UNICEF involvement in PSM – Case of Ethiopia PSM Consultants Briefing Seminar Copenhagen 30 Jan. – 2 Feb. 2005

UNICEF UNICEF involvement in involvement in PSM – Case of PSM – Case of

EthiopiaEthiopia

PSM PSM Consultants Consultants

Briefing Briefing SeminarSeminarCopenhagenCopenhagen

30 Jan. – 2 Feb. 200530 Jan. – 2 Feb. 2005

OverviewOverview1.1. History of UNICEF involvement in History of UNICEF involvement in

PSMPSM

2.2. UNICEF capacity for PSM assistanceUNICEF capacity for PSM assistance

3.3. Challenges faced by partner Challenges faced by partner countiescounties

4.4. Nature of UNICEF assistanceNature of UNICEF assistance

5.5. Impact of UNICEF assistance Impact of UNICEF assistance

6.6. Critical success factors Critical success factors

7.7. Remaining challengesRemaining challenges

UNICEF is the leading agency for children’s supplies

UNICEF SuppliesUNICEF Supplies• UNICEF procures vaccines for UNICEF procures vaccines for

40 per cent of children in 40 per cent of children in developing countries (2.5 developing countries (2.5 billion doses a year)billion doses a year)

• UNICEF is the world’s largest UNICEF is the world’s largest buyer of mosquito nets (15 buyer of mosquito nets (15 million nets in 2005)million nets in 2005)

• UNICEF procures New ACTs - UNICEF procures New ACTs - effective medicines against effective medicines against malaria ($7.6m in 2005)malaria ($7.6m in 2005)

• UNICEF has procured 40 UNICEF has procured 40 million packets of Oral million packets of Oral Rehydration Salts in 2005Rehydration Salts in 2005

• UNICEF currently delivers UNICEF currently delivers antiretroviral medicines to antiretroviral medicines to 44 countries ($33.5 million in 44 countries ($33.5 million in 2005)2005)

• During 2005, UNICEF During 2005, UNICEF reached around $7.7 million reached around $7.7 million worth of test kits.worth of test kits.

UNICEF SuppliesUNICEF Supplies

• During 2005, UNICEF During 2005, UNICEF played key role in played key role in emergenciesemergencies

• UNICEF has stock of ARVs UNICEF has stock of ARVs in Copenhagen for in Copenhagen for emergenciesemergencies..

UNICEF SuppliesUNICEF Supplies

Role of UNICEF Supply Role of UNICEF Supply DivisionDivision

• OverseeOversee UNICEF’s UNICEF’s global procurement global procurement and logistics and logistics operation. operation.

• EnsureEnsure that high that high quality, good value quality, good value supplies reach supplies reach children and their children and their families quickly. families quickly.

• MaintainMaintain the highest the highest ethical standards for ethical standards for procurement.procurement.

• ProvideProvide technical technical support to UNICEF support to UNICEF offices and Procurement offices and Procurement Services customers Services customers globally.globally.

• ShareShare procurement procurement know-how with know-how with development partners.development partners.

• InnovateInnovate to find ever- to find ever-better supply solutions better supply solutions for children.for children.

Country Office PresenceCountry Office Presence

• Active Procurement activities in Active Procurement activities in support of Governments and NGOssupport of Governments and NGOs

• In-country logistics, for all In-country logistics, for all commoditiescommodities

• Capacity building in programming Capacity building in programming and supply managementand supply management

• Partnership buildingPartnership building

UNICEF partner

constraints in PSM

An Overview of the An Overview of the SystemSystem

The Supply Management The Supply Management FrameworkFramework

Rational Use

HR

SupplySystem

CostContainment

Financing

LegalFramework

Formulation

Principles

Access

Research

The Supply Management The Supply Management FrameworkFramework

Location of constraintsin the Supply Cycle

Quantification

Distribution Acquisition

Selection l e

Definition of Responsibilities

Identification of Coordination Mechanisms

Integration of Existing Institutions & Programs

Procurement

Case of EthiopiaCase of Ethiopia

• Long procurement lead Long procurement lead time (average 84 weeks)time (average 84 weeks)

