Global Fund Update

IPC meeting, 11 December 2012

1st MDAG Meeting Geneva 27-28 June 2012

Outline

Global Fund Secretariat

Procurement

Collaboration

Grant Management divisionGrant

ManagementMark Edington

High Impact Africa 1

Michael Byrne

High Impact Africa 2

Linden Morrison

High Impact Asia

Urban Weber

Africa andMiddle East

Lelio Marmora

AELAC

Maria Kirova

Technical hubs

(procurement,

legal, monitoring &

program finance)

LFA, Quality,

Risk, CCM,

Operational Policy

and Renewals

Grant Mgt. Support

Oren Ginzburg

6 Country Teams 7 Country Teams 7 Country TeamsSouthern &

Eastern AfricaCynthia Mwase

Western AfricaTina Draser

Central AfricaRonald Tran Ba

Huy

MENAJoseph Serutoke

South and East Asia

Luca Occhini

LACSilvio Martinelli

EEU / CANicolas Cantau

3 Regions70 countries

4 Regions48 countries

20 countries comprising

70% of global disease burden

23 PSM Specialists

Embedded in the regional teams

• Provide recommendations for approval of the PSM plan (or Procurement Plan) and identify solutions towards effective grant implementation.

• Provide technical guidance on PHPM issues and how to ensure compliance with the Global Fund PSM Policies.

• Develop recommendations to strengthen systems and capacity in the Pharmaceutical Sector.

PSM Hub

• Operational Policies • Technical support• Partnership• Managing consistency in processes • Member of the Operational Risk Management

Committee

4

3. HPM & Health Services Delivery

Risks

3.1 Treatment disruptions

3.2 Substandardquality of PHP2

3.3 Poor selection and use of PHP2 or quality

of health services

Better Grant Management project

• Risk based Management supported by a ORM Committee

• Review of the Pharmaceutical Country Profile implementation

– Strengthened partnership

– Streamlined the tool (part 2)

– Reengineering processes

– Improved procurement planning tool

• Health product procurement Information system– IT tool for PSM plan management, monitoring of procurement activities, and

automating VPP process – with end activities linked to PQR√ improve management and oversight of the status of health product procurement and supply at the grant level

(active Monitoring)

√ Providing data to forecast demand

√ Market intelligence

� Initial modules during 2013

1st MDAG Meeting Geneva 27-28 June 2012

Outline

Global Fund Secretariat

Procurement

Quality Assurance

Procurement strategy

• Strengthen Secretariat’s Capacity for strategic market shaping

“optimize price, quality, design, & sustainable supply”• 3 additional staff to complement PSS/VPP team

• Recruitment of Senior Procurement Officer

• Full staff complement and necessary structure completed by Q1 2013

• Fully implement voluntary pooled procurement (VPP) • Improve and reform VPP Mechanism

• Facilitating Payment options, including allowing for VPP disbursements based on a “cost-estimate” instead of individual invoices

• Real time indicative/reference prices from VPP• Build previous internal price information sharing

• Publish quarterly� externally: indicative prices/ranges

� internally: more in-depth analysis/trend information

• Initially: ARVs, ACTs, LLINs, HIV rapid tests, Malaria rapid tests

Strategic Interventions

1st & 2nd

line ARVs

New 1st

line ARVs

Paed. ARVs

Initial focus

Procurement of key products with grant funds

• From 2009, more than US$ 2.122 billion1 of ARVs, long-lasting insecticidal nets, antimalarial and anti-TB medicines were delivered to Principal Recipients and reported to the PQR.

1 As reported to the PQR on 02 April 2012

Product Category Total Product Cost (USD)

Bednet $863,800,266

Anti-Retroviral $816,509,939

Anti-Malaria Medicine $145,187,211

Diagnostic test $135,067,022

Anti-TB Medicine $124,169,159

Condom $37,407,498

Grand Total $2,122,141,095

41%

38%

7%

6%

6%

2%

Total Product Cost (USD)

Bednet

Anti-Retroviral

Anti-Malaria Medicine

Diagnostic test

Anti-TB Medicine

Condom

Global Fund-financed medicines procurement reported in PQR: Purchase orders 2010-2012 to date (in million US$)

Source: PQR data as at 10 September 2012

Procurement since January 2010 as per Global Fund QA Policy

A: WHO-prequalified

(including “A and B”)

B: SRA-autho-rized*

Source: PQR data as at 10 Sep 2012

Second-line TB: USD 69 million

First-line TB incl.streptomycin:US$ 53 million

Outline

Global Fund Secretariat

Procurement

Quality Assurance

Partnerships in Quality Assurance

• Collaboration with WHO PQ – Expert advice

– QA Policy implementation: ERP management

• WHO Disease Programs: HIV, Malaria, TB, WHOPES

• Collaboration/information sharing with other donors and procurement agencies

• Regular communication with manufacturers

• Monitoring QA activities and publication of results

Quality monitoring at country level

Quality

Ass

ura

nce b

efo

re a

rriv

al of pro

ducts

in c

ountr

y

� Procurement:

Product selection according to Global Fund QA Policy

Pre-shipment quality control testing for ERP-reviewed products (organized by Global Fund Secretariat as per QA Policy)

� Receipt in country, storage, distribution

� Quality control in countries:

Step 1: Selection of quality control laboratory

Step2: Designing a sampling and testing programme

Step 3: Sampling

Step 4: Transport of samples to the laboratory

Step 5: Quality control testing results and reports

Step 6: Records and documentation

� Monitoring storage and distribution sites

� Safe disposal of pharmaceutical products

14

1. Clinical Criteria 2. Quality Criteria 3. Monitoring Quality

Collaboration

• Collaboration at country and global level:

– CPP initiative focus on financing flow/situation

– ACT task force

– ACT Global Demand Forecast

– RBM PSM working group

• National collaboration and coordination:

– Joint PSM planning, (pharmaceutical country profile)

– National forecasting and quantification committee

– Development of procurement plan

– Harmonize and Streamline supply chain tools, reporting system and data collection

• Risk assessment and risk mitigation measures

• Joint action plan for strengthening country systems