story 16,366

MSN Latino Internet Services 1 story 84,573

Yahoo! España Internet Services 1 story 59,575,492

Yahoo! Español Internet Services 1 story 3,810,940

United States

PR Newswire News service 1 story; 1 spot 53,000

Total Media Impressions 70,248,135

Table 2. Post-Ceremony Press Release Source Media Type Coverage Reach

Latin America

Agencia Orbita News 1 story 25,746

United States

PR Newswire News service 1 story 53,000

Bio-Medicine News 1 story 231,882

EurekAlert News 1 story 111,895

Genetic Engineering & Bio-Technology News 1 story 39,046

SurfWax Technology News 1 story 64,120

Total Media Impressions 70,248,135


Annex 2: Press Release (English and Spanish)

FOR IMMEDIATE RELEASE Press Office: 202-712-4320 Public Information Office: 202-712-4810 Email: [email protected]; www.usaid.gov

PERU’S MEDICINES QUALITY CONTROL LAB ACHIEVES INTERNATIONALLY RECOGNIZED ACCREDITATION FOR HIGH STANDARD OF OPERATION

Dedicated staff of professionals aid in the distribution of good quality critical medicines

Washington, D.C.—Peru’s National Center for Quality Control, or Centro Nacional de Control de

Calidad (CNCC), which is part of Peru’s National Institute of Health, or Instituto Nacional de

Salud, achieved ISO/IEC 17025:2005 accreditation, an internationally recognized standard for

testing and calibration laboratories. CNCC attained the accreditation for five critical analytical

tests. This important achievement by a laboratory responsible for the quality control of

pharmaceutical products will have a significant impact on the distribution of good quality

medicines.

CNCC was awarded ISO/IEC 17025:2005 accreditation from ACLASS, an internationally

recognized accrediting body based in Washington, D.C.; it ensures that CNCC’s technical

operations and administrative systems are functioning at the highest quality levels by

international standards.

“The ISO/IEC 17025:2005 accreditation positions CNCC as an international reference for labs

working on quality control of pharmaceutical products. It consolidates our technical

competitiveness, widens our reach, and allows us to contribute to the sustainable development

of Peru and the region in public health,” says Dr. Ruben Tabuchi, CNCC General Director.

mailto:[email protected]

http://www.usaid.gov/


This accreditation certifies that the CNCC provides accurate, valid, and trustworthy information

to the Peruvian Ministry of Health, guaranteeing the distribution of only good quality

pharmaceutical products to the population.

“Obtaining such a stringent accreditation is not simple. CNCC deserves to be recognized for their

commitment and hard work,” says Adrian Barojas, Program Manager of the U.S. Pharmacopeia

Drug Quality and Information (USP DQI) Program. Victor Pribluda, Manager of Latin American

Programs at USP DQI, stressed that CNCC is one of few official medicines control laboratories in

Latin America that has achieved ISO/IEC 17025:2005 accreditation, putting the lab in a position

that undoubtedly will contribute to improving access to good quality medicines in the region.

USP DQI is a cooperative agreement with the United States Agency for International

Development (USAID) that works with local governments, USAID Missions, the World Health

Organization (WHO), and other partners to advance strategies to improve drug quality and the

appropriate use of drugs in developing countries.

In Peru, USP DQI has been supporting quality assurance and quality control systems in general,

and the CNCC in particular, through the USAID-funded Amazon Malaria Initiative (AMI) since

2002 and South American Infectious Diseases Initiative (SAIDI) since 2005. AMI is a regional

initiative working in Bolivia, Brazil, Colombia, Ecuador, Guyana, Peru, and Suriname, whose

main objective is to improve malaria control at the sub-regional level and contribute to

decreasing morbidity and mortality at the national level. Partners include the Pan American

Health Organization (PAHO), the U.S. Centers for Disease Control and Prevention (CDC),

Management Sciences for Health (MSH), Links Media, the Research Triangle Institute (RTI), and

seven AMI country members. SAIDI, which works in Bolivia, Paraguay and Peru, strives to work

at the national and community levels in each country to contain the spread of antimicrobial

resistance (AMR). Partners in this effort include USP DQI, MSH, CDC, PAHO, Alliance for the

Prudent Use of Antibiotics (APUA), and Links Media.

