ministry of health pharmacy division … ssr 1st...lopinavir/ritonavir 40/10mg (oral pellets) 1*120...

Anti malaria medicines and supplies

Laboratory commodities

NMS and JMS have high stock levels(>6 MOS) for Artesunate, AL 6*4, AL 6*2 , AL 6*3 and mRDTs. Issues of ACTs from the central warehouses are Lower than originally projected . Supply plans have been revised and shipments delayed to

mitigate overstocks.

MINISTRY OF HEALTH

PHARMACY DIVISION

STOCK STATUS REPORT AS AT 1st December 2018

A Publication of The Ministry of Health Uganda

The purpose of this report is to inform the Ministry of Health and all stakeholders of the stock levels in the country as a tool that enables appropriate logistics decisions making . This report highlights stock status, real challenges,

bottlenecks but also recommends potential solutions to mitigate stock outs and expiries of ARVs & HIV test kits, ACTs, Anti-TB medicines, Reproductive Health items, selected Laboratory commodities,Vaccines and selected medicines for

treatment of Opportunistic Infections In the Repubic of Uganda

This report serves to: - Act as an early warning indicator for potential stock outs and possible expiries of EMHS

- Identify challenges and recommendations to avert supply interruptions

- Encourage preparation and sharing of joint supply plans with stakeholders

- Identify strategies for regularly reviewing supply plans for all the commodities

- Encourage donors to honor their commitments in terms of quantities of products expected, timeliness of deliveries and flexibility.

Summary of the stock status report as of 1st December 2018

Antiretroviral medicines

This is a 1st December 2018 tock status report but updated with sock on hand data as of 31st December 2018. Warehouse data utilized includes information from NMS, JMS, MAUL, JCRC and UHMG .

SD Bioline HIV test kits are adequately stocked (above 3 MOS) both at NMS and JMS however there are low stock levels of SD Bioline at MAUL. Stat-pak test kits are well stocked at NMS (> 3 mos) however there are low stock levels at JMS

and MAUL at less than 3MOS. Determine test kits are well stocked (>3 MOS) at JMS and MAUL however there are low stock levels at NMS .Transfer of PEPFAR procured for HIV determine test kitsfrom JMS to NMS has been iniated (2.4

MOS). Shipments are expected from Global Fund for HIV test kits in 2019. Shipment for Stat-Pak is expected by end of January 2019 for JMS. Order needs to be placed for all HIV test kits for MAUL.

Viral load testing kits and EID commodities (at UNHLS), TB sputum mugs and GeneXpert catridges (at NMS) have low stock levels of less than 3 MOS. TB LAM kits and Hepatitis B test kits are well stocked with more than 3 MOS.

CD4+ reagents of BD FACS and Partec are stocked out at NMS, however shipments for all commodities are expected by end of January 2019.

The PNFP sector: JMS is fairly well stocked with most of the commodities having over 3 months of stock except for LPV/r 200/50 mg,AZT/3TC/NVP 300/150/200, NVP 200 mg,NVP 50mg and NVP suspension with less than 3 MOS. MAUL is

fairly stocked with ARVs having more than 3MOS except for TDF/3TC/EFV 300/300/600 mg,TDF/3TC 300/300 mg ,AZT/3TC 300/150 mg and DTG 50 mg with less than 3 Months of stock.

The public sector: NMS has low stock levels of less than 3 MOS for a number of the ARV medicines except AZT/3TC/NVP 300/150/200 mg,TDF/3TC 300/300 mg,TDF/3TC/DTG 300/300/50 mg,NVP 200 mg ,LPV/r 200/50 mg ,AZT/3TC 60/30

mg ,EFV 200mg and LPV/r 100/5mg. Public sector stock under the PEPFAR $18.7m and $ 65m support is however available at JMS and MAUL to be transferred upon tranche requests from NMS. More shipments are expected from Global

Fund , PEPFAR and GOU to ensure adequate stock availability through 2019.

Anti-Tuberculosis medicines

At NMS, Fluconazole formulations are fairly well stocked with more than 3 MOS. There are low stock levels of Cotrimoxazole 960mg; cotrimoxazole 120mg is well stocked with about 5.9 MOS at NMS.

JMS has sufficient stock of fluconazole suspension. There is an over stock of Fluconazole IV infusion and low stock levels of (< 3 MOS ) for Fluconazole 200mg tablets. Shipment for Fluconazole 200mg tablets is expected by the end of

January 2019. Transfer of fluconazole IV infusion from JMS to NMS is to be effected once the stock levels drop below minimum level at NMS. Cotrimoxazole 960mg is well stocked at JMS. There is however an over stock of Cotrimoxazole

120mg. Consumption of Cotrimoxazole 120mg at JMS is projected to increase with increased number of children as a result of rationalisation of USAID/CDC supported facilities.

MAUL is currently well stocked on both fluconazole and cotrimoxazole formulations however there are low stock levels of less than 3 MOS for Fluconazole IV infusion at MAUL. Shipment for Fluconazole IV infusion is expected by end of

January 2019.

First line and second line anti-TB medicines have low stock levels except for RHZ 75/50/150 mg, Capreomycin, Kanamycin and Cycloserine. There is a stock out of RHZE 150/75/400/275 mg. Shipments for RH mg 150/75 (4.2 MOS) and RHZE

150/75/400/275 mg (3.3 MOS) from GOU were received in December 2018. Additional 3.5 MOS for RH 150/75mg and 9.4 MOS for RHZE are expected in March and April 2019 from GOU.

Injectable Kanamycin and Capreomycin are to be phased out following WHO recommendation of exclusive use of oral MDR-TB regimens. The phase out is expected to start in July 2019.

Reproductive health commodities

Most reproductive health commodities are stocked out at NMS except Misoprostol and Combined Oral Contraceptives. Interwarehouse transfer from UHMG and JMS to NMS has been initiated for DPMA-IM and Combined oral

contraceptives.

There are low stock levels of RH commodties for the Alternative Distribution Channel (ADS) except for Combined oral Contraceptives, Implanon NXT, IUDs, DPMA-SC and DPMA-IM.

Shipments for male condoms, DPMA-IM, Levonorgestrel 75mg/rod, female condoms and IUDs are expected from USAID, GF and UNFPA.

