UNICEF- Update on key activities and plans IPC, 5 th -6 th
June. 2014
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Procurement in support of programmes- 2013 Supplies and
services for 134 countries and areas Total procured $2,839
Emergency $127 Supplies to 33 countries and areas Procurement
Services $1,363 Supplies to 99 countries
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Supplier and destination countries
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Medicines: 2014 Activities Procurement strategies to address
increasing demand for priority medicines: ORS/Zinc, amoxicillin DT,
gentamicin, CHX, dexamethasone inj, IFA Support work of UNCLSC and
Pneumonia and Diarrhoea WG: Amoxi DT ERP, availability of medicines
and diagnostics, collaboration to increase sources, country
implementation including activities resulting from GF/UNICEF MoU.
Optimization of kits: iCCM (DRC), Diarrhoea kit, PEP Kit
Partnerships to ensure availability of pediatric ARVs: IATT
Formulary development Pediatric ARV WG Pediatric ARV Procurement
Working Group Controlled temperature shipments Improve internal
process and supplier relations to provide optimal service
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The market dashboard Inspired from UNITAID Market dynamics
Dashboard The Dashboard monitors the market dynamics of more than
50 essential commodities for women and children. It provides a
qualitative assessment of the determinants of a healthy market,
including: Availability Affordability Competition Quality
Acceptability Delivery Funding security
http://www.unicef.org/supply/index_70578.html Published twice a
year, aim is to encourage internal and collaborative thinking on
ways to address gaps and achieve a more balanced market
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ORS/Zinc co-pack: 3 LTAs established, first procurement of over
200K packs Chlohexidine 4% for umbilical cord care: collaboration
through UNCLSC to increase number of manufacturers and qualify gel
formulations. Amoxicillin DT: increase in demand and initiation of
substitution of suspension Introduction of optimal products
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Kit delivery Majority are health kits
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Supply of commodities to manage sexual assault of children and
women in the context of emergencies Challenges Forecasting the need
Kit design not addressing diversity of situations where it is used
(target, skills and care services) Repacking of kits at Country
Office level to meet needs Split up kit contents to distribute to
smaller health facilities Split up blisters/packs to dispense to
patients Specific needs of children usually not taken care of, e.g.
paediatric dosages Lack of specific Guidance PEP Children PEP
Adults Wound Care Psychosocial Support Associated Conditions +
Guidance Documents Proposed Response (for discussion with partners)
Easy identification of the necessary items for management of sexual
assault More flexibility in procurement of PEP for children
Holistic response, Clear guidance Guidelines to be reviewed 2014
(WHO)
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Consolidate regimens used Consolidate formulations used Ensure
pediatric ART guidelines are up to date Identify regimens and
products that can be phased out of formulary (eg. d4T, ddI) Review
current procurement list for redundancies Explore areas for
transition to optimal products such as FDCs and phase out
suboptimal or redundant formulations Partnerships to ensure
availability of optimal treatment for HIV in children Consolidate
formulations used Coordinate pediatric ARV procurement amongst
partners Align both supply and demand to more efficient products.
Interagency Task Team (IATT)/ Pediatric ARV Working Group Pediatric
ARV Procurement Working Group/ Buyer Consortium
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Health Technology Centre Essential supplies for Health
Programmes Medical equipment and consumables, diagnostics tests and
clinical laboratory equipment Long Lasting Insecticide treated bed
nets ( LLINs), Insecticides and Rapid Tests Malaria Prevention and
Diagnostics Medical Devices and Laboratory Cold Chain Cold chain
equipment, refrigerators, waste disposal, injection safety devices
Maternal and New born Health Issues INNOVATION FOCUS Injection
safety devices, waste disposal. Immunisation Devices
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Health Technology: 2014 Activities Optimization strategies
defined for Health Technologies Supply Chains,.i.e. Performance
indicators, Forecasting, Shipments optimization and Total Landed
Cost options Quality policies prepared, harmonization with key
partners (IVD, High Risk Medical Devices, mapping high-risk
products that could be those correspond to class IIB and III of
European MDD and develop its risk mitigation protocol). Innovation
ARIDA project ( pneumonia diagnostics ), in collaboration with WHO,
Malaria Consortium, BMGF Partnerships LLIN procurement GF, UNDP,
DfiD, PMI, Partnerships POC technology UNITAID, CHAI, 7
countries
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Ensure a cold chain for all TTSPP . Scale up of old vaccines .
