1 SUPPLY DIVISION Procurement and Supply Management Technical Assistance.

1 SUPPLY DIVISION

Procurement and Supply Management

Technical Assistance

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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

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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

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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

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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

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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

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2006-2007 Consolidated Technical Support Plan for AIDS

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BACKGROUND

• Funds available but scale up not accelerating

• Lacking technical capacity• Lack of harmonisation• Duplication and gaps• Need for improved

coordination

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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PSM activities started:

• Bolivia

• Ethiopia

• Guinea Bissau (GIST)

• India

• Malawi

• Mali

• Nepal

• Niger (GIST)

• Nigeria (GIST)

• Russia

• Somalia

• Zimbabwe (GIST)

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PSM Group Proposes:

• Cameroon

• Central Africa Republic

• Liberia

• Nigeria – WHO/TCM

• Sudan

• Uganda

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Upcoming Training Activities:

• Consultants Training Copenhagen Jan 06

• Consultants Training Dakar Feb 06

• PSM Workshop Nairobi Feb 06

• PSM Workshop Moscow March 06

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THANK YOU

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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

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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

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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

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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

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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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Supply