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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
3
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
6
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
De
fin
itio
n o
f n
ee
d
(i.e
. tim
ing
/qty
etc
.)
Bu
dg
etin
g &
Pla
nnin
g
Pro
cu
rem
ent
De
live
ry &
Cle
ara
nce
Insp
ectio
n
Wa
reho
usin
g,
Dis
trib
utio
n &
Re-o
rde
rin
g
(na
tio
nal,
pro
vin
cia
l, d
istr
ict,
co
mm
unity)
Utilis
atio
n b
y
Beneficia
ry
Mo
nito
rin
g &
Eva
lua
tio
n
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 ….