Challenges for procurement and the supply chain: Why is Africa always out of stock

1
Challenges for procurement and the supply
chain Why is Africa always out of stock
2
The procurement system

• Weak procurement systems
• Lack of clear policy guidelines in government
• Slow registration processes
• Taxes, duties, wholesaler and dispenser mark-ups
  on ARVs

3
The procurement system

• Corrupt practices
• Intense lobbying by suppliers
• Influence peddling at all levels
• Poor monitoring and evaluation systems
• Low human resource capacity

4
The procurement system

• Strong public procurement agency
• Private sector distributors
• Direct from manufacturers
• Local manufacturers

5
Recommended actions by governments

• National HIV/AIDS treatment guidelines
• ARVs in EMLs, including paed. Formulations
• Fast track registration processes esp where there
  is WHO pre-qualification
• Lower or abolish taxes, duties on ARVs
• Work to increase information on patent status of
  ARVs

6
Recommendations for ARV procurers

• To try to get ARVs of assured quality at the
  lowest available price
• Advocate for full and fast registration (rather
  than special authorizations)
• Forecasting drug requirements in advance to avoid
  shortages Tracking system
• Inform suppliers in advance

7
Recommended action by manufacturers

• Develop fixed-dose combinations (FDCs) and
  paediatric formulations
• Develop user friendly diagnostics
• Commitment to developing differential pricing
  mechanism, participating in WHO pre-qualification
  project and in maintaining stocks at country
  level

8
Recommendations for UN and International agencies

• Explore a differential pricing system for newer
  medicines at International level
• Support Regional and National ARV procurement
  initiatives
• If requested, stock ARV supplies on behalf of a
  country

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Thank you