National PSM Coordination Mechanism

Dr Vincent HabiyambereWHO/HIV Department

AIDS Medicines & Diagnostics Service (AMDS)Bangkok, 25-30 July 2005

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Background

6 M people need ART but only 12% have access to it: 1 M in June 2005: significant progress compared 400 000 in December 2003.

This was possible thanks to national and international commitment: the GFATM, bilateral (PEPFAR, ESTHER, DFID, CIDA, etc.), Multilateral (MAP, TAP, WB, etc.), civil society, etc.

Scale-up of the number of people on ART to reach the 3 by 5 Target:• Overstretches not only the health systems but also the national

procurement and supply management (PSM) systems• Introduces the concept of "full supply" required for the treatment of

acute and chronic care: over 100 commodities needed for the management of HIV/AIDS.

• Offers opportunities to improve the national PSM systems and to increase access to essential drugs: ex. TB and malaria drugs.

There are many stakeholders operating at global, regional, national and sub-national levels Hence the need for coordination or at least collaboration.

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At global levelAMDS Partners UN Agencies

• WHO (HIV, TCM, PSM, RO & COs), 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

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

Melinda Gates Foundation

Secretariat• AMDS unit of HIV Department of WHO

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AMDS partner functions Procurement

UNICEF, IDA, CHMP and WHO/CPS on a competitive basis• Stockpile development

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

Operational• Country level staffing• Capacity building at country and regional levels

• PSM training (Nairobi, Addis Ababa, Arusha, Abuja, Beirut, Honduras, Barbados, Bangkok, Johannesburg, Pretoria, DKR, etc.)

• Technical support to countries: ex. joint country missions

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AMDS: The repository of PSM information and tools for HIV/AIDS…….

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

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Global price reporting mechanismhttp://www.who.int/3by5/amds/gprm/en/index.html

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The PSM partners at country level

What are the partner institutions involved in PSM in your country ?

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The PSM partners at country level

How these partner institutions are coordinated or what are the PSM areas in which they are collaborating?

What is the coordinating body?

Areas in which collaboration has occured?

National PSM Coordination ( e.g. Kenya )

WHO: HIV NPO/3by5 Officer, EDM NPO

GFATM

WB

PEPFAR

JSI

KEMSA

MEDS CEDMAP

Other

AMDS – HQ

RO staff

MOH: NASCOP or Nat'l Drugs Programme

MSH

FHI

UNICEF

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National PSM Coordination BodyPossible activities

Regular information sharing on PSM• Current activities• Strategic info (e.g. sources and prices, patent status, local

production capacity, quantities procured, stock in hand, etc.) Harmonization of country-level PSM planning, implementation

& reporting mechanisms• One LMIS for drug management for multiple donor streams

Training & Implementation Tools• Common approaches for product selection, rational drug use,• Harmonise LMIS and monitoring/reporting tools• Facility-level guidelines on stock management and reporting• Jointly forecast national needs• Common Programme M&E tool.

Common agenda to address HR gap in pharmaceutical sector: coordinate training activities, common incentive policies.