Scale up of new vaccines Scale up of new versions such as IPV .
Healthy market for innovative cold chain equipment Supply Chain
integration Oxytocin, Insulin Cold chains for lab samples, blood
banks, test kits Immunization devices available for all Optimizing
immunization shipments/cost per device delivered Untangling the web
of quality requirements Waste management for immunization,
diagnostic testing ? Aligning with WHO PQS for injection safety
devices procurement and providing feedback on evaluation protocols
and technical specifications Contribute to the updating of WHO
guideline of injection safety. 2014 Activities
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UNICEF-CHAI Project: Accelerate Access to Innovative Point of
Care (PoC) HIV Diagnostics: CD4, Early Infant Diagnosis, and Viral
Load Funded by UNITAID Targets: 7 focus countries Zimbabwe,
Tanzania, Kenya, Ethiopia, Uganda, Mozambique, Malawi Programmatic
and Supply coverage: CD4 testing, which is used for staging and
monitoring HIV patients prior to initiation onto antiretroviral
therapy (ART). Early Infant Diagnosis (EID) testing for infants
less than 18 months of age (this technology can be performed on
viral load platforms as well). Viral Load (VL) testing, which is
mainly used for monitoring HIV patients following initiation to ART
UNICEF Quality Policy for procurement of IVDs consulted with WHO,
CDC, MSF and fully harmonized with Global Fund. Phase 1 Nov
2012-December June 2014 US$ 20million Phase 2a Project proposal
approved and MOU currently under negotiations Period July 2014 Dec
2015 US$ 35million Phase2b Project ending 2018 funding remains
subject to UNITAID board approval
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Source: UNIICEF Supply Division Immunization Supplies Vaccines
BCG, DTP, TT/Td/DT, Measles containing, OPV, HepB, YF, DTP-HepB,
DTP-HepB/Hib, DTP/Hib, Hib, MR, Meningitis, MMR, PCV, RV IPV, HPV
etc. Safe Injection equipment Cold Chain Equipment Vaccines BCG,
DTP, TT/Td/DT, Measles containing, OPV, HepB, YF, DTP-HepB,
DTP-HepB/Hib, DTP/Hib, Hib, MR, Meningitis, MMR, PCV, RV IPV, HPV
etc. Safe Injection equipment Cold Chain Equipment Vaccines
Supplies: US$ 1, 285 million 2.79 billion doses 2,185 shipments
2013 Countries UNICEF procures on behalf of Full schedule Partial
schedule UNICEF has a key role in vaccine procurement, procuring
immunization supplies on behalf of around 100 countries annually
Source UNICEF Supply Division
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Vaccines: 2014 Activities* Support to countries / on-going
operations: Coordination internally and support to countries for
high number of new vaccine introductions (79 new vaccine
introductions (13 IPV) in GAVI supported countries in 2014; 123 (59
IPV) in 2015), and continuing programmes; specific innovative
projects follow up: VAR, Visual Vaccines; KPIs Continued/increased
support to MICs and GAVI graduating countries through procurement
practitioners forum to support countries moving to
self-procurement, review VII and other financing mechanisms,
engagement with partners and countries, MIC tender for new vaccines
Polio eradication IPV tender concluded in Q1 2014 and
operationalized during the year; OPV supply and demand planning for
vaccines and funding; strategy for type 2 withdrawal Timely
completion of tender activities and additional awards (JE, Mening,
penta, HPV, PCV, Rota); develop consolidated strategy for achieving
price goals Provide more useful and accessible information for
countries, manufacturers and partners (eg, update website, pricing
data, procurement contexts, market updates) Continue to strengthen
supplier relationships, including at least 1 visit to each of the
top 10 suppliers and visit to China Follow-up with DRC and Nigeria
on supply chain optimization projects Coordination with partners,
including GAVI, BMGF, WHO, GPEI, etc *Key activities, not all
inclusive
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Virus detection & interruption Last wild polio
caseCertification RI strengthening & OPV withdrawal Containment
& certification Introduce IPV Wild virus interruption Outbreak
response (esp. cVDPVs) RI strengthening & OPV2 pre-requisites
OPV2 withdrawal Legacy Planning Finalize long-term containment
plans Complete containment & certification globally
Consultation & strategic plan Initiate implementation of legacy
plan Last OPV2 use Endgame Major Objectives 2013 2014 2015 2016
2017 2018 Source: WHO
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WHA endorsement in 2013 of Endgame Strategy require IPV
introductions in 123 countries globally within 20 months
