Transcript Pediatric HIV/AIDS: Logistics Issues and Recommendations

Supply Chain Management
System Project
The Partnership for Supply Chain Management
March 2006
The President’s Emergency Plan for AIDS
Relief (PEPFAR)
• Targets
– Prevent 7 million new HIV infections
– Provide treatment for 2 million HIV-infected people
– Provide care to 10 million people infected and affected by
HIV/AIDS, including orphans and vulnerable children
• Scope
– 15 initial focus countries
– 5 years
– Up to $15 billion
SCMS Project Purpose
To establish and operate a safe, secure, reliable, and sustainable supply
chain management system (SCMS) to procure pharmaceuticals and other
products needed to provide care and treatment of persons with HIV/AIDS
and related infections
Haiti
Guyana
Around the world,
but initially
focused on:
Nigeria
Ethiopia
Vietnam
Uganda Kenya
Côte d’Ivoire
Rwanda
Zambia
Namibia
Tanzania
Mozambique
Botswana
South Africa
Project Objective
To create, enhance, and promote an uninterrupted
supply of high-quality, low-cost products that flow
through accountable systems which can:
– Rapidly scale up to support HIV/AIDS prevention, treatment,
and care
– Ensure quality of drugs, test kits, and other supplies
– Build capacity for long-term sustainable procurement and
distribution of drugs and commodities
– Respect intellectual property law at international and national
levels
Procurement Perspective, Moscow
• Procurement is not an isolated activity, part of PSM Cycle
• Procurement should be embedded in local legislation, be
transparent and accountable
• For professional procurement one needs a proper support
framework, covering vital functions (admin, budgeting, timely
payments, development of procedures, available in the public
domain.
• Solutions should aim at capacity building, no duplication or
programme or donor specific solutions.
• Demand forecasting is bottom up, defined by in country
programmes
Categories of HIV/AIDS Commodities
• ARVs (including FDA tentatively approved generics)
for adults and children
• Drugs for opportunistic infections
• Drugs for STIs
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Drugs for home care and palliative care
Drugs for tuberculosis
Rapid HIV test kits
Laboratory equipment and supplies
Medical supplies
Miscellaneous (e.g., vehicles)
Project Components
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In-country technical support
Competitive and transparent procurement capacity
Quality assurance program
Freight forwarding and warehousing services
• Comprehensive logistics Management Information
System
• Comprehensive management system
In-Country Technical Support
• Assessments and technical assistance (where requested)
• Procurement assistance
– Drug selection
– Forecasting/quantification
– Drug registration
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Customs clearance and delivery
Theft/diversion – corrective actions
Human capacity for supply chain management
Quality assurance plans
Sustainability plans
Procurement
• Volume purchasing leveraged to achieve best
worldwide price
• Drugs and commodities of assured quality
• Compliance with all US Government (USG) laws and
regulations
• E-catalog
• Manufacturing capacity constraints
• Clients
– Initially, USG PEPFAR participants
– After year 2, others
Procurement, Moscow
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Competitive (what is this and how to measure?
Transparency (what does this mean)
For ARV’s limited number of quality supplier, (innovators/generics, role
of local industry??
Qty API sources even more limited( parallel with TB)
Unknown capacity, eg shortages will occur in case short time horizon is
used, or when no clear picture exists on where API/starting material is
made.
Complicated market, Access prices, rerouting of products, commercial
versus other packs, Voluntary licensing, unclear IP issues, unclear local
registration status in case of replacement (see FDA replacement,or
voluntary licensing)
Not only capacity is sufficient it is the quality is the Chain which should
be ensured.
Quality Assurance
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Vendor, donor, and commodity qualification
Quality assurance document maintenance
Compliance testing
Suspect commodity testing
• Storage, handling, and monitoring standards
Freight Forwarding and Warehousing
• Timely, accurate, and safe transport and warehousing
• Delivery of drugs and commodities “door-to-door”,
ensure the last mile
• Appropriate cold/cool chain management
• Regional warehousing for efficiency and cost
• Shipment tracking from supplier to recipient
• Physical security measures
Logistics Management Information
Systems
• Global supply chain visibility
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Requirements estimates
Product registration status
Funds
Production capacity
Procurement status
Shipment and receipt status
Regional distribution center inventory management
Returns
• Product pedigree
• National/local supply chain visibility (on request)
Project Management System
• Project Management Office (PMO)
– Virginia, near JSI and MSH
– ~ 70 central staff to start
• Global supply chain monitoring
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Requirements estimates
Production capacity for key products
Supply imbalances of key products
Exception reporting
• Collaboration with USG, international donors, others
Cross-cutting Strategies
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One-stop shopping for HIV/AIDS programs
Pooled procurement using framework contracts
Begin and end in country
Strengthen — don’t replace — in-country supply
systems
• Regional warehousing and distribution
– Protect country infrastructure
– Increase responsiveness
• Collaboration, globally and locally
SCMS Implementation
• Pick and choose: one size does not fit all
• Additive to current supply chain management
mechanisms
• Based on demand and requests from the field
• Public-private-NGO-FBO partnerships
The Partnership for Supply Chain
Management (PSCM)
• Non-profit partnership established for SCMS
– JSI Research & Training Institute, Inc. (JSI)
– Management Sciences for Health (MSH)
• SCMS project team: 17 institutions
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Nonprofit organizations
Commercial private sector corporations
Academic institutions
Faith-based organizations
SCMS Benefits
Responsive
Continuous availability
Forward procurement
Regional distribution
SCMS
Effective
Cost-effective
Assured quality
One-stop shopping
Secure supply chains
Capacity building
Sustainability
Simpler ordering
Lower prices
Reduced inventory
Questions?
Thanks!
For more information:
Website: scms.pfscm.org
Email: [email protected]
Main phone: +1.703.341.4999
Main fax: +1.703.310.5270