Transcript Global Fund Workshop - World Health Organization

Procurement and
Supply Management
(PSM) Workshop:
Understanding basic drug
management elements for
proposal writing
Bangkok, Thailand
July 25-30, 2005
Thomas Moore, Management Sciences for Health
Introduction (1)
• Key GFATM documents
– Guidelines for Proposals
– Proposal Form
– M & E Toolkit
– PSM Assessment Tool
• Workshop handouts
– “Description of Interventions”
– “Pharmaceutical Management Guide for Procurement and
Supply Management plan for GFATM proposals”
– “Tools for forecasting drug needs”
– This Power Point presentation
Introduction (2)
• Describe your drug management system
– Use the six basic elements in the “framework” slide
– Describe any gaps within each of the six elements
in your drug management system
Examples: (1) no drug policy to govern supply and use;
(2) no mechanism for good forecasting
– Describe how you will use the GFATM funds to
overcome the gaps
Note: see other suggestions on your handout
“Pharmaceutical Management Guide for Writing
Procurement and Supply Management plans for
GFATM proposals
Introduction (3)
• In GFATM budget proposal must include a
breakdown of:
– Functional areas for:
• Monitoring and Evaluation
• Procurement and Supply Management
• Technical Assistance
– Service delivery areas
– Partner allocation
Framework:
Pharmaceutical Management Cycle
Selection
Use
Management
Support
Procurement
Distribution
Policy and Legal Framework
Policy, Regulations, and Laws (1)
• Develop or update government TB policy
• Develop policy for health care system
reforms
– Decentralized vs. Centralized
– Vertical vs. integrated
– Role of Private sector healthcare providers
Policy, Regulations, and Laws (2)
• Update drug policy for good procurement
and supply management
– Reinforce drug regulation capacity
• National Drug Authority
– Update Essential drugs list
– Require use of generic vs. brand names
– Develop regulations re: Importing, distribution,
sales
– Promote good manufacturing practices (GMPs)
Suggestions for PSM plan-Policy (1)
• Personnel needs
– Regulatory activities
– Monitoring, inspection, surveillance,
enforcement
– Training
• Infrastructure
–
–
–
–
Office space
Computers, software, equipment
Access to Quality Control laboratory facilities
Vehicles for distribution, inspection, enforcement
Suggestions for PSM plan-Policy (2)
• Update drug laws and regulations
– Publish standard treatment guidelines
– Update National Essential Medicines List
– Disseminate information to all organizational
levels
– Require good procurement practices
– Require drug registration to promote public safety
– Require GMP compliance by local drug
manufacturers
Indicators for M & E - Policy
• Average time, in days, required to clear shipments
of TB drugs from the port of entry*
• Average number of days to register TB drugs
• Percentage of TB treatment facilities that have the
latest official manual of TB treatment guidelines
• When post-marketing surveillance exists
– Product quality complaints
– Adverse drug reaction reporting
– Inspection of wholesalers and retail pharmacies
– Testing/sampling
Procurement - quantification/forecasting
• Needed for:
– Planning, budgeting, and ordering
• Critical issues:
– Must first have good selection of drugs
– Decide who will quantify - centralized vs.
decentralized activity
– Tools to use - manual vs. computerized
– Knowledge of lead times, stock-outs, safety
stock, growth, losses
– Reconcile quantities needed with budget
Options for Quantification
• Morbidity based: Base estimates on
expected number of cases
• Consumption based: Estimates based on
past consumption
• Adjusted-consumption based: Estimates
based on data from another region or
health service
Comparison of Quantification Methods
Consumption versus Morbidity
• Consumption – need good inventory
records
• Morbidity- need patient attendance data
• Both methods – need data on existing
stocks, lead times, costs
QUAN8
Indicators for M & E – drug quantification
• Average percentage of a set of tracer TB
commodities available in TB facilities and
medical stores
• Average percentage of time out of stock for
a set of TB tracer commodities in TB
facilities
• Presence of 6 months buffer stock at
national level and 3 months stock at district
level