Transcript PSM_wed_9

AMDS Contribution to the
Technical Briefing Seminar
October 2007
AMDS Secretariat within the New Organizational
Structure - HIV/AIDS DEPARTMENT
Office
of the Director
PMU
K.M. De Cock
T. Guerma
Policy and
UN coordination
Communications
Prevention in the
Health Sector
ART & HIV Care
Ying Ru Lo
Coordinator
Charlie Gilks
Coordinator
• HIV Testing
& Counselling
• PMCT
• MARP
• Emerging
Technologies
• Prevention
with Positives
Operational & Technical
Systems
Support
Strengthening for HIV
Bradley Hersh
Coordinator
Jos Perriëns
Coordinator
Resource
Mobilization
Strategic
Information
Yves Souteyrand
Coordinator
• Surveillance
• ARVs
• Paediatrics
• O.I
• TB/HIV
• Drug Resistance
• RCC
• IMAI
• Partnerships
with Civil Society
• HR for Health
• AMDS
• Health Financing
•M&E
• Operational
Research
• Country
Information
What is AMDS
• AMDS is a network of partner organisations working
in procurement and supply management of HIV
commodities.
• The secretariat of this network is in WHO/HIV
Department.
AMDS Partners
Why do we need partnership
Drug procurement is more than "shopping" drugs
Drug procurement is more than
"shopping" Procurement Cycle
Demand
Creation
Product
Selection
Monitoring
Effective
Use
Forecasting
Receipt,
Storage,
Distribution
Financing
Product
Procurement
Quality
Assurance
Supplier
Agreements
How we work
• Open ended partnership, loose network structure
• Work on concrete problems as opportunities arise or
needs become acute: GFATM Supply Chain planning;
GPRM; regulatory database, IMAI module; forecasting
ARV market; Training in drug supply management for
HIV programmes.
• Work in under-laboured HIV-specific domains: prices
of production, data production for strategy
development (ex. API)
• Foster collaboration in and outside WHO based on
areas of drug supply chain management.
Results and influence
• Procurement and supply management plans to support
Global Fund PR
• Strategic information highly valued : GPRM, Regulatory
status
• Strong support from partners for strategic orientation
chosen: keep network open, no need for MOUs; focus
collaboration on problem solving and practical issues
• Expectations of partners for WHO work increasing:
support creation of national level SM coordination
groups, organisation of partners in technical
communities, broker collaboration between partners,
map TA sources, provide normative leadership, increase
visibility and commitment to strengthening supply chain
management at country level
Strategic Information: Global Observatory
Why
• Collect, consolidate and disseminate strategic information
regarding affordability, accessibility, and availability of HIV
drugs:
In-house Products
• Global Price Reporting Mechanism - on AMD website
• API prices -on AMD website
• Regulatory status database - on AMD website
Global Price Reporting Mechanism (GPRM)
http://www.who.int/hiv/amds/price/hdd/
Why
 To improve price transparency on ARV market
 To inform MoHs, state and non state procurement officers and
favour price negotiation
 To inform WHO management in their strategic decision in
advocacy
How
 Collection and disseminate transactional data of ARV drugs
prices on the web
 Produce summary analysis of trend and prices of ARVs
(Summary report)
 Contributors: CHAI, Crown Agents, GFATM, IDA HIV Group,
JSI, MSH, UNICEF, UNDP, WHO-CPS, WHO NPO, Mission
Pharma, SCMS.