“As the malaria situation evolves, monitoring the quality of antimalarials becomes even more

important for ensuring that good quality drugs are routinely available at the point of use and


when efficacy studies are done,” says Dr. Jaime Chang, project management specialist from the

Health office of USAID-Peru and AMI and SAIDI coordinator. “Attaining accreditation for these

key tests does contribute to ensuring the validity of results provided by CNCC, something

critical for supporting the Peruvian health authorities’ efforts to ensure antimicrobials available

to treat not only malaria, but tuberculosis and other infectious diseases – ranging from skin

infections to AIDS – are of good quality.”

For more information about the CNCC, please visit

http://www.ins.gob.pe/gxpsites/hgxpp001.aspx?2,6,20,O,S,0,MNU;E;1;19;MNU. For more

information on USAID, please visit www.usaid.gov. Other participating organizations can be

found at www.uspdqi.org, www.paho.org, www.msh.org, www.cdc.gov,

http://www.tufts.edu/med/apua, , http://www.rti.org. Links Media can be found at

www.linksmedia.net.

http://www.ins.gob.pe/gxpsites/hgxpp001.aspx?2,6,20,O,S,0,MNU;E;1;19;MNU


http://www.uspdqi.org/

http://www.paho.org/

http://www.msh.org/

http://www.cdc.gov/

http://www.tufts.edu/med/apua

http://www.rti.org/

http://www.linksmedia.net/


Comunicado de Prensa (Aprobado por USAID) Para su divulgación inmediata 16 de Abril, 2009 Oficina de Prensa: 202-712-4320 Oficina de Información Pública: 202-712-4810 Email: [email protected]; www.usaid.gov

CENTRO NACIONAL DE CONTROL DE CALIDAD DE MEDICAMENTOS DEL PERÚ OBTIENE ACREDITACIÓN DE RECONOCIMIENTO INTERNACIONAL

POR ALTO ESTÁNDAR DE TRABAJO Un dedicado grupo de profesionales contribuye a la distribución

de medicamentos de buena calidad

Washington, D.C. – El Centro Nacional de Control de Calidad del Perú (CNCC), parte del Instituto Nacional de Salud, recibió la acreditación ISO/IEC 17025:2005, un indicador reconocido internacionalmente que se concede a laboratorios que realizan pruebas, medidas y calibraciones. El CNCC recibió esta acreditación para cinco pruebas analíticas críticas. Este importante logro por parte de un laboratorio responsable del control de calidad de productos farmacéuticos tendrá un impacto significativo en la distribución de medicinas de buena calidad. La acreditación ISO/IEC 17025:2005 le fue otorgada al CNCC por ACLASS, un ente acreditador

con reconocimiento internacional y base en Washington, D.C. Esta acreditación certifica que los

sistemas de operación técnicos y administrativos del CNCC funcionan con los más altos

patrones de calidad de acuerdo a estándares internacionales.

“El haber obtenido la Acreditación ISO/IEC 17025:2005 nos posiciona como uno de los laboratorios de referencia internacional en control de calidad de productos farmacéuticos, consolidando nuestra competencia técnica, ampliando nuestra cobertura y contribuyendo al desarrollo sostenido del país y la región en el sector salud”, dice el Dr. Rubén Tabuchi, Director General del CNCC. Esta acreditación certifica que el CNCC proporciona información precisa, válida y confiable al Ministerio de Salud, garantizando de este modo que la población peruana reciba únicamente medicamentos de buena calidad. “No es fácil recibir una acreditación tan exigente como ésta y el CNCC merece ser reconocido

por su compromiso y arduo trabajo para lograrlo”, refiere Adrián Barojas, gerente del Programa

de Información y Calidad de las Drogas de US Pharmacopeia (USP DQI, por sus siglas en inglés).

