From 3by5 to Universal Access to HIV/AIDS Treatment: AMDS Technical Briefing Seminar for Consultants...

From 3by5 to Universal Access to HIV/AIDS Treatment: AMDS

Technical Briefing Seminar for Consultants on Procurement and Supply Management for HIV, TB

and Malaria

30 January 2006

Copenhagen

Peter Graaff, AMDS, HIV

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Content

Procurement and Supply Management• Issues• Tools

Aids Medicines and Diagnostics Service• Partners• Activity Areas

From 3by5 to Universal Access• Investment• Coordination

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Drug procurement is more then "shopping" Procurement Cycle

DemandCreation

SupplierAgreements

FinancingReceipt, Storage,

Distribution

Forecasting

QualityAssurance

EffectiveUse

ProductProcurement

ProductSelection

Monitoring

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A moving goalpostFrom procurement to supply management to……

Price

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A moving goalpost From procurement to supply management to……

Price

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A moving goalpost From procurement to supply management to……

Procurement

•What?•Where?•How much (quantification)?• IP barriers

•Patents•Bilateral trade agreements

•Registration (fast track)•Quality (PQ)?

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A moving goalpost From procurement to supply management to……

Procurement

•What?•Where?•How much (quantification)?• IP barriers

•Patents•Bilateral trade agreements

•Registration (fast track)•Quality (PQ)?

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A moving goalpost From procurement to supply management to……

Supply management

•Customs clearance•Volume •Expiry & stock-outs•Information flow•Task shifting•……..

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A moving goalpost From procurement to supply management to……

Supply management

•Customs clearance•Volume •Expiry & stock-outs•Information flow•Task shifting•……..

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A moving goalpost From procurement to supply management to……

Adherence

• Rational use•Patient tracking•Side effects•Community involvement•………….

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A moving goalpost From procurement to supply management to……

price and procurement

• Increasing lead times with increasing chances of wastage• Global capacity• IP barriers

•Patents•Bilateral trade agreements

•…………..

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Content

Procurement and Supply Management• Issues• Tools

Aids Medicines and Diagnostics Service• Partners• Activity Areas

From 3by5 to Universal Access• Investment• Coordination

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Too much work and too little time

Build on existing capacityDevelop the AMDS as a network with WHO

taking on secretariat functions

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Initiatives by the AMDS and its partners

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PartnersUN Agencies

• WHO, UNICEF, World Bank, UNAIDS, UNFPA, UNDP

Technical organizations and donor agencies• Centrale Humanitaire Medico-Pharmaceutique, Clinton

HIV/AIDS Initiative, Commonwealth Pharmaceutical Association, Crown Agents, Ecumenical Pharmaceutical Network, GFATM, IDA, JSI, MSH, ESTHER, USAID

Observers• MSF, US State Department (OGAC/PEPFAR),Bill and

Melinda Gates Foundation

Secretariat• AMDS unit of HIV Department of WHO

•National•Regional •Global

•PSM / TCM / HIV

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AMDS partnerstake responsibility for:

Procurement UNICEF, IDA, CHMP and WHO/CPS • Stockpile development

"Normative" activities• Prequalification• Monograph development• Forecasting and quantification tool development• Supply chain management system development

Operational work• Country level staffing• Capacity building• Technical support

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Strategic information

Price Information System

Patent Status Database

ARV Market Intelligence

Inform Local Productionof ARVs

Market Forecast

AMDS website

Regulatory Status Database

API price, capacity &quality/specification info

ARV production costing

Global ARV price reporting mechanism

Key activity in

2006

www.who.int/3by5/amds

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Global price reporting mechanismhttp://www.who.int/3by5/amds/price/hdd/

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Technical support for PSM

Tools

Planning

Capacity building

PSM workshops• GFATM and WB recipients• Consultant briefing

national capacity building plans

national levels PSM coordination bodies

IMAAI training manual for facility level PSM

Country level assessments (including local production)

inventory of training activities

Harmonized monitoring systemfor reporting to donors

TA for identified "bottlenecks"

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Content

Procurement and Supply Management• Issues• Tools

Aids Medicines and Diagnostics Service• Partners• Activity Areas

From 3by5 to Universal Access• Investment• Coordination

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Too much work and too little time

Build on existing capacityDevelop the AMDS as a network with WHO

taking on secretariat functions

Moving from 3by5 to universal accessToo much work and tool little time…….. and

now more then ever at country level

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What next?PSM in the context of universal access

National coordinationIntegration

• Universal access requires investment in the health (care delivery) system

Opportunity• HIV/AIDS as the engine to develop the

pharmaceutical sector

Investment• Spending, say 15%, of the value of the product

on its delivery to the client is normal but systematically ignored

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Coordination

versus

Fragmentation

What next?PSM in the context of universal access

The Global Task Team (GTT)

UN coordination and cooperation at country level

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National PSM Coordination BodyPossible activities

Regular information sharing on PSM• Current activities• Strategic info (e.g. prices, patent status, local production potential)

Harmonization of country-level PSM planning/budgeting, reporting, implementation for ARV supply• One system for drug management for multiple donor streams

Training & Implementation Tools• Harmonise Supply Chain Management and Monitoring systems • Facility-level guidelines on stock management and reporting• Common country-level forecasting tool

Common agenda to address HR gap in pharmaceutical sector

A code of conduct for the sales and distribution of ARVs

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For further information please visit the AMDS website

http://www.who.int/3by5/amds/en/

or send an e-mail to

AMDS@who.int (unit) or graaffp@who.int (direct)