Vaccines

Medicines for opportunistic infections

Vaccines are fairly stocked with 60% of the vaccines having more than 3MOS. Order needs to be placed for all vaccines.

A : National Medical Stores -Adult Formulations Stock Status

Product Name Unit of measure

Closing Bal at 31st

December 2018 AMC Nov 2018 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19

Efavirenz/Lamivudine/Tenofovir 600/300/300mg 1*30 tabs 1,073,084 500,405 2.1 4.1 3.1 4.0 3.0 3.8

Dolutegravir/Lamivudine/Tenofovir 50/300/300mg 1*30 tabs 586,058 177,061 3.3 2.3 1.3 0.3 3.0 9.4

Lamivudine/Zidovudine/Nevirapine 150/300/200mg 1*60 tabs 589,505 177,849 3.3 3.4 2.4 2.2 1.2 0.2

Lamivudine/Zidovudine 150/300mg 1*60 tabs 1,402 56,829 0.0 0.0 0.0 0.0 0.0 0.0

Tenofovir DF/Lamivudine 300/300mg 1*30 tabs 380,257 124,988 3.0 2.0 1.0 0.0 0.0 2.6

Dolutegravir 50mg 1*30 tabs 6,859 2,909 2.4 1.4 0.4 0.0 7.7 6.7

Nevirapine 200mg 1*60 Tabs 174,008 44,923 3.9 2.9 1.9 0.9 0.0 0.0

Efavirenz 600mg 1*30 tabs 144,551 139,359 1.0 2.2 1.2 0.2 0.0 0.0

Abacavir/Lamivudine, Scored, 600/300mg 1*30 tabs 11,910 13,862 0.9 7.4 6.4 5.4 4.4 6.2

Atazanavir/Ritonavir 300/100mg 1*30 tabs 42,639 25,169 1.7 5.0 4.0 3.0 2.0 4.0

Lopinavir/Ritonavir 200/50mg 1*120 tabs 47,506 13,991 3.4 7.8 6.8 5.8 9.7 13.5

Min 3MOS, Max 6MOS

A detailed account is given below for selected commodities per warehouse.

Months of Stock at the end of the month

Antiretroviral Medicines

Adult first line formulations

Adult second line formulations

Adult ARV formulations have low stock levels of less than 3MOS except LPV/r 200/50 mg , NVP 200mg, TDF/3TC 300/300mg, AZT/3TC/NVP 300/150/200mg and TDF/3TC/DTG 300/300/50mg that are well stocked with more than 3

MOS. Stock is available in-country for ATV/r 300/100mg, EFV 600Mg,TDF/3TC/EFV 300/300/600mg and ABC/3TC 600/300mg. Stock levels are expected to improve with the transfer of PEPFAR stock at JMS to NMS. There is a stock out

of AZT/3TC 300/150mg caused by API challenges, hindering GOU supply that was meant to cover this period. Efforts are ongoing to expedite the PEPFAR shipment of 44,040 packs.

Notes: Adult ARVs at NMS

A:National Medical Stores -Pediatric Formulations Stock Status


Closing Bal at 31st


Abacavir/Lamivudine 120/60mg 1*30 tabs 19,301 48,108 0.4 2.3 1.3 0.3 2.3 6.5



Nevirapine 10mg/ml 100 ml 1 bottle 16,377 6,802 2.4 8.1 11.0 10.0 9.0 8.0

Nevirapine 50mg 1*30 tabs 23,172 10,509 2.2 7.4 13.2 12.2 11.2 10.2



Lopinavir/Ritonavir 40/10mg (oral pellets) 1*120 caps 2,901 5,519 0.5 4.2 3.2 2.2 1.2 9.0Min 3MOS, Max 6MOS

Notes: NMS ARVs stock status for pediatric formulations

Pediatric ARV medicines have low stock levels of less than 3 MOS of stock except AZT/3TC 60/30 mg and NVP 50 mg with above 3MOS.

PEPFAR Stock is available in-country for LPV/r 40/10mg pellets, NVP 50mg, NVP suspension, LVP/r 100/25mg, ABC/3TC 120/60mg and AZT/3TC 60/30 mg.

Pediatric first line formulations

Pediatric Second line formulations

Stock status for Public sector PEPFAR stock ($8.6m,$11.5m,$16.5m and $65.5m )


Closing Bal at 31st

December 2018 at

JMS

Closing Bal at

31st

December2018

at MAUL

Closing Bal

at 31st

December

2018 at

NMS

Commodity

NMS MOS

Pipeline from

PEPFAR Pipeline MoS

Abacavir/Lamivudine 120/60mg 1*30 tabs 137,977 2.9 628,766 13.1

Abacavir/Lamivudine, Scored, 600/300mg 1*30 tabs 70,620 33,334 7.5 99,000 7.1

Atazanavir/Ritonavir 300/100mg 1*30 tabs 1,125 108,245 41,871 6.0 103,394 4.1

Efavirenz 200mg 1*90 tabs 33,266 16,000 4.8 95,310 9.3

Efavirenz 600mg 1*30 tabs 210,623 86,490 101,942 2.9 -

Efavirenz/Lamivudine/Tenofovir 600/300/300mg 1*30 tabs 909,512 457,503 2.7 1,314,622 2.6

Dolutegravir/Lamivudine/Tenofovir 50/300/300mg 1*30 tabs 577,030 3.1 1,719,668 4.0

Dolutegravir 50mg 1*30 tabs - 18,220 6.3

Lamivudine/Zidovudine 150/300mg 1*60 tabs - 44,040 0.8

Lamivudine/Zidovudine 30/60mg 1*60 tabs 3,605 0.3 68,720 5.9

Lamivudine/Zidovudine/Nevirapine 150/300/200mg 1*60 tabs 31,836 0.2 -

Lamivudine/Zidovudine/Nevirapine 30/60/50mg 1*60 tabs - 114,432 3.2

Lopinavir/Ritonavir 100/25mg 1*60 tabs 33,792 - - 3.9 71,040 8.3

Lopinavir/Ritonavir 200/50mg 1*120 tabs 75,681 - - 5.4 178,422 12.8

Lopinavir/Ritonavir 40/10mg (oral pellets) 1*120 caps 21,939 4,055 4.7 125,023 22.7

Nevirapine 10mg/ml 100 ml 1 bottle 45,709 8,411 6,942 9.0 62,648 9.2

Nevirapine 50mg 1*30 tabs 65,507 23,476 8.5 140,911 13.4

Tenofovir DF/Lamivudine 300/300mg 1*30 tabs - - - - - -

Zidovudine 300mg 1*60 tabs 2,000 - - 10.0 - -

-

2,000

Total USG central level Stock

available

137,977

103,954

151,241

49,266

399,055

1,367,015

61,062

88,983

-

3,605

577,030

25,994

Note: All public sector stock at JMS and MAUL has been reflected under NMS stock status.

