Transcript Slide 1

Challenges and Lessons Learned in Establishing a
Successful CD4 Count System using FACSCount in
Vietnam
NGUYEN Van Kinh1, Ritu SHRIVASTAVA2, VU Duc Canh1, Marvin COULDWELL3, David KUHL3, LUU
Ho Thanh Tuan3, TRAN Phuong Thuy3, Grace HAFNER3
1 Vietnam Administration of HIV/AIDS Control, Hanoi, Vietnam, 2 Centers for Disease Control and Prevention (CDC), Hanoi,
Vietnam, 3 Supply Chain Management System (SCMS), Hanoi, Vietnam. Correspondence: Ritu Shrivastava,
[email protected]
1. Socialist Republic of Vietnam
•Location: South East Asia.
Land area: 331,114 sq km
•64 provinces
•Population: 84 million
•Pop. growth rate: 1.33%
4. Lessons learnt
•Not to start a CD4 system without
establishing a back-up specimen
referral system, early on
•Import equipment only via a
specialist experienced partner
•GDP per capita: $639
•HIV prevalence 0.44%
Source: Health Statistics
Year Book 2006, UNDP
March 05)
•Establish a reliable stock
management system in laboratories
2. Background
•Ensure a quality cold chain
distributor
•17,000 patients on ART by
September 2008: MOH/PEPFAR goal
5. Critical steps to set up a
reliable CD4 system
•103 patients, initiated ART in
September 2005
With support from MOH, PEPFAR,
SCMS, CHAI, CDC Thailand and
Atlanta, WHO, BD and Delta we
eventually facilitated
•Vietnam National Program supported
1 FACSCount and 1 FASCALIBUR,
1994
•Given geographically scattered sites,
PEPFAR ordered FACSCount for 5
key provinces.
3. Surprises in implementation
•1.5 years to import and install
FACSCounts
•Most FACSCounts had broken pump
in the first month
•First shipment of reagents took 7
months to import resulting in nearly
expired reagents (USG regulations for
VAT and duty waivers)
•Training for equipment operation
and maintenance
•Stock management system
•Cold chain distributor
•Hired appropriate staff
•CD4-related guidelines
•CD4 EQA system
•Specimen referral network
•Difficulty in fore-casting, resulting in
under and over-ordering supplies
6. Next steps
Several donors are offering different brands of CD4 equipment in Vietnam
•Additional co-ordination among partners is required to maximize program
effectiveness.
•Conduct a review of demand curve and respond by adjusting the capacity
(example replacing FACSCount with FACSCalibur).