Quantification: Historical procurement informing forecasts and programmatic influencers

April 9-10, 2015

Jason Williams, Principal Laboratory Advisor

WHO Meeting with Diagnostic Manufacturers and Stakeholders

Overview

• Core diagnostic challenges

• Forecasting related challenges

• Effect of rapid scale-up, acceleration plans

• Effect of introducing point of care (POC)

• Actual procurement variance versus forecasts

• What will CD4/VL transitions look like?

• Where do we want to be?

2

Core diagnostic challenges: scale-up

• Donor funding vs. government commitments

• Increased treatment targets vs. shrinking budgets

• Program and laboratory and logistics interface

• Increased access, priority populations, and/or targeted

response

• Mixed model approaches — conventional and POC

• Country ownership and donor agendas

• CD4 or viral load monitoring of HIV

• Centralization or decentralization

Forecasting in-country challenges

• Conflicting donor priority areas of focus

• Responding to dynamic public health programs

• Parallel funding streams, procurement, and distribution

systems

• Disconnect between programmatic expectations vs.

laboratory service delivery

• Need to fully institutionalize quantification efforts

• Need for enhanced communication and strategic

coordination across all program implementers — working

from one strategic framework

• Need to leverage data from all key stakeholders to assist

in programmatic planning

4

CD4: Rapid scale-up ambitions, reduced uptake (Country A)

5

Introducing CD4 POC: Impact on conventional platforms (Country A)

6

CD4 tests procured vs. forecasted: Country A Procurement quantities can cross years

7

CD4 tests procured vs. forecasted: Country B Introducing new instruments

8

Introduction of 148

new instruments

CD4 tests procured vs. forecasted: Country C Realigning forecasts based on service delivery

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Realigning forecasts due to

greater data availability

CD4 tests procured vs. forecasted: Country C Programmatic expectations versus service delivery

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What will CD4/viral load transitions look like? Need for active monitoring

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Actual?

Forecasting: Where do we want to be?

• Improved data management associated with scale-up

implementation

• Need to institutionalize laboratory quantification

efforts, aligned with HIV RTKs and ARVs

• Consensus-driven approach on developing

assumptions and validating final forecasts

• Multi-method approaches for comparative purposes

(ForLab)

• Enhanced programmatic involvement (RTKs, ARVs, lab

linkage)

• Development of coordinated national supply plans

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Questions/comments

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