31,836

-

33,792

75,681

-

B : Joint Medical Stores -Adult Formulations Stock Status


Closing Bal at 31st


Efavirenz/Lamivudine/Tenofovir 600/300/300mg 1*30 tabs 350,263 58,176 6.0 5.0 4.0 6.7 5.7 4.7





Dolutegravir 50mg 1*30 tabs 7,001 609 11.5 19.9 18.9 17.9 16.9 15.9

Nevirapine 200mg 1*60 Tabs - 7,532 0.0 0.0 0.0 0.0 0.0 0.0





Min 3MOS, Max 6MOS

Notes: JMS Adult formulations




Adult ARV medicines at JMS are well stocked with more than 3MOS except for AZT/3TC/NVP 300/150/200mg and LPV/r 200/50mg. Shipment for LPV/r 200/50mg is expected by end of January 2019.

There is a stock out of NVP 200mg. Interwarehouse transfer of NVP 200mg and AZT/3TC /NVP 300/150/200mg from NMS has been initiated.

B : Joint Medical Stores -Pediatric Formulations Stock Status


Closing Bal at 31st


Efavirenz 200mg 1*90 tabs 20,876 769 27.2 26.2 25.2 24.2 23.2 22.2



Lamivudine/Zidovudine 30/60mg 1*60 tabs 8,910 512 17.4 16.4 15.4 14.4 22.5 21.5

Nevirapine 10mg/ml 100 ml 1 bottle 1,271 958 1.3 3.9 2.9 1.9 3.9 2.9


Lopinavir/Ritonavir 100/25mg 1*60 tabs 4,689 946 5.0 4.0 3.0 2.0 15.0 14.0

Lopinavir/Ritonavir 40/10mg (oral pellets) 1*120 caps 2,469 332 7.4 6.4 5.4 23.9 22.9 21.9Min 3MOS, Max 6MOS

Notes: JMS pediatric formulations



Peadiatric second line formulations

There is an overstock of EFV 200mg, ABC/3TC 120/60mg, AZT/3TC/NVP 60/30/50 mg and AZT/3TC 60/30 mg. NVP suspension and NVP 50mg tablets have low stock levels.

Close monitoring of consumption for EFV 200mg, ABC/3TC 120/60mg, AZT/3TC/NVP 60/30/50mg and AZT/3TC 60/30 mg is recommended to avoid wastage.

Shipments for NVP suspension and NVP 50 mg are expected by the end of January 2019.

C : Medical Access Uganda Limited-Adult Formulations Stock Status


Closing Bal at 31st


Efavirenz/Lamivudine/TDF 600/300/300mg 1*30 tabs 246,495 127,805 1.9 8.3 7.3 9.7 8.7 7.7






Dolutegravir 50mg 1*30 tabs 9,687 8,319 1.2 0.2 0.8 0.0 0.0 0.0





Min 3MOS, Max 6MOS

Notes: ARV Adult formulations at MAUL


ARV Adult formulations at MAUL are fairly stocked with more than 3 MOS except for TDF/3TC/EFV 300/300/600 mg, AZT/3TC 300/150 mg, DTG 50 mg and TDF/3TC 300/300 mg.

Shipments for AZT/3TC 300/150 mg and TDF/3TC 300/300 mg are expected by end of January 2019.

Order needs to be placed for DTG 50 mg tablets.



C : Medical Access Uganda Limited Pediatric Formulations Stock Status


Closing Bal at 31st






Nevirapine 10mg/ml 100 ml 1 bottle 4,257 1,361 3.1 7.1 6.1 5.1 9.4 8.4



Lopinavir/Ritonavir 40/10mg (oral pellets) 1*120 caps 6,234 1,127 5.5 4.5 3.5 2.5 1.5 0.5Min 3MOS, Max 6MOS

Notes: ARV pediatric medicines at MAUL



Peadiatric second line formulations

ARV pediatric medicines are well stocked at MAUL with more than 3 MOS

D: THIRDLINE ARVS Stock Status at Joint Clinical Research Centre

Product description Pack Size

SOH at JCRC as of

31.12.2018 AMC Nov 2018 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19Etravirine (Intellence) 100mg 1*120 tabs 1,165 156 7.5 12.7 11.7 13.6 12.6 14.9Ritonavir (Norvir) 100mg 1*60 tabs 228 304 0.8 7.3 8.4 7.4 10.9 9.9Raltergravir (Isentress) 400mg 1*60 tabs 1,715 256 6.7 11.4 10.4 9.4 8.4 7.4Darunavir (Prezista) 600mg 1*60 tabs 670 273 2.5 7.9 6.9 5.9 5.9 4.9Saquinavir 500mg 1*120 tabs 188 10 18.3 17.3 16.3 15.3 14.3 13.3Darunavir 150mg 1*240 tabs - 3 0.0 0.0 0.0 0.0 0.0 0.0Darunavir 75mg 1*480 tabs - 1 0.0 0.0 0.0 0.0 0.0 0.0Notes: Thirdline ARVs at JCRC 7.9

D: THIRDLINE ARVS Stock Status at National Medical Stores

Product description Pack Size

SOH at NMS as of

31.12.2018 AMC Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19Etravirine (Intellence) 100mg 1*120 tabs 506 52 9.7 13.9 12.9 11.9 10.9 23.6Ritonavir (Norvir) 100mg 1*60 tabs 444 101 4.4 10.8 17.0 16.0 24.5 23.5Raltergravir (Isentress) 400mg 1*60 tabs 1,537 85 18.0 26.5 25.5 24.5 23.5 22.5Darunavir (Prezista) 600mg 1*60 tabs 976 91 10.7 21.6 20.6 19.6 26.3 25.3Darunavir 150mg 1*240 tabs 66 1 66.0 65.0 64.0 63.0 62.0 61.0Darunavir 75mg 1*480 tabs 7 1 11.2 10.2 9.2 8.2 7.2 6.2


Thirdline medicines are fairly stocked with more than 3 MOS except for Ritonavir 100mg and Darunavir 600mg. There is a stock out of Darunavir 150mg and Darunavir 75mg.