• Forex transfer difficultiesForex transfer difficulties• Serious constraints in Serious constraints in

distribution systemdistribution system• Preparedness of treatment Preparedness of treatment

sitessites• Limited HR capacityLimited HR capacity

General CharacteristicsGeneral Characteristics

– Inaccurate quantification information Inaccurate quantification information due to poor LMIS due to poor LMIS

– Non optimum drug availability => Non optimum drug availability => waste and expiration waste and expiration

– Non-systematic inventory control Non-systematic inventory control management systemsmanagement systems

– Inadequate storage facilitiesInadequate storage facilities– Limited transport for distribution of Limited transport for distribution of

drugsdrugs– Non-optimum demand for commoditiesNon-optimum demand for commodities

Ethiopia UNICEF Ethiopia UNICEF InvolvementInvolvement

• Procurement servicesProcurement services• Forex “transfer Forex “transfer

facilitation”facilitation”• Overhaul of in-country Overhaul of in-country

logistics system (in logistics system (in process)process)

• Assistance with Assistance with commodity distributioncommodity distribution

• Technical Assistance to Technical Assistance to FMOH in logistics FMOH in logistics managementmanagement

Ordering

Product Receipt

Stock Management

Distribution

Ethiopia UNICEF InvolvementEthiopia UNICEF Involvement

Selection, QuantificationSuppliers, Quality Monitoring

Delivery Times

Customs, Registration, Quality &

Order verification

Product quality, batch no, Shelf life monitoring, Environ. control, etc

Allocation,Transport,

Usage Evaluation

UNICEF PSM

support making a difference

Performance – Delivery of Performance – Delivery of ProductsProducts

Results for EthiopiaResults for Ethiopia• More than 3 million treatments of More than 3 million treatments of

Artemether-Lumefantrine to all regions of Artemether-Lumefantrine to all regions of Ethiopia Ethiopia

• Forecasting & procurement– 600,000 P. Forecasting & procurement– 600,000 P. falciparum malaria cases to be treated in falciparum malaria cases to be treated in 2005-6 2005-6

• Largest distribution of ITNs in Ethiopian Largest distribution of ITNs in Ethiopian history (3.5m nets)history (3.5m nets)

• 1.8m RDTs distributed in 20051.8m RDTs distributed in 2005• $ 6 m ARV procured and delivered in 6 mths$ 6 m ARV procured and delivered in 6 mths• System overhaulSystem overhaul

The Case of ARV suppliesThe Case of ARV supplies

MATERIALMATERIAL

No. of Packs No. of Packs SuppliSuppli

eded

Current No. of Current No. of Packs in Packs in

StockStock Expiry DateExpiry Date

Reamining Reamining shelf shelf life life

(mont(months) hs)

No. of No. of TreatTreat

ments/ments/mth mth Monthly consumptionMonthly consumption

11 Didanosine 100mg tabs/PAC-60 pbDidanosine 100mg tabs/PAC-60 pb 16,000 16,000 16,000 16,000 7/6/067/6/06 1010 1,6001,600 00

22 Efavirenz 200mg caps/PAC-90 pbEfavirenz 200mg caps/PAC-90 pb 1,500 1,500 1/8/081/8/08 2828 5454 00

33 Efavirenz 200mg caps/PAC-90 pbEfavirenz 200mg caps/PAC-90 pb 1,334 1,334 3/6/063/6/06 66 222222 5858

44 Efavirenz 600mg tabs/PAC-30 pbEfavirenz 600mg tabs/PAC-30 pb 4,000 4,000 5,893 5,893 2/7/072/7/07 1717 347347 52015201

55 Lamivudine 150mg tabs/PAC-60 gpLamivudine 150mg tabs/PAC-60 gp 100,501 100,501 1/7/071/7/07 1616 6,2816,281 69326932

66 Lamivudine oral sol.10mg/ml/BOT-240ml pbLamivudine oral sol.10mg/ml/BOT-240ml pb 3,864 3,864 7/6/067/6/06 1010 386386 00