Víctor Pribluda, gerente de Programas Latinoamericanos de USP DQI, enfatizó que la

acreditación al CNCC, que es uno de los pocos laboratorios gubernamentales de control de

mailto:[email protected]



calidad de medicamentos en América Latina que la ha recibido, va a contribuir sin ninguna duda

a que mejore el acceso a medicinas de buena calidad en la región. USP DQI es un acuerdo de

cooperación con la Agencia de los Estados Unidos para el Desarrollo Internacional (USAID, por

sus siglas en inglés) para trabajar con los gobiernos locales, las misiones de USAID, la

Organización Mundial de la Salud (OMS) y otros socios cooperantes, con el objetivo de

promover y avanzar estrategias en los países en desarrollo, para mejorar la calidad de los

medicamentos y el uso apropiado de los mismos.

En Perú, USP DQI ha proporcionado asistencia técnica para el fortalecimiento de los sistemas de

aseguramiento y control de calidad en general y al CNCC en particular, a través de la Iniciativa

Amazónica contra la Malaria (AMI, por sus siglas en inglés) desde el año 2002, y desde el 2005

también a través de la Iniciativa Sudamericana contra las Enfermedades Infecciosas (SAIDI, por

sus siglas en inglés); ambas iniciativas son financiadas por USAID. AMI es una iniciativa regional

que funciona en Bolivia, Brasil, Colombia, Ecuador, Guyana, Perú y Surinam, cuyo objetivo

principal es mejorar el control de la malaria en el plano subregional y contribuir a disminuir la

morbilidad y mortalidad en el plano nacional. Los socios de AMI incluyen a la Organización

Panamericana de la Salud (OPS), los Centros para el Control y la Prevención de Enfermedades

de los Estados Unidos (CDC, por sus siglas en inglés), Management Sciences for Health (MSH) y

Links Media, y a los siete países miembros. SAIDI opera en Bolivia, Paraguay y Perú, y trabaja en

cada país a nivel nacional y local, con la misión de contener la propagación de la resistencia

antimicrobiana. Los socios de SAIDI incluyen a USP DQI, MSH, CDC, la Alianza para el Uso

Prudente de los Antibióticos (APUA, por sus siglas en inglés), la OPS y Links Media.

“Monitorear la calidad de los medicamentos antimaláricos es muy importante para asegurar

que drogas de calidad estén disponibles cuando sean necesarias y cuando los estudios de su

eficacia hayan concluido”, indicó el doctor Jaime Chang, especialista en gestión de proyectos en

salud de USAID y coordinador de AMI y SAIDI. “Cumplir con los requisitos para obtener esta

acreditación contribuye a asegurar la validez de los resultados de pruebas clave que realiza el

CNCC, lo cual es crítico en el apoyo al esfuerzo de las autoridades peruanas de la salud para

asegurar que los antimicrobianos disponibles para los peruanos para tratar la malaria, la

tuberculosis y otras enfermedades infecciosas – incluido el SIDA – sean de buena calidad.”

Para más información sobre el CNCC, por favor visite http://www.ins.gob.pe/gxpsites/hgxpp001.aspx?2,6,20,O,S,0,MNU;E;1;19;MNU. Si desea más información sobre USAID, por favor visite www.usaid.gov. Sobre otras organizaciones participantes en los programas, puede visitar www.uspdqi.org, www.paho.org, www.msh.org, www.cdc.gov, http://www.tufts.edu/med/apua/, y http://www.rti.org. Links Media puede ser ubicada en www.linksmedia.net.

# # #

http://www.ins.gob.pe/gxpsites/hgxpp001.aspx?2,6,20,O,S,0,MNU;E;1;19;MNU


http://www.uspdqi.org/

http://www.paho.org/

http://www.msh.org/

http://www.cdc.gov/

http://www.tufts.edu/med/apua/

http://www.linksmedia.net/

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