Stock for Etravirine 100mg (6.2 mos), Ritonavir 600mg (7.5 mos), Raltegravir 400 mg (5.7 MOS) and Darunavir 600mg (6.4 mos) are available in- country at MAUL.

Thirdline ARVs medicines are well stocked at NMS

NMS started distribution of Thirdline medicines to regional referral hospitals in January 2019.

A: National Medical Stores-Malaria Commodities Stock Status

Category Unit of measure (Pack)

Closing Bal at 31st


Artemether 20mg + Lumefantrine 120mg ( 6's) 1*30 strips - 14,420 0.0 0.4 0.0 0.0 0.0 0.0

Artemether 20mg + Lumefantrine 120mg (12's) 1*30 strips 69,179 3,498 19.8 18.8 17.8 16.8 19.2 18.2



Artesunate 60mg Powder for Injection, 1 vial 1 vial 3,011,748 171,128 17.6 16.6 17.4 16.4 17.1 16.1

Malaria Antigen Rapid tests 1*25 tests 663,568 85,791 7.7 6.7 5.7 4.7 3.7 2.7Notes: Malaria Commodities at NMS

Antimalarial Medicines

Malaria laboratory commodities


Artemether/ Lumefantrine (AL) 20/120mg formulations, Malaria RDTs and artesunate injection at NMS are over stocked except AL 6*1 MOS. Shipment for AL 6*1 is expected by end of January 2019.

Supply plan has been reviewed and some shipments delayed to avert overstocks.

There are 6.8 MOS of Sulfadoxine/Pyrimethamine 500/25mg available at NMS.

B: Joint Medical Stores-Malaria Commodities Stock Status

Category Unit of measure (Pack)

Closing Bal at 31st






Artesunate 60mg Powder for Injection, 1 vial 1 vial 758,815 75,202 10.1 9.1 8.1 7.7 6.7 5.7

Malaria Antigen Rapid tests 1*25 tests 61,361 6,927 8.9 10.5 9.5 8.5 7.5 6.5Notes: JMS Malaria Stock status

Malaria laboratory commodities


There is an over stock of AL 6*2, AL 6*3, AL 6*4, Artesunate 60mg powder for injection and Malaria RDT test strips however there are low stock levels of AL 6*1.

Supply plan has been reviewed to delay shipments for malaria commodities that are over stocked. Shipment of AL 6*1 is expected by end of February 2019.

There are 12,000 doses (36*1000 tablets) of Sulfadoxine/Pyrimethamine 500/25mg available at JMS.

National Medical Stores /UNICEF-ICCM Commodities Stock Status

Product Name Unit of measure (Pack)

Closing Bal at 31st


Co-packaged ORS and zinc tablets (2 sachets ORS/10 tab zinc) 1 pack 219,563 103,068 2.1 1.1 0.1 0.0 0.0 0.0Amoxicillin 250mg 1*10 Tablets Pack of 10 118,792 103,068 1.2 3.8 2.8 1.8 0.8 0.0Amoxicillin 250mg 1*20 Tablets Pack of 20 113,688 103,068 1.1 3.3 2.3 1.3 0.3 0.0Amoxicillin envelopes Red Pack of 100 1,886 1,031 1.8 0.8 0.0 0.0 0.0 0.0Amoxicillin envelopes Green Pack of 100 1,886 1,031 1.8 0.8 0.0 0.0 0.0 0.0

Artemether/Lumefantrine 20mg/120mg 6 pack 1*30 strips 18085 5154 3.5 2.5 1.5 0.5 0.0 0.0Artemether/Lumefantrine 20mg/120mg 12 pack 1*30 14991 5154 2.9 1.9 0.9 0.0 0.0 0.0Malaria RDTs ( Combined iCCM ) 1*25 tests 38250 25768 1.5 4.0 3.0 2.0 1.0 0.0

Safety Boxes Piece 75125 25988 2.9 3.0 3.0 2.0 1.0 1.1 Examination gloves Box of 50 pairs 35250 12884 2.7 4.6 3.6 2.6 1.6 0.6

All non- malarial medicines have low stock levels of less than 3 MOS. Shipments for Amoxicillin 10s and 20s are expected at the end of January 2019.

Non Malaria commodities

Malaria commodities

ICCM Program Stock status


AL formulations and mRDTS have low stock levels

Safety boxes and Examination gloves have low stock levels of less than 3 MOS. Shipments for examination gloves and safety boxes are expected by January 2019.

iCCM supplies

ICCM supplies

Envelopes

Antimalaria commodities

Envelopes have low stock levels of less than 3 MOS.

Notes: ICCM commodities at NMS

A. CPHL Viral Load and EID Laboratory commodities Viral load commodities

Category Unit of Measure

Closing Bal at 31st

December 2018 AMC Nov 2018 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19Roche Cobas AmpliPrep/Taqman (CAP/CTM) HIV-1Test, v2.0 48 Test-VL 48 Tests 676 102 6.6 5.6 6.4 5.4 4.4 3.4Roche Cobas KIT COBAS 6800/8800 HIV 96T CE-IVD-VL 96 Tests 1,212 601 4.8 3.8 2.8 4.6 3.6 2.6Abbott RealTime HIV-1 Amplification Reagnt Kit,96Test,-VL 96 Tests 5,007 653 7.7 8.9 7.9 6.9 5.9 4.9DBS collect.Kit VL sticker,50 Test, Single Use 50 Tests 18,177 1,800 10.1 9.6 8.6 7.6 6.6 5.6Early Infant Diognosis (EID) CommoditiesRoche Cobas@KIT CAP-G/CTMHIV-1 QAUL 48 test CE-IVD EID 48 Tests 817 311 5.0 4.0 3.0 5.4 4.4 3.4DBS Collect.Kit for EID,50 Tests, Single Use 50 Tests 3,239 544 6.0 12.4 11.4 10.4 9.4 8.4