99 Nelfinavir 250mg tabs/PAC-270 pbNelfinavir 250mg tabs/PAC-270 pb 15,500 15,500 15,500 15,500 6/7/076/7/07 2121 738738 00

1010 Nevirapine 200mg tabs/PAC-60 gpNevirapine 200mg tabs/PAC-60 gp 50,500 50,500 50,490 50,490 2/7/072/7/07 1717 2,9702,970 1218112181

1111 Nevirapine 200mg tabs/PAC-60 gpNevirapine 200mg tabs/PAC-60 gp 5,075 5,075 6/6/066/6/06 99 564564 00

1212 Nevirapine oral sol.10mg/ml/BOT 100ml gbNevirapine oral sol.10mg/ml/BOT 100ml gb 2,163 2,163 6/9/066/9/06 99 240240 13491349

1313 Nevirapine oral sol.10mg/ml/BOT-240ml pbNevirapine oral sol.10mg/ml/BOT-240ml pb 9,000 9,000 9,000 9,000 6/7/076/7/07 2121 429429 00

1414 Stavudine 30 mg caps/PAC-60 gbStavudine 30 mg caps/PAC-60 gb 16,200 16,200 10,596 10,596 4/7/074/7/07 1919 558558 4,164 4,164

1515 Stavudine 40 mg caps/PAC-60 gbStavudine 40 mg caps/PAC-60 gb 20,000 20,000 20,000 20,000 4/7/074/7/07 1919 1,0531,053 27792779

1616 Stavudine 40 mg caps/PAC-60 gbStavudine 40 mg caps/PAC-60 gb 13,575 13,575 5/6/065/6/06 88 1,6971,697 00

1717 ZDV + 3TC 300+150mg tabs/PAC-60 pbZDV + 3TC 300+150mg tabs/PAC-60 pb 11,182 11,182 11/7/0711/7/07 2626 430430 1039710397



2020 Zidovudine 300mg tabs/PAC-60 gpZidovudine 300mg tabs/PAC-60 gp 7,138 7,138 11/7/0711/7/07 2626 275275 3232

2121 Zidovudine 300mg tabs/PAC-60 gpZidovudine 300mg tabs/PAC-60 gp 1,000 1,000 1,000 1,000 1/7/071/7/07 1616 6363 00

2222 Zidovudine oral sol.10mg/ml/BOT-100ml pbZidovudine oral sol.10mg/ml/BOT-100ml pb 3,500 3,500 3,500 3,500 4/7/074/7/07 1919 184184 00

2323 Zidovudine oral sol.10mg/ml/BOT-200ml pbZidovudine oral sol.10mg/ml/BOT-200ml pb 12,057 12,057 12/6/0612/6/06 1515 804804 414414

2424 Zidovudine oral sol.10mg/ml/BOT-200ml pbZidovudine oral sol.10mg/ml/BOT-200ml pb 9,144 9,144 7/6/067/6/06 1010 914914 00

Critical success factorsCritical success factors• Technical expertise within the Technical expertise within the

procurement teamprocurement team• Country specific interventionCountry specific intervention• Stakeholder involvement Stakeholder involvement • Interpersonal and inter-institutional Interpersonal and inter-institutional

working relationshipworking relationship• Communication and information Communication and information

sharing: SD-CO; CO-MOH; partner-sharing: SD-CO; CO-MOH; partner-partnerpartner

• Clear plan for in-country logisticsClear plan for in-country logistics• Periodic review of PSM plansPeriodic review of PSM plans

Remaining challengesRemaining challenges

• Human resource Human resource shortagesshortages

• Weak health system Weak health system and capacity in and capacity in procurementprocurement

• Capacity building plan Capacity building plan for in country logisticsfor in country logistics

• Hands on PSM supportHands on PSM support• Financing mechanismsFinancing mechanisms

For every child… For every child…

Documents

UNICEF involvement in PSM – Case of Ethiopia PSM Consultants Briefing Seminar Copenhagen 30 Jan. – 2 Feb. 2005