1 supply division procurement and supply management technical assistance
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2 SUPPLY DIVISION
PSM and MTSP goals
Strengthen organisation and national capacities to meet essential supply needs for children and families
Ensure access and availability to core commodities
Leverage resources through partnerships
3 SUPPLY DIVISION
PSM support has to be seen in the context of the inter-related steps of the complete supply chain cycle
DemandCreation
SupplierAgreements
FinancingReceipt, Storage,
Distribution
Forecasting
QualityAssurance
EffectiveUse
ProductProcurement
ProductSelection
Monitoring
4 SUPPLY DIVISION
The supply chain comprises three distinct phases: product planning, product acquisition and product delivery
DemandCreation
SupplierAgreements
FinancingReceipt, Storage,
Distribution
Forecasting
QualityAssurance
EffectiveUse
ProductProcurement
ProductSelection
Monitoring
Acquisition
PlanningDelivery
5 SUPPLY DIVISION
UN Agencies combine field office capacities with HQ to cover the full supply chain cycle
DemandCreation
SupplierAgreements
FinancingReceipt, Storage,
Distribution
Forecasting
QualityAssurance
EffectiveUse
ProductProcurement
ProductSelection
Monitoring
Acquisition
PlanningDelivery
FieldOffice
HQSD
6 SUPPLY DIVISION
UNICEF so far has supported countries in strengthening planning and delivery systems in support of increased ARV access where it provides ARVs
DemandCreation
FinancingReceipt, Storage,
Distribution
ForecastingEffective
Use
ProductSelection
Monitoring
PlanningDelivery
8 SUPPLY DIVISION
BACKGROUND
• Funds available but scale up not accelerating
• Lacking technical capacity• Lack of harmonisation• Duplication and gaps• Need for improved
coordination
9 SUPPLY DIVISION
UN Consolidated Technical Support Plan for AIDS
• Procurement and supply management (PSM) UN agencies to provide technical assistance are:
• WHO, WB, UNDP, UNFPA, UNICEFthrough country presence
10 SUPPLY DIVISION
UNICEF has been designated by UNAIDS/GTT as Lead Agency in procurement and supply management
Main roles of the Lead Agency:•Single entry point for UN Technical Support (broker)•Co-ordination and facilitation of technical assistance•Establish global and regional support mechanisms•Liaison between providers of technical support, UN Theme Groups and global support mechanisms
11 SUPPLY DIVISION
A set of preliminary interventions have been identified and a tentative budget determined for 2006-7
Intervention
Strengthening procurement + supply management planning and implementation
Strengthening warehousing management + distribution systems
Enhancing national medicines management information systems
Regional capacity building and training
12 SUPPLY DIVISION
Global level joint problem solving and implementation team (GIST) has been established especially related to implementation of Global Fund grants
•Formed by UNAIDS, WHO, UNICEF, UNDP, UNFPA, World Bank and Global Fund, with links to bi-lateral agencies•Facilitates rapid country driven process for identification of technical support needs with one of UN agencies as country lead•SD participates in monthly GIST meetings
13 SUPPLY DIVISION
5 Priority areas Meeting 6-7 December 2005
1. Health structures Multiple funding channels and coordination
mechanisms2. PSM plan
Consensus and participative generation Commitment from top level Can be used as baseline for M&E
3. Selection of OI medicines4. Quantification & Forecasting5. Storage and Distribution
Need for logistical expertise Transportation Organisation of health systems as whole, not only
HIV/AIDS-relate supply
14 SUPPLY DIVISION
Key challenges to the ARV supply chain lie in
quantification of demand and security of receipt and distributionDemand
Creation
SupplierAgreements
FinancingReceipt, Storage,
Distribution
Forecasting
QualityAssurance
EffectiveUse
ProductProcurement