A: National TB Laboratory commodities Months of Stock at the end of the month

TB Laboratory commodities


Closing Bal at 31st

December 2018 AMC Nov 2018 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19GeneXpert catrigdes 50 Tests 172 677 0.3 2.3 3.4 2.4 1.4 0.4TB Sputum Containers 100pcs 4,430 1,588 2.8 1.8 0.8 0.0 0.0 0.0Strong Carbol Fuschin 1000ml Solution (ZN) 1000 ML 5,494 331 16.6 15.6 14.6 13.6 12.6 11.6MICROSCOPE SLIDES, FROSTED 76X26MM (TB only) 50 Tests 22,640 3,340 6.8 5.8 4.8 3.8 2.8 1.8TB LAM Diagnostic KIT 100 Tests 100 Tests 200 45 4.4 4.4 3.4 2.4 4.5 3.5

Viral Load and EID commodities are well stocked. PSM and MUAL has placed orders for Q1, Q2 and Q3. MAUL is yet to confirm Q4 orders.

1,420 GeneXpert (GXP) kits are expected from PEPFAR under GDF and will be delivered in Feb 2019. Orders for GXP catridges funded by GF were placed, the order processing was delayed as the bundling MOU had not been signed. GF is

expediting the process with the supplier. Orders for TB LAM kits were also placed with GF. ZN reagents and Microscope slides are well stocked.

A: National Medical Stores Laboratory commodities PART AMonths of Stock at the end of the month


Closing Bal at 31st


HIV test Kits Determine HIV-1/2 Complete Kit, 100 Tests 100 Tests 13,774 8,556 1.6 4.5 4.4 5.1 4.1 4.7HIV, Stat-Pak HIV 1 / 2 Kit, 30 Tests 30 Tests 8,538 1,213 7.0 11.0 16.2 15.2 14.2 13.2SD Bioline, HIV 1/2, Bioline 3.0 Kit 25 Tests 10,136 1,178 8.6 7.6 6.6 5.6 4.6 3.6HIV/Syphilis Dou HIV 1/2, 25 Tests 25 Tests 28,119 5,081 5.5 4.5 3.5 4.5 3.5 2.5CD4+ commoditiesPartec-CD4 % Easy Count Kit 100 tests 100 Tests 8 173 0.0 6.0 5.0 4.0 3.0 2.0BD FACS PRESTO 100 Test s 101 Tests 14 80 0.2 6.0 5.0 4.0 3.0 2.0Pima Analyzer CD4 Cartridge Kit, 100 tests 100 Tests 45 160 0.3 6.0 5.0 4.0 3.0 2.0Crag LFA testing Kits 50 tests 50 Tests 45 200 0.2 6.0 5.0 4.0 3.0 2.0

Category Unit of Measure Closing Bal at 31st

December 2018

AMC Nov 2018 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19

Blood Collection Tube, K2 EDTA, 4mL, Lav, 100 Pcs 100 pcs 14,573 2,714 5.4 4.4 3.4 2.4 0.0 0.0Vacutainer Needle 21G 100 Tests 377 1,561 0.2 0.0 0.0 0.0 0.0 0.0

Syphilis testing devices, 30 tests 30 Tests 3,204 986 3.2 2.2 6.6 5.6 4.6 3.6Hepatitis B Antigen screening Kits 50 Tests 47,650 7,343 6.5 5.5 4.5 3.5 2.5 1.5

There are low stocks of Determine, however 20,201 packs of Determine is available to be transfered to NMS from JMS. There is also pipeline for Determine from Global Fund expected in April 2019. Statpak, SD Bioline and Syphilis Duo

are well stocked. CD4 reagents in all platforms are stocked out but orders have been placed under Global Fund. Pipeline for Crag is expected at the end of January 2019.

A: NMS Laboratory Commodities PART B


Other commodities

Blood collection tubes, syphilis testing devices and Hepatitis B antigen screening tests are well stocked with more than 3 MOS. There is a stock out of Vacutainer Needles. NMS is to make call offs for these commodities.

Category Unit of Measure Closing Bal at 31st

December 2018

AMC Nov 2018 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19

Determine HIV-1/2 Complete Kit, 100 Tests 100 Tests 12,440 2,529 4.9 8.1 7.1 6.1 5.1 8.7

HIV, Stat-Pak HIV 1 / 2 Kit, 20 Tests 30 Tests 1,843 636 2.9 8.1 7.1 6.1 5.1 8.7

SD Bioline, HIV 1/2, Bioline 3.0 Kit 25 Tests 3,770 280 13.5 12.5 11.5 10.5 9.5 8.5

HIV/Syphilis Duo HIV 1/2, 25 Tests 2,988 1,434 2.1 1.1 7.0 6.0 5.0 4.0

Oraquick HIV test 50 Tests 255 125 2.0 3.1 2.1 1.1 2.9 1.9

BD FACS, MultiTest CD3/CD8/CD45/CD4, 50 Tests 50 Tests 84 13 6.5 5.5 4.5 3.5 2.5 1.5

Partec-CD4 % Easy Count Kit 100 tests 100 Tests 25 17 1.5 3.6 2.6 1.6 0.6 0.0

BD FACS Presto 100 Tests 160 25 6.4 5.4 4.4 3.4 2.4 1.4

Pima Analyzer CD4 Cartridge Kit, 100 tests 100 Tests 193 15 12.9 11.9 10.9 9.9 8.9 7.9

Crag LFA testing Kits 50 tests 50 Tests 18 7 2.6 1.6 0.6 0.0 0.0 0.0

Blood Collection Tube, K2 EDTA, 4mL, Lav, 100 Pcs 100 Tests 1,154 1,495 0.8 0.0 3.9 2.9 1.9 0.9

Vacutainer Needle 21G 100 Tests 3,437 938 3.7 2.7 1.7 0.7 0.0 0.0

B: JMS Laboratory commodities


HIV test kits

CD4+ Commodities

Other commodities

HIV Test kits are at risk of stocking out except SD Bioline and HIV determine. Shipments for Detemine and Sat-pak test kits are expected by end of January 2019. CD4 reagents are fairly stocked with more than 3 MOS except for Partec

with less than 3 MOS. Shipment for Partec is expected to be delivered by end of January 2019.