Achievements
 Features and reports improved
 Number of contributors improved
 Scope expanded from HIV products to TB, malaria medicines
API Price and producer database
http://www.who.int/hiv/amds/sourcespricesAPI.pdf
Why
 Improve price transparency and favour price negotiation
 Anticipate potential shortage in APIs and inform API
producers
 Inform WHO management in their strategic decision for
advocacy
How
 Collect and disseminate lowest and highest prices of each
API on AMD website
 Analyse API price trends
 Contributors: all Generic API producers – contact details on
AMD website
Achievement
 Tool and product Refined
 Updated information
 Increased number of companies reporting to AMDS
Regulatory status database
http://ftp.who.int/htm/AMDS/drugsdatabase.pdf
WHY
 Limited access to information on ARV marketing
authorizations by countries
 Inform WHO management team in making strategic
decision and advocacy
 Inform state and non state procurement officers, donation
programmes, countries using the GFATM grant on which
drug is registered and where
How
 Collect regulatory information and make it available in the
public domain
 Contributors: all R&D and generic ARV producers
Achievements
 Searchable database
 Cross check information at country level with support from
AMD partners
Forecasting of the ARV market
Why
• To avoid global supply shortages of antiretroviral drugs as it
happened during the scaling-up efforts.
How we took it forward
• Production of draft ARV forecasts 2007-2008 for discussion
with manufacturers
• Consortium of partners: UNAIDS, UNICEF, PfSCM, USAID,
Clinton Foundation, Mexico National Inst of Public Health
• Approaches: normative and consumption models.
• Survey 2006: uptake of ARVs in low & middle income
countries. Published in AIDS Journal, July 2006
Country Support in Supply Management
Rationale
• PSM constraints are major obstacles in the health system
• Access to HIV commodities requires wide partnership
• Several partners at country level work in isolation sometimes
in competition
• Lack of sharing of information/harmonization of practices
Two major areas of focus
• Increase collaboration to strengthen the supply management
in program planning and implementation processes (Unicef,
TCM, WB, GF, DELIVER, IDAsolution)
• Support the creation of national PSM coordination groups to
achieve integrated national supply chain management
systems.
Country support in Supply Management
Capacity building for PSM planning, training and TA
•
•
•
•
PSM workshops for national professionals (e.g. IDAsolution,
Global Fund)
Exchange of information and experience sharing among
participants
Consultant database in PSM
TA to urgent request for PSM support when no other
partner is available.
Country support in Supply Management:
The Future
Increase visibility and commitment of PSM in
planning process
• Collaborate with RCC in RO & CO planning processes to
ensure that PSM issues are well addressed
Support creation of national PSM coordination
groups
• Map country level presence of partners and their PSM area
of work
• Increase WHO capacity to play its convening role of
partners at country level: work with TCM, ROs and COs
• Foster collaboration for technical support between WHO
and the AMDS Network Organizations: Global Fund, SCMS,
WB, UNICEF, etc.
Tool Development
Reporting and M&E
Importance
• Vertical reporting puts a huge burden on national
programmes
• Lack of clarity at implementing levels of the reporting
requirements
• Harmonized reporting helps decide where to start improving
supply chain management system
Opportunity
• High level of consensus that "verticalization" in reporting
requirements by donors has gone too far: harmonization
needed at country level
• The need for AMD network partners (esp. PfSCM) to
develop/implement a harmonized and M&E PSM system.
• Partners asked WHO to take this process forward
Tool Development: Reporting and M&E; Handbook of
supply management at first-level health care facilities
What we did
Reporting and M&E of ART-PSM system
• Get the facts and move towards consensus
– JSI, MSH, PfSCM,
– Programme experts from Rwanda, Tanzania, Uganda, Vietnam
– CHMP, CRS, Global Fund, IDA, PEPFAR/OGAC, UNAIDS, UNICEF,
World Bank
• Develop outline interagency document
• Constitute a working group on content
Next steps
• Draft ART-PSM M&E document developed
• Field-test and finalise the document
Handbook of supply management at first-level health care
facilities
• Manual published and ready for use
Conclusion
• AMDS is part of health system strengthening Unit of HIV
Department
• PSM is a wide area requiring strong partnership: AMDS works
by fostering partnership among technical institutions working
in PSM
• Major areas of AMDS work to increase access to HIV
commodities:
• Strategic information: GPRM, regulatory status, API,
patent (in progress)
• Forecasting of HIV drug needs
• Regional and country support including capacity
building: support in planning (PSM plans) and training
of professionals working in national supply chain
management systems.
• M&E