UNICEF Engagement in Pneumonia

Malaria Consortium Consultation

June 2014

Outline

About UNICEF

About UNICEF supply

About pneumonia …..

Realizing the rights of every child, especially the most disadvantaged

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SURVIVE FROM BIRTH

TO THRIVE INTO ADULTHOOD

Realizing the Rights of Every Child

Supply in the UNICEF structure

UNICEF Supply Division, Copenhagen

What we do

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Procurement, warehousing & logistics – UNICEF

programmes & for procurement partners

Market shaping – ensuring availability, quality, price and right formulations of essential commodities

Ensuring local delivery of essential commodities to

children and families

Rapid emergency response

Partnerships, policy & monitoring

Innovation for children

UNICEF’s supply function vision

Procurement Services Direct Delivery

Direct Delivery Procurement Services CD IV

Direct Delivery Procurement Services IV & MI

Capacity Development

Direct Delivery Procurement Services Capacity Development Innovation &

Mrket Influence

2008

2010-11

2012-13

2020

Direct Delivery Procurement Services

2005

Health

HIV/AIDS

WASH

Nutrition

Education

Protection

Inclusion

Service Delivery

Emergency

Influencing Markets

Innovation

SD Supply Chain improvement initiatives

Strengthening & Optimising Supply Chains with Governments

Capacity Development

Supply Community & Professional Development

Monitoring:

(Performance Targets, Supply Outcome Targets, Results Matrix , PS)

Results-based management, reporting & project management

Partnership

UNICEF Supply Strategies for 2014-2017

UNICEF Outcome Areas UNICEF Global Supply Strategies

Looking at the supply chain

M & E Logistics & delivery Procurement Planning

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UPSTREAM DOWNSTREAM

A look into pneumonia…

- pneumonia diagnosis -

World Health Organization. Were, Qazi. June 2014

It is not only about the technology….

….but about defining the functional requirements

based on user needs

$1.23

•WHO and Save The Children (STC) exchange mails on inadequacy

of ARI timer for assessment by CHWs of fast breading.

•UNICEF PD & SD invited by WHO, STC and Philips Philanthropic

Design Initiative (PPDI) to participate in designing a new

generation ARI timer.

•Progress with newly designed timer stalls on (i) open source

discussion with PPDI, (ii) no funds to make a prototype, and (iii) no

funds for field testing.

•REoI to potential producers new ARI timer: 20 invited, 2 respond

(1 rejected, 1 current manufacturer Moneray). Monopoly PPDI /

Moneray not acceptable.

•Work on newly designed ARI discontinued, refocus on needs of

end-users.

Aug 2005

May 2007

March

2008

Nov 2008

Oct 2010

ARI Timer Time Line ….

•RFI successfully scouts for potential technologies and

organizations working on a pneumonia diagnostic aid. All are

promising but very early initiatives.

•Evaluation of RFI selects most promising ones. During follow-up

all organizations request support, guidance and financial means.

•Field research with various concepts (by Innovation Unit ), creates

for the first time very good insight into ARI diagnostic

requirements at community level.

•SD workshop with industry and academia, (i) creates personas, (ii)

common design denominators, (iii) need for short and long term

TPP, and (iv) creates frequent progress exchange with BMGF.

•Parallel to the innovation track, in cooperation with supplier,

specifications of current S0845010 were updated. ARI timer, mark 2

is expected Q3 2014.

•TPP development starts

Dec 2011

Q1+Q2

2012

Q2+Q3

2012

Jan 2013

Q3 2013

Jan 2014

ARI Timer Time Line (2) ….

About the products

Diagnostics (respiratory rate timers)

Amoxicilin DT

Pneumonia

Pulse Oximetry

Oxygen concentration, Accessories

Oximetry

Also consider dispersible paracetamol for fever

management

Pneumonia Diagnostics

Current timing tool(s) for pneumonia diagnosis:

Basic supply for community health

ARI Timer

Watch

Different Pneumonia Diagnostic Aids

Device Name Description

ARI Counting Beads

Counting beads designed as a simple, cheap and effective way to improve a CHW’s

ability to keep track and count a patient’s breathing rate. To be used in conjunction with

the ARI Timer. The beads are colour-coded to ease diagnosis.