Closing Bal at 31st


HIV test Kits

Determine HIV-1/2 Complete Kit, 100 Tests 100 Tests 9,819 2,286 4.3 3.3 2.3 1.3 0.3 0.0

HIV, Stat-Pak HIV 1 / 2 Kit, 30 Tests 30 Tests 2,132 912 2.3 1.3 0.3 0.0 0.0 0.0

SD Bioline, HIV 1/2, Bioline 3.0 Kit 25 Tests 215 177 1.2 0.2 0.0 0.0 0.0 0.0

MAUL- CD4+ Commodities

BD FACS, MultiTest CD3/CD8/CD45/CD4, 50 Tests 50 Tests 178 57 3.1 4.7 3.7 3.5 2.5 1.5

Partec, Counter CD4, CD4% Easy count kit 100 Tests 10 9 1.1 0.1 0.0 0.0 0.0 0.0

PIMA Cartridges 100 Tests 248 23 10.8 9.8 8.8 8.3 7.3 6.3

BD-FACS Presto cartridge Kit 100 Tests 41 23 1.8 3.6 2.6 3.2 3.3 2.3

Crag LFA testing Kits 50 tests 50 Tests 381 53 7.3 6.3 5.3 4.3 3.3 2.3

Other commodities

Blood Collection Tube, K2 EDTA, 4mL, Lav, 100 Pcs 100 Tests 5,689 1039 5.5 4.7 3.7 4.7 3.7 2.7

Vacutainer Needle 21G 100 Tests 3,153 417 7.6 7.9 6.9 8.3 7.3 6.3

C: Medical Access Uganda Limited Laboratory commodities

There are low stock levels of HIV test kits and Partec CD4 easy count. Order need to be placed for all HIV test Kits and Partec CD4 easy count.

A: National Medical Stores-Medicines for Opportunistic Infections Stock Status


Closing Bal at 31st


Fluconazole 200mg Tab 1*28 tabs 23,951 4,752 5.0 4.0 3.0 2.0 1.0 0.0

Fluconazole 2mg/ml I.V. Infusion 100ml 1 7,999 2,381 3.4 2.4 1.4 0.4 0.0 0.0

Fluconazole 50mg/5ml suspension 35 ml 1 5,188 1,558 3.3 2.3 1.3 0.3 0.0 0.0

Cotrimoxazole 120mg, 1000 Tabs 1*1000 tabs 23,228 3,905 5.9 4.9 3.9 2.9 1.9 0.9

Cotrimoxazole 960mg Tabs , 1000 tabs 1*1000 tabs 21,906 24,302 0.9 0.0 0.0 0.0 0.0 0.0

Min 3MOS, Max 6MOS

NMS :Medicines for Opportunistic infections

Cotrimoxazole 120mg is well stocked with more than 3 MOS however there are low stock levels of Cotrimoxazole 960mg.

Order placed for both Cotrimoxazole formulations from Global Fund for CY 2019

Fluconazole formulation:

Cotrimoxazole formulations:


Fluconazole fomulations are fairly stocked with more than 3 MOS. There is a projected stock out of all Fluconazole formulations starting April 2019.

Order needs to be placed for all fluconazole formulations.

B: Joint Medical Stores-Medicines for Opportunistic Infections Stock Status


Closing Bal at 31st


Fluconazole 200mg Tab 1*28 tabs 3,427 1,768 1.9 4.7 3.7 2.7 1.7 0.7

Fluconazole 2mg/ml I.V. Infusion 100ml 1 8,612 372 23.1 22.1 21.1 20.1 19.1 18.1

Fluconazole 50mg/5ml suspension 35 ml 1 1,173 332 3.5 2.5 4.9 3.9 2.9 1.9

Cotrimoxazole 120mg, 1000 Tabs 1*1000 tabs 5,312 476 11.2 10.2 18.6 17.6 16.6 15.6

Cotrimoxazole 960mg Tabs , 1000 tabs 1*1000 tabs 20,037 3,985 5.0 6.5 5.5 4.5 3.5 2.5

Min 3MOS, Max 6MOS

JMS : Medicines for Opportunistic infections

Cotrimoxazole 960mg at NMS is well stocked with more than 3 MOS however there is an overstock of Cotrimoxazole 120mg tablets.

Consumption of Cotrimoxazole 120 mg is being closely monitored following geographical rationalisation of CDC-USAID aided ART accredited facilities.



There is an over stock of Fluconazole IV infusion and low stock levels of Fluconazole 200 mg. Shipment for Fluconazole 200 mg is expected by end of January 2019


Medical Access Uganda Limited -Medicines for Opportunistic Infections Stock Status

Item description Unit of Measure

Closing Bal at 31st


Fluconazole 200mg Tab (Diflucan) 1*28 tabs 7,416 798 9.3 11.9 10.9 9.9 8.9 7.9

Fluconazole 2mg/ml I.V. Infusion 100ml 1 387 175 2.2 16.3 15.3 14.3 13.3 12.3

Fluconazole 50mg/5ml suspension 35 ml 1 920 76 12.1 11.1 10.1 9.1 8.1 7.1

Cotrimoxazole 120mg, 1000 Tabs 1000 4,592 914 5.0 4.0 3.0 2.0 1.0 0.0

Cotrimoxazole 960mg Tabs , 1000 tabs 1000 52,904 7,341 7.2 6.2 5.2 4.2 3.2 2.2

Min 3MOS, Max 6MOS

MAUL: Medicines for opportunistic infections


Fluconazole 200mg and Fluconazole suspension are over stocked with more than 6MOS. There are low stock levels of Fluconazole I.V infusion.

Shipment for Fluconazole I.V infusion is expected by end of January 2019.

Cotrimoxazole formulations are well stocked at MAUL with more than 3MOS.

Order needs to be placed for Cotrimoxazole formulations.



