aids campaign team for africa (actafrica) the world bank
DESCRIPTION
ARV and related drugs Supply Chain Management. AIDS Campaign Team for Africa (ACTafrica) The World Bank. Africa Region HIV/AIDS Consultation Addis Ababa, December 14-18 2004. Presentation Outline. Key steps of Supply Chain Management/Logistics What causes delays at each step - PowerPoint PPT PresentationTRANSCRIPT
WORLD HEALTH ORGANIZATIONTHE WORLD BANK
ARV and related drugs
Supply Chain Management
AIDS Campaign Team for Africa (ACTafrica)
The World Bank
Africa Region HIV/AIDS ConsultationAddis Ababa, December 14-18 2004
The World Bank
Presentation Outline
Key steps of Supply Chain Management/Logistics What causes delays at each step What can we do Management weaknesses Financing The way forward
The World Bank
Revisiting key steps
Steps Emphasis
Product Selection Patents, quality, availability, affordability
Forecasting Full or non-full supply, estimates, absorptive capacity
Procurement Planning, procedures, acquiring
Warehousing Shelf life, storage capacity
Inventory Mgmt. Stock levels, critical monitoring
Transportation Timely distribution, various means
Serving clients Improve health outcomes
The World Bank
What cause delays?
The World Bank
What causes delays? Product
SelectionLack of clinical protocols, guidelines or policies.
Forecasting Lack of data on consumption patterns or stock levels or both (M&E: LMIS+Surveillance+…).
Procurement - Poor specifications - Flexibilities
- Incomplete projections - Opportunities
- Unclear procedures Warehousing
or Storing- Storage staff not informed of the procurement in the pipeline.
- Lack of guidelines.
- Sheer volume: new thinking on options
The World Bank
What causes delays?
Managing Inventory
- Lack of computerized system
- Lack of stock cards Transportation - Unclear transport procedures.
- Transported as ‘secondary’ item as part of other programs.
- Transport mgmt on an ad-hoc basis. Serving clients Lack of availability of commodities;
Lack of procedures for re-supplyLack of sufficient budget allocations (capacity strengthening)
The World Bank
What can we do?
The World Bank
What can we do? Product Sel. Use WHO guidelines to develop protocols.
Forecasting - Develop forecast based on the information available, (# of cases, service absorptive capacity).
- Full supply vs non-full supply?
- Install a LMIS as soon as possible
- Test and recommend forecasting software Procure-
ment- Use WHO pre-qualified suppliers (Clinton Foundation) New challenges?!?!
- Outline procurement process.
- Use flexible purchasing options.
The World Bank
What can we do? Warehousing
or Storing- Need for warehousing (?)
- Outline communication between proc. and storage staff.
- Develop a procedures manual, outlining storage guidelines.
Managing Inventory
Outline the system and inventory management procedures. Daily stock management (Automation is a need)
Transportation Develop a transport management plan Serving clients Monitor stock outs at Service Delivery
Points.
The World Bank
Management Weaknesses
The World Bank
Creating an effective and efficient Team Work among Ministry of Health National HIV/AIDS Councils and/or CCMs Drug Regulatory Authority / National Laboratory Ministries of Trade/Commerce and justice/legal National Tender Boards NGOs and Civil Society Organizations Donors and various agencies
Harmonized procedures and coordinated planning
Management Weaknesses
The World Bank
Management Weaknesses
Lack of: Dedicated fulltime staff. Qualifications to plan and manage logistics. Need for a Logistics champion. Clear job descriptions. Necessary tools. Clearer Procedure Manuals. Encouragement and empowering staff. Performance measures for various functions. Monitoring and strengthening. Supervision (follow-up).
The World Bank
Financing
The World Bank
Financing
Estimated US $2.7 billion committed for HIV/AIDS to Sub-Saharan Africa by the World Bank and the Global Fund.
(Commitment = Agreement signed with the governments)
The World Bank
Financing Coordinate the available financing from all sources
(GFATM, MAP, Bilateral, Others). Establish policies to maintain funding for commodities as
well as for logistics management functions. Adjust program targets if the financing is not available for
the commodities or the supply chain functions. Ensure that the logistic costs are funded as part of the
program. Start establishing a long-term plan for future financing of
the programs. (Advance donor commitment should not be a pre-requisite in estimating future requirements).
The World Bank
Financing Available financing for PSMP
Faculty, materials, rollout expenses Bank-Netherlands Partnership Program (BNPP) Canadian International Development Agency (CIDA) UNAIDS Budgeted Workplan (UBW) World Bank Training Budget (for Africa region) Nearly $1.0million raisedCountry participants Multi-Country HIV/AIDS Program (MAP) funds at the country
level Global Fund financing Bilateral donors and development partners
The World Bank
The Way Forward
The World Bank
The way forwardFacts
~6,000 deaths per day in Sub-Saharan Africa due to AIDS~8,000 new infections every day
ChallengeShall we continue to do the business as usual?
A Bureaucrat or a Warrior mentality against AIDS?
ApproachUse “exceptional” measures
No time for conventional approach
The World Bank
The way forward Keep the objectives of the Three Ones in focus
One National framework One Institution One M&E system
Use exceptional measures They are expensive, but what is our priority? Contract out routine and mechanical tasks Learn by doing and adapt quickly (flexible MAP
design)
The World Bank
The way forward Need for a coordinated effort
One national plan agreed by all partners Harmonized procedures and reporting Regional knowledge sharing Resources sharing Joint reviews and follow-ups
The World Bank
The way forward A comprehensive capacity building program on ARV &
Related Supplies Procurement and Supply Chain Management Program (PSMP) Addis Ababa (Francophone) - Feb 2005 Tanzania (Anglophone), Nigeria - Apr, May 2005 …and so on during 2005
PSMP Phase 1: Training of Trainers (TOT) in all countries
PSMP Phase 2: In-Country rollout by a national institution or a consortium of institutions and local partners (including refresher courses).
The World Bank
The way forward PSMPs will be Global training events financed by The Bank,
Dutch, Canadians, WHO (TA), UNAIDS (for 2005) Will improve country’s overall planning and management
capacity Country level Core Team Technical Guidelines and Training modules available A coordinated effort by development partners – (less
confusion for country teams)
The World Bank
The way forward TOT to target:
Ministry of Health Ministry of Trade/Commerce Law/justice/Patent National Pharmacist National HIV/AIDS Council/Commission/Secretariat Principal Recipient