ProductSelection
Monitoring
Security Quantification
UNICEF/HQ96-1172/GIACOMI PIROZZI
15 SUPPLY DIVISION
Recommendations for country level
• PSM Working Group – PSM problem analyses – GAP analyses– Division of labour– Existing assessments– Advocate for PSM– ART planning and monitoring
WHO/AMDS prepared TOR for working group
16 SUPPLY DIVISION
Recommendations for country level
• BASELINE ASSESMENT • Existing assessments• Roles and responsibilities of partners• Map out completed TA and lessons learned• Map out ongoing/planned TA • Lessons learned• Coordination• Avoid duplication of efforts• Synergies amongst partners
17 SUPPLY DIVISION
Recommendations for country level
• PSM PLAN - LIVING DOCUMENT• ‘Three ones’ national PSM plan• Procurement and distribution plan• Scale up plan• Identification of bottle necks • Roles and responsibilities • Include TA and capacity building plan• Review regularly• Monitor progress• Update
18 SUPPLY DIVISION
Resources needed- consultants training in CPH January 2006
•Need to expand consultants roster for PSM
•Training organised in by WHO and AMDS partners in SD to improve capacity in PSM
•HIV/AIDS, malaria and TB -synergies
•Brief on WHO’s normative guidance in treatment access
•Share technical tools
•Create a network of PSM professionals-potential consultants
19 SUPPLY DIVISION
PSM activities started:
• Bolivia
• Ethiopia
• Guinea Bissau (GIST)
• India
• Malawi
• Mali
• Nepal
• Niger (GIST)
• Nigeria (GIST)
• Russia
• Somalia
• Zimbabwe (GIST)
20 SUPPLY DIVISION
PSM Group Proposes:
• Cameroon
• Central Africa Republic
• Liberia
• Nigeria – WHO/TCM
• Sudan
• Uganda
21 SUPPLY DIVISION
Upcoming Training Activities:
• Consultants Training Copenhagen Jan 06
• Consultants Training Dakar Feb 06
• PSM Workshop Nairobi Feb 06
• PSM Workshop Moscow March 06
23 SUPPLY DIVISION
UN Consolidated Technical Support Plan for AIDS
UNICEF the lead agency in Procurement and Supply Management (PSM) – role:Single entry point for requesting TA on country levelCoordination and facilitation of TABrokering roleCountry owned and driven process of TA that builds on existing support frameworks
24 SUPPLY DIVISIONUNICEF/HQ00-0354/ALEJANDRO BALAGUER
Continuous monitoring of demand
Comprehensive supply plansDelivery arrangementsStockpiling
Key elements to consider in starting capacity building
25 SUPPLY DIVISION
Over 2.1 million children under 15 are estimated to be living with HIV/AIDS, with 700,000 in need of ARV treatment
26 SUPPLY DIVISIONUNICEF/HQ98-0910/GIACOMI PIROZZI
■ Paediatric ARV dosing schedules are not available for some drugs■ Most available paediatric ARV formulations require children to take frequent doses of unpalatable syrups■ Many need cold chain storage, have limited shelf life and stability■ No FDCs specifically available for paediatric use
27 SUPPLY DIVISION
Both originator and generic ARV manufacturers have given positive signals for developing appropriate paediatric formulations
•UNICEF met with 15 manufacturers 12 September to discuss the situation of paediatric formulations•Various types of developments underway for both single products and FDCs•Soluble tablets, granules, melts, scored tablets are some of the initiatives•Target of having WHO pre-qualified products by mid-2006
28 SUPPLY DIVISION
Due to a better access to treatment, more people are willing to undertake HIV testing
Number of patients on ARVs increased to 10,000 by Dec. 2004 in 24 sites. By end-2005, 40,000 patients to be on treatment in 59 health facilities
MALAWI
UNICEF/HQ02-0566/GIACOMI PIROZZIUNICEF/HQ02-0519/AMI VITALE
29 SUPPLY DIVISION
GISTGlobal Problems Solving and Implementation Team
Rapid assistance to countriesSolve bottlenecks Assist in implementationMonthly meetings UN agencies and GFATMCountries participate via video conferencesAction agreed
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