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Sufficient supply secured to meet projected demand through
UNICEF at affordable prices, but planning needed 20 countries
requiring supply in 2014, with 7 planned introductions A total of
75 countries to introduce in this period, and two continuing
countries 20 LMIC/MIC countries to continue or introduce sourcing
through UNICEF Flexibility required with regards to product
preferences, number of shipments per year, delivery of buffer
stocks, month of introduction, registration requirements
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UNICEF support to the tOPV/bOPV switch Global synchronized
switch from tOPV to bOPV requires careful planning at global and
country level Engagement with partners, countries, and industry to
ensure smooth transition and no shortages of any product Protocols
and strategies under development for operationalization of a
switch
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Vaccines stock monitoring and projection tool ViVa (Visibility
for Vaccines) Enabling identification and communication of upcoming
potential constraints linked to supply through graphs. From May to
August 2014: Pilot phase with EPI in DRC, Niger and Senegal. Next:
Feedback interest survey and decision on continuity and
scaling-up.
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Supporting Middle Income Countries to Access New Vaccines For
additional information on UNICEFs MIC New Vaccine Procurement
Initiative see http://www.unicef.org/supply/index_67101.html
http://www.unicef.org/supply/index_67101.html UNICEF Vaccine
Procurement Practitioners Forum (Q4 2014) EURO Inter-country
Vaccine Procurement Workshop 2013 Transition planning for GAVI
graduating countries Vaccine Procurement System Assessments
Coordination of MIC support with global/regional partner
activities: Global MIC Task Force Vaccine Product, Price and
Procurement (V3P) Project EMRO Pooled Vaccine Procurement (PVP)
initiative GAVI support for access to appropriate pricing for
graduates & other LMICs Sharing of knowledge of (i) the vaccine
market, (ii) Vaccine Security and underlying elements of
forecasting, funding and appropriate contracting, (iii) vaccine
procurement. Issue market analyses. Publish Reference Prices to
serve as a benchmark for self- procuring MICs. Aggregate MIC demand
forecasts for new vaccines to provide better visibility to
industry. Pool MICs vaccine procurement to improve demand
predictability, reduce transaction costs and improve pricing. MIC
Pooled Procurement Information Access Capacity Building Technical
Assistance Strategic Partnerships
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Some countries where we are already working with the govt to
strengthen the supply chain and develop capacity DRC Immunization
and Essential Medicines Nigeria Immunization Sierra Leone All
Health Commodities Kenya Essential medicines Zambia Essential
Medicines Afghanistan Immunization Madagascar Essential Medicines
Myanmar All Health Commodities Eritrea Education Ethiopia Essential
Medicines Niger Essential Medicines and Nutrition Tanzania
Essential Medicines Cote dIvoire Bednets Malawi All Health
Commodities Mozambique All Health Commodities
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2014 Activities Support to development and implementation of
national supply chain strategies Global networking and
collaboration (GAVI, Global Fund, RBM etc.) Communication strategy
and advocacy tools to raise awareness internally and externally
Research to increase understanding of national supply chain models
and promising practices Guidelines for capacity development with a
supply chain toolkit for COs and partners (including a SC health
check and performance monitoring tools) Roster of consultants for
technical assistance Support development of the supply community
technical skills framework and professional development plan
Develop the Global Learning Centre Strategy including the initial
curriculum (starting with vaccines, bednets and nutrition) South to
south exchanges
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What does success look like in 2017? Increased use of national
supply chains, from determination of need through to delivery to
the last mile, across all programmes and including monitoring
Increased number of countries actively implementing national supply
chain strategies, led by government Strong networks created with
increased collaboration, sharing and co-ordination in capacity
development and supply chain systems strengthening initiatives at
global, regional and country level At least 20 government supply
chains strengthened and optimized for targeted products