Main Title

1
AMDS Contribution to the Technical Briefing
Seminar
October 2007
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AMDS Secretariat within the New Organizational
Structure - HIV/AIDS DEPARTMENT
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What is AMDS

• AMDS is a network of partner organisations
  working in procurement and supply management of
  HIV commodities.
• The secretariat of this network is in WHO/HIV
  Department.

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AMDS Partners
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Why do we need partnership

• Drug procurement is more than "shopping" drugs

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Drug procurement is more than "shopping"
Procurement Cycle
Demand Creation
Product Selection
Monitoring
Forecasting
Effective Use
Financing
Receipt, Storage, Distribution
Quality Assurance
Product Procurement
Supplier Agreements
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How we work

• Open ended partnership, loose network structure
• Work on concrete problems as opportunities arise
  or needs become acute GFATM Supply Chain
  planning GPRM regulatory database, IMAI module
  forecasting ARV market Training in drug supply
  management for HIV programmes.
• Work in under-laboured HIV-specific domains
  prices of production, data production for
  strategy development (ex. API)
• Foster collaboration in and outside WHO based on
  areas of drug supply chain management.

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Results and influence

• Procurement and supply management plans to
  support Global Fund PR
• Strategic information highly valued GPRM,
  Regulatory status
• Strong support from partners for strategic
  orientation chosen keep network open, no need
  for MOUs focus collaboration on problem solving
  and practical issues
• Expectations of partners for WHO work increasing
  support creation of national level SM
  coordination groups, organisation of partners in
  technical communities, broker collaboration
  between partners, map TA sources, provide
  normative leadership, increase visibility and
  commitment to strengthening supply chain
  management at country level

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Strategic Information Global Observatory

• Why
• Collect, consolidate and disseminate strategic
  information regarding affordability,
  accessibility, and availability of HIV drugs
• In-house Products
• Global Price Reporting Mechanism - on AMD website
• API prices -on AMD website
• Regulatory status database - on AMD website

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Global Price Reporting Mechanism (GPRM)
http//www.who.int/hiv/amds/price/hdd/

• Why
• To improve price transparency on ARV market
• To inform MoHs, state and non state procurement
  officers and favour price negotiation
• To inform WHO management in their strategic
  decision in advocacy
• How
• Collection and disseminate transactional data of
  ARV drugs prices on the web
• Produce summary analysis of trend and prices of
  ARVs (Summary report)
• Contributors CHAI, Crown Agents, GFATM, IDA HIV
  Group, JSI, MSH, UNICEF, UNDP, WHO-CPS, WHO NPO,
  Mission Pharma, SCMS.
• Achievements
• Features and reports improved
• Number of contributors improved
• Scope expanded from HIV products to TB, malaria
  medicines and substitution therapy

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API Price and producer database
http//www.who.int/hiv/amds/sourcespricesAPI.pdf

• Why
• Improve price transparency and favour price
  negotiation
• Anticipate potential shortage in APIs and inform
  API producers
• Inform WHO management in their strategic decision
  for advocacy
• How
• Collect and disseminate lowest and highest prices
  of each API on AMD website
• Analyse API price trends
• Contributors all Generic API producers contact
  details on AMD website
• Achievement
• Tool and product Refined
• Updated information
• Increased number of companies reporting to AMDS

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Regulatory status database http//ftp.who.int/htm/
AMDS/drugsdatabase.pdf

• WHY
• Limited access to information on ARV marketing
  authorizations by countries
• Inform WHO management team in making strategic
  decision and advocacy
• Inform state and non state procurement officers,
  donation programmes, countries using the GFATM
  grant on which drug is registered and where
• How
• Collect regulatory information and make it
  available in the public domain
• Contributors all RD and generic ARV producers
• Achievements
• Searchable database
• Cross check information at country level with
  support from AMD partners

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Forecasting of the ARV market

• Why
• To avoid global supply shortages of
  antiretroviral drugs as it happened during the
  scaling-up efforts.
• How we took it forward
• Production of draft ARV forecasts 2007-2008 for
  discussion with manufacturers
• Consortium of partners UNAIDS, UNICEF, PfSCM,
  USAID, Clinton Foundation, Mexico National Inst
  of Public Health
• Approaches normative and consumption models.
• Survey 2006 uptake of ARVs in low middle
  income countries. Published in AIDS Journal, July
  2006

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Country Support in Supply Management

• Rationale
• PSM constraints are major obstacles in the health
  system
• Access to HIV commodities requires wide
  partnership
• Several partners at country level work in
  isolation sometimes in competition
• Lack of sharing of information/harmonization of
  practices
• Two major areas of focus
• Increase collaboration to strengthen the supply
  management in program planning and implementation
  processes (Unicef, TCM, WB, GF, DELIVER,
  IDAsolution)
• Support the creation of national PSM coordination
  groups to achieve integrated national supply
  chain management systems.

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Country support in Supply Management

• Capacity building for PSM planning, training and
  TA
• PSM workshops for national professionals (e.g.
  IDAsolution, Global Fund)
• Exchange of information and experience sharing
  among participants
• Consultant database in PSM
• TA to urgent request for PSM support when no
  other partner is available.

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Country support in Supply Management The
Future

• Increase visibility and commitment of PSM in
  planning process
• Collaborate with RCC in RO CO planning
  processes to ensure that PSM issues are well
  addressed
• Support creation of national PSM coordination
  groups
• Map country level presence of partners and their
  PSM area of work
• Increase WHO capacity to play its convening role
  of partners at country level work with TCM, ROs
  and COs
• Foster collaboration for technical support
  between WHO and the AMDS Network Organizations
  Global Fund, SCMS, WB, UNICEF, etc.

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Tool Development Reporting and ME

• Importance
• Vertical reporting puts a huge burden on national
  programmes
• Lack of clarity at implementing levels of the
  reporting requirements
• Harmonized reporting helps decide where to start
  improving supply chain management system
• Opportunity
• High level of consensus that "verticalization" in
  reporting requirements by donors has gone too
  far harmonization needed at country level
• The need for AMD network partners (esp. PfSCM) to
  develop/implement a harmonized and ME PSM
  system.
• Partners asked WHO to take this process forward

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Tool Development Reporting and ME Handbook of
supply management at first-level health care
facilities

• What we did
• Reporting and ME of ART-PSM system
• Get the facts and move towards consensus
• JSI, MSH, PfSCM,
• Programme experts from Rwanda, Tanzania, Uganda,
  Vietnam
• CHMP, CRS, Global Fund, IDA, PEPFAR/OGAC, UNAIDS,
  UNICEF, World Bank
• Develop outline interagency document
• Constitute a working group on content
• Next steps
• Draft ART-PSM ME document developed
• Field-test and finalise the document
• Handbook of supply management at first-level
  health care facilities
• Manual published and ready for use

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Conclusion

• AMDS is part of health system strengthening Unit
  of HIV Department
• PSM is a wide area requiring strong partnership
  AMDS works by fostering partnership among
  technical institutions working in PSM
• Major areas of AMDS work to increase access to
  HIV commodities
• Strategic information GPRM, regulatory status,
  API, patent (in progress)
• Forecasting of HIV drug needs
• Regional and country support including capacity
  building support in planning (PSM plans) and
  training of professionals working in national
  supply chain management systems.
• ME