A: National Medical Stores-Vaccines Stock Status

Item description Unit of Measure

Closing Bal at 31st


Penta vaccine (DPT- HEPB +HIB) 10 dose vial 1 vial 160,803 46,058 3.5 2.6 1.6 0.6 0.0 0.0

Bacillus Calmette -Guerin (BCG) 20 dose vial 1 vial 110,850 27,175 4.1 3.1 2.1 1.1 0.1 0.0

Hepatitis B Vaccine - 10 dose vial 1 vial 223,618 36,269 6.2 5.2 4.2 3.2 2.2 1.2

Measles vaccine - 10 dose vial 1 vial 34,360 28,442 1.2 1.9 0.9 0.0 0.0 0.0

Polio Bivalent vaccine (BOPV) 20 dose vial 1 vial 31,655 33,246 1.0 3.5 2.5 1.5 0.5 0.0

Inactivate Polio Vaccine (IPV)10 dose vail 1 vial 104,040 18,924 5.5 4.5 3.5 2.5 1.5 0.5

Human Papiloma Vaccine (HPV) 1 vial 211,633 128,401 1.6 0.6 0.0 0.0 0.0 0.0

Rabies Vaccine 10 dose vial 1 vial 2,096 1,947 1.1 0.1 0.0 0.0 0.0 0.0

Rota vaccine 1 dose vail 1 vail 1,675,650 296,100 5.7 4.7 3.7 2.7 1.7 0.7

Tetanus toxoid vaccine (TT) 20 dose vial 1 vial 18,770 15,823 1.2 0.2

Tetanus & Diphtheria Vaccine (TD) 10 dose vial 1 vial 252,290 15,823 15.9 14.9 13.9 12.9 11.9 10.9

Pneumococcal conjugate (PCV) 2 dose vail 1 vial 702,200 190,267 3.7 2.8 1.8 0.8 0.0 0.0

Min 3MOS, Max 6MOS

Notes: Stock Status of Vaccines at NMS

Vaccines are fairly stocked with 60% of the Vaccines having more than 3MOS .Order needs to be placed for all vaccines

Vaccines


A: National Medical Stores-Reproductive Health Commodities Stock Status

Item Description Unit of Measure

Closing Bal at 31st

December 2018 AMC Nov 2018 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Medroxyprogesterone Acetate 150 mg/ml (Depo-Provera) 1 vial 62,600 92,750 0.7 0.0 0.0 0.0 0.0 0.0Depot (SC) Medroxyprogesterone Acetate 104 mg/0.65 mL, Pre-Filled Uniject Device (Sayana Press)1 54,400 54,399 1.0 4.5 3.5 2.5 1.5 0.5IUD - Copper Containing Device TCU380A*** 1 - 6,169 0.0 0.0 0.0 0.0 0.0 0.0Etonogestrel 68 mg/rod, 1 rod Implant (Implanon NXT ) 1 2 11,429 0.0 0.0 0.0 0.0 0.0 0.0Male Condom (52MM with and without Logo) 1 3,098,592 4,056,855 0.8 4.4 3.4 8.9 7.9 6.9Combined Oral Contraceptives (Microgynon) 1 cycle 142,227 32,217 4.4 6.1 5.1 4.1 3.1 2.1Levonorgestrel 1.5mcg (Emergency Contraceptive)*** 1 tab 30 3,204 0.0 0.0 0.0 0.0 0.0 0.0Maama Kit (Safe Maternity Kit) 1 95,470 40,146 2.4 1.4 0.4 0.0 0.0 0.0Misoprostol 200mcg Tabs 100 6,314 1,253 5.0 4.0 3.0 2.0 1.0 0.0

Min 3MOS, Max 6MOS

Notes: Reproductive health commodities at NMS


Reproductive Health Commodities

Reproductive health commodties have low stock levels at NMS except Misoprostol 200mg and Combined Oral Cotraceptives with more than 3 MOS. Interwarhouse transfer has been initiated for Sayana press and Combined oral

contraceptives from UHMG and JMS to NMS.

Item Description Unit of Measure

Closing Bal at 31st


Medroxyprogesterone Acetate 150 mg/ml (Depo-Provera) 1 vial 1,998,660 173,699 11.5 10.5 21.2 20.2 19.2 18.2Depot (SC) Medroxyprogesterone Acetate 104 mg/0.65 mL, Pre-

Filled Uniject Device (Sayana Press) 1 891,417 91,196 9.8 15.9 15.2 16.0 15.0 14.0

Etonogestrel 68 mg/rod, 1 rod Implant (Implanon NXT ) 1 146,928 33,726 4.4 3.4 2.4 4.3 3.3 2.3

Levonorgestrel 75mg/rod, 2 rod Implant (Jadelle) 1 60,540 42,016 1.4 2.8 1.8 0.8 0.0 0.0

IUD - Copper Containing Device TCU380A 1 123,890 22,289 5.6 4.6 8.5 7.5 6.5 5.5

Male Condom (53MM with and without Logo) 1 30,332,668 11,055,701 2.7 5.1 4.1 3.1 2.1 1.1

Female Condoms 1 0 113,333 0.0 7.1 6.1 5.1 4.1 3.1

Levonorgestrel 1.5 mg(Emergency Contraceptive) 1 47,090 34,337 1.4 4.8 3.8 2.8 1.8 0.8

Combined Oral Contraceptives (Microgynon) 1 cycle 4,947,834 312,307 15.8 14.8 13.8 12.8 11.8 10.8

Levonorgestrel 30 mcg (Microlut) 1 42,741 24,400 1.8 3.5 2.5 1.5 0.5 0.0

Misoprostol 200mcg Tabs 100 120 224 0.5 0.0 0.0 0.0 0.0 0.0

Min 3MOS, Max 6MOS

Reproductive health commodties have low stock levels of less than 3 MOS except Depo-provera, Sayana Press, Implanon NXT, IUDs and Combined oral contraceptives. There is a stock out of Female condoms. Shipment for Female

condoms is expected by end of January 2019.

There is a projected stock out of Misoprostol and Jadelle by end of January 2019 and February 2019 respectively

Order needs to be placed for Misoprostol, Jadelle, Emergency contraceptives and Microlut.