Respiratory Rate

Application

A mobile phone application that tracks a CHW’s count rate using an “any button” press

function on the phone to count and then calculate a patient’s mean respiratory rate.

Solar and Cell Phone Pulse

A device powered by using old mobile phone batteries charged by solar cells measures

the saturation level of a patient’s haemoglobin. It determines whether a patient is

receiving sufficient oxygen through breathing, as well as the patient’s heart rate.

StethoCloud

A concept still in development which records the respiration rate through a stethoscope

attached to a smart phone or a cloud device. The data is processed against an existing

database used to diagnose pneumonia.

mPneumonia

An android prototype mobile phone application in development which uses the IMCI

pneumonia protocol, paired with a respiratory rate counter and pulse oximetre to guide

and inform diagnosis.

The Nossal ‘Smart Cable’

Project

A device that transforms a simple mobile phone into capturing data from three sensing

devices: oximetre, respiratory rate counter and thermometer.

The Phone Oximetre for

Sepsis

An oximetre device and application that attaches to a smart phone

and measures respiratory rate, peripheral blood flow and

heart rate, facilitating diagnosis. Ongoing

developments

Ref: Pneumonia Diagnostics: Current outlook and perspectives : UNICEF Supply Division - May 2013

Pneumonia Treatment

Amoxicillin 250mg DT

Cost: Amox 125mg/5ml suspension (100ml) Versus Amox 250mg DT

UNICEF Catalogue Product FCA lowest

Price (US$)

Treatment cost <

1 year olds

Treatment cost

1-5 years

S1505046 Amox 125mg/5ml Suspension 0.40 0.40 0.80

S1505043 Amox 250mg DT 10 X10 Pack 1.70 0.17 0.34

S1505044 Amox 250mg DT 10 X 2 Pack 0.37 N/A 0.37

S1505045 Amox 250mg DT 10 X 1 Pack 0.24 0.24 N/A

Amox 250mg DT: UNICEF Procurement Activities

Suppliers Country

Microlabs India

Medopharm India

Medreich India

Sandoz Austria

Remedica Cyprus

Pneumonia: Treatment with Amoxi 250mg DT

Fever Management

UNICEF Product (material description) Unit price Cost of

treatment

S1555990 Paracetamol 125mg/5ml or.sol/BTL-60ml 0.43 USD 0.43 USD

S1555965 Paracetamol 500mg tabs/PAC-1000 5.48 USD N/A

S1555978 Paracetamol 100mg tabs/PAC-1000 3.65 USD N/A

S1555979 Paracetamol 100mg disp. Tabs 10X10 pack 0.75 USD 0.075 USD

S1555979 Paracetamol 250mg disp. Tabs 10X10 pack 0.81 USD 0.081 USD

Use of Paracetamol DT significantly reduces the cost of fever

treatment compared to the use of Paracetamol oral suspension

Fever: Treatment with Paracetamol DT

Introduction of 100mg & 250mg Paracetamol dispersible

tablets for the treatment of fever in under fives

Pulse Oximetry

UNICEF Product (material description)

( Prices are indicative )

Unit price

S0002036 Pulse oximeter,spot-check,w/access, 300 USD

S0002033 Pulseoximeter,portable,w/access, 3,435 USD

S0002031 Monitor,patient,all vitals signs,portable,w/access 2,025 USD

S0002047 Oxygen concentrator/SET 880 USD

S0370100 Prongs,nasal,Oxygen,adult,s.u 0.21 USD

S0370110 Prongs,nasal,Oxygen,child,s.u 0.22 USD

S0370120 Prongs,nasal,Oxygen,neonate,s.u 0.21 USD

Pulse Oximetry

Questions ….