Experiences and challenges in PSM: Nigeria, a case study Bart van der Grinten, Country Manager IDA Foundation Nigeria AMDS Partners and stakeholders meeting, March 2010
Experiences and challenges in PSM: Nigeria, a case studyBart van der Grinten, Country Manager IDA Foundation Nigeria
AMDS Partners and stakeholders meeting, March 2010
Introduction
February 2010
Agenda• Nigeria
• IDA Foundation Nigeria
• PSM Experiences and challenges
Nigeria: ‘Giant of Africa’
• Total population 154,729,000• ‘Democratically’ elected President• 6th largest producer/exporter of oil in the world• 15 domestic airlines• GDP: 120.8 billion USD• Per capita: 780 USD• 13th poorest country in the world• Population below poverty line: 70%
Nigeria: ‘Giant of Africa’
• Population growth rate 2.8%• Health system performance: 187th out of
191 countries• Infant mortality 71: 1000• Life expectancy: 48 years
Nigeria: Health care
Nigeria: HIV/AIDS, TB, Malaria
– 3.6 % HIV/AIDS prevalence (2007) - third largestnumber of people living with HIV/AIDS
– Fourth largest tuberculosis burden: more than460,000 estimated new cases in 2007
– Largest malaria burden: 225,424 deaths in 2006
Aids Epidemic Update 2009, WHO/UNAIDS
Towards Universal Access – Progress Report 2009,WHO/UNAIDS/UNICEF
Nigeria: PMTCT
SOCIETY FORFAMILY HEALTH
NACA
IDA FOUNDATION NIGERIA
IDA Foundation Nigeria
• Regional office since 2005• Registered with CAC and PCN• Procurement Agent for GF PR’s (NACA, SFH),
PEPFAR IP’s, TB-CAP, WHO/CDC, FMoH,SMoH, CHAN
• Responsible for DDU delivery• Close collaboration with NAFDAC• Link between Nigerian partners and head office
IDA Foundation in Amsterdam
IDA Foundation Nigeria
Case study example: NACA/SFH PSM backbone• Set up by DG Prof. Osotimehin• M&E plus forecasting/quantification: JSI Deliver• Procurement and delivery: Crown Agents and
IDA• Distribution: CHAN• SR’s running programme: FHI (90%) and
Hygeia (10%), no role NASCP
IDA Foundation Nigeria
NACA/SFH PSM backbone challenges• Choice of products (stavudine,
artesunate/amodiaquine)• Planning of ordering• Import of unregistered products (waiver OI’s)• Clearing (form M) and DDU delivery at CMS• Storage
Nigeria: Challenges
• Limited local capacity/collapsed educationalsystem
• Lack of centralised systems(procurement/storage/distribution)
• Lack of transparency• Lack of electricity• Importation/customs• No wholesalers i.e. open market• Cost vs Quality• Registration NAFDAC• Coordination/harmonisation/integration
Nigeria: pharmaceutical system
LEVELS PRIVATE SECTOR PUBLIC SECTOR PARTNERS
International TB GDF GFATM
National Government
Procurement UnitQuality Control Lab
Regulatory Agency
Local WholesalersAcademic Institutions
Regional Regional Store
District
Private
Prescribers
Community
District Store
HIV/AIDS
Prevention &
Care Facilities
Users
Local
Manufacturers
Multinational Suppliers
Distributors
Shops,
Pharmacies
Professional Associations
NGO & Community
Organizations
PEPFAROther Procurement
Agencies
Other Donors
& Lenders
National
HIV/AIDS
Committee
Central Medical Store
Vertical Program
The HIV/AIDS Pharmaceutical System
Example of a centralized distribution system
LEVELS PRIVATE SECTOR PUBLIC SECTOR PARTNERS
International TB GDF GFATM
National Government
Procurement UnitQuality Control Lab
Regulatory Agency
Local WholesalersAcademic Institutions
Regional Regional Store
District
Private
Prescribers
Community
District Store
HIV/AIDS
Prevention &
Care Facilities
Users
Local
Manufacturers
Multinational Suppliers
Distributors
Shops,
Pharmacies
Professional Associations
NGO & Community
Organizations
PEPFAROther Procurement
Agencies
Other Donors
& Lenders
National
HIV/AIDS
Committee
Central Medical Store
Vertical Program
The HIV/AIDS Pharmaceutical System
Example of a centralized distribution system
Nigeria: Opportunities
Nigeria: Objectives
Nigeria: Targets
Nigeria: Challenges
OUR MISSION (not only in Nigeria)