Notes: Reproductive health commodities at UHMG

Months of Stock at the end of the monthB: Alternative Distribution System (JMS and UHMG)-Reproductive Health Commodties Stock Status

A: National Medical Stores -First Line TB medicines Stock statusFirst Line TB Medicines

Item Description Pack size

Closing Bal at 31st


2-FDC RH (150/75) 150+75mg 28 Tablets ,24 1* 672 tabs 6,899 2,188 3.2 6.4 5.4 4.4 3.4 2.4

3-FDC RHZ (75/50/150) 75+50+150mg Tablet 1* 84 tabs 14,353 1,210 11.9 10.9 9.9 8.9 11.5 10.5

2-FDC RH (75/50) 75+50 mg Tablet 1*84 tabs 13,305 1,670 8.0 7.0 6.0 5.0 4.0 3.0

Ethambutol 100mg 1*100tabs 11,177 806 13.9 12.9 11.9 10.9 9.9 8.9

4-FDC RHZE (150/75/400/275) 150+75+400+275mg 1*672 tabs 71 1,856 0.0 3.3 2.3 1.3 0.0 0.0Min 9MOS, Max 15MOS

Notes: First Line TB commodities at NMS


TB Medicines

First Line TB medicines have low stock levels except for RHZ 75/50/150 mg and Ethambutol 100 mg . Shipments for RH mg 150/75 (4.2 MOS) and RHZE 150/75/400/275 mg (3.3 MOS) from GOU were received in December 2018.

Additional 3.5 MOS for RH 150/75mg and 9.4 MOS for RHZE are expected in March and April 2019 from GOU. Isoniazid

100mg is well stocked-252,969 packs of 100 (75,288 patient courses) ,however Isoniazid 300mg is low in stock-3203 packs of 672 (12,812 patient courses). A shipment of additional 177,000 adult patient doses (44,398 packs) arrived in-

country by end of December and hence delivery to the warehouse should be expedited.

Orders have been placed through GDF for all First Line TB medicines for CY 2019.

MDR TB Medicines Stock status


Closing Bal at 31st


Capreomycin 1000mg Powder for injection 1 1 vial 23,683 2,110 11.2 10.2 9.2 8.2 7.2 6.2

Kanamycin 1000mg Powder for injection 1*10 vials 6,464 439 14.7 13.7 12.7 11.7 10.7 9.7

Cycloserine 250mg Capsule(s) 100 1*100 caps 4,057 246 16.5 15.5 14.5 16.7 15.7 14.7

Ethionamide 250mg Film coated tablet(s) 100 1*100 tabs 5,267 375 14.0 13.0 21.9 20.9 19.9 18.9

Isoniazid 300mg Tablet, 672 1*672 tabs 1,301 100 13.0 12.0 11.0 10.0 9.0 8.0

Levofloxacin 250mg Film coated tablet(s) 100 1*100 tabs 2,318 568 4.1 3.1 2.1 1.1 0.1 0.0

Amikacin 500mg/2ml injection 1*100 vails 6 1 6.0 5.0 4.0 3.0 2.0 1.0

Ethambutol 400mg 1*672tabs 182 140 1.3 0.3 0.0 0.0 0.0 0.0

Moxifloxacin 400mg Film coated tablet(s) 100 1*100 tabs 1,118 166 6.7 5.7 4.7 3.7 2.7 1.7

Pyrazinamide 400mg Film uncoated tablet(s) 1*672 tabs 1,467 136 10.8 9.8 8.8 7.8 6.8 5.8

Min 9MOS, Max 15MOS Notes: MDR TB commodities at NMS

MDR TB Medicines are fairly stocked with more than 9 MOS except for Levofloxacin 250mg, Amikacin 500mg/2ml injection, Moxifloxacin 400mg and Ethambutol 400mg.

Order had been placed through GDF for Levofloxacin 250mg, Amikacin 500mg/2ml, Moxifloxacin 400mg and Ethambutol 400mg.

Injectable Kanamycin and Capreomycin are to be phased out following WHO recommendation of exclusive use of Oral MDR-TB regimens. The phaseout expected to start in July 2019.


TB-XDR medicines stock status 7.429


Closing Bal at 31st


Bedaquiline (#patient courses) 188 46 21 2.2 1.2 0.2 6.4 5.4 4.4

Clofazimine 100mg 100 1,629 112 14.6 13.6 12.6 11.6 10.6 9.6

Linezolid 600 mg 20 934 51 18.4 17.4 16.4 40.4 39.4 38.4

Clofazimine 100mg and Linezoli 600 mg are well stocked with more than 9 MOS, however there are low stock levels of Bedaquiline .Shipment for Bedaquiline (7.4 MOS) is expected to be delivered by end of March 2019.Additional 7.4

MOS are expected by end of September 2019

Total Stock Net AMC MOS

Kanamycin 1g Vial 1*10 Vials 23,090 3,529 6.5 450

Capreomycin 1g vial 1 Vial 7,827 1,795 4.4 208

Amikacin 500mg inj 1 Vial 1,610 112 14.4

Cycloserine 250mg tab 1*100 caps 158,228 41,530 3.8

Ethionamide 250mg tab 1*100 tabs 152,800 65,740 2.3

Ethambutol 400mg tablets 1*672tabs 282,743 33,066 8.6 11768 810 14.52839506 29568Levofloxacin 250mg tab 1*100 tabs 156,466 53,735 2.9

Moxifloxacin 400 mg tab 1*5 tabs 57,939 8,648 6.7

Pyrazinamide 400mg 1*672 tabs 1,134,630 64,570 17.6

PreXDR TB medicinesBedaquiline 188 patient courses 9,077 3,600 2.5

Clofazimine 100mg 1*100 25,097 11,632 2.2

Linezolid 600mg 1*20 tabs 3,560 830 4.3

Regimen

Unit of Measure

Facility stock status report

Total stock available (Units)

MDR TB medicines facility stock status as of 1st December 2018

Notes: MDR - TB medicines facility level stock statusMDR TB medicines are well stocked above 2.0 MOS. Pyrazinamide 400mg, Ethambutol 400mg, Kanamycin 1g inj, Moxifloxacin 400mg and Amikacin 500mg inj are overstocked. Redistributio of excess stock of these items is recommended to prevent wastage. Facility consumption of Kanamycin has declined with a slight increase in consumption of Capreomycin.

The reporting rate was 82% (14/17)

ministry of health pharmacy division … ssr 1st...lopinavir/ritonavir 40/10mg (oral pellets) 1*120...

Documents