1. 1 SUPPLY DIVISION Procurement and Supply Management Technical Assistance

2. 2 SUPPLY DIVISION PSM and MTSP goals  Strengthen organisation and national capacities to meet essential supply needs for children and families  Ensure access and availability to core commodities  Leverage resources through partnerships

3. 3 SUPPLY DIVISION PSM support has to be seen in the context of the inter- related steps of the complete supply chain cycle Demand Creation Supplier Agreements Financing Receipt, Storage, Distribution Forecasting Quality Assurance Effective Use Product Procurement Product Selection Monitoring

4. 4 SUPPLY DIVISION The supply chain comprises three distinct phases: product planning, product acquisition and product delivery Demand Creation Supplier Agreements Financing Receipt, Storage, Distribution Forecasting Quality Assurance Effective Use Product Procurement Product Selection Monitoring Acquisition Planning Delivery

5. 5 SUPPLY DIVISION UN Agencies combine field office capacities with HQ to cover the full supply chain cycle Demand Creation Supplier Agreements Financing Receipt, Storage, Distribution Forecasting Quality Assurance Effective Use Product Procurement Product Selection Monitoring Acquisition Planning Delivery Field Office HQ SD

6. 6 SUPPLY DIVISION UNICEF so far has supported countries in strengthening planning and delivery systems in support of increased ARV access where it provides ARVs Demand Creation Financing Receipt, Storage, Distribution Forecasting Effective Use Product Selection Monitoring Planning Delivery

7. 7 SUPPLY DIVISION 2006-2007 Consolidated Technical Support Plan for AIDS

8. 8 SUPPLY DIVISION BACKGROUND Funds available but scale up not accelerating Lacking technical capacity Lack of harmonisation Duplication and gaps Need for improved coordination

9. 9 SUPPLY DIVISION UN Consolidated Technical Support Plan for AIDS Procurement and supply management (PSM) UN agencies to provide technical assistance are: WHO, WB, UNDP, UNFPA, UNICEF through country presence

10. 10 SUPPLY DIVISION UNICEF has been designated by UNAIDS/GTT as Lead Agency in procurement and supply management Main roles of the Lead Agency: Single entry point for UN Technical Support (broker) Co-ordination and facilitation of technical assistance Establish global and regional support mechanisms Liaison between providers of technical support, UN Theme Groups and global support mechanisms

11. 11 SUPPLY DIVISION A set of preliminary interventions have been identified and a tentative budget determined for 2006-7 Intervention Strengthening procurement + supply management planning and implementation Strengthening warehousing management + distribution systems Enhancing national medicines management information systems Regional capacity building and training

12. 12 SUPPLY DIVISION Global level joint problem solving and implementation team (GIST) has been established especially related to implementation of Global Fund grants Formed by UNAIDS, WHO, UNICEF, UNDP, UNFPA, World Bank and Global Fund, with links to bi-lateral agencies Facilitates rapid country driven process for identification of technical support needs with one of UN agencies as country lead SD participates in monthly GIST meetings

13. 13 SUPPLY DIVISION 5 Priority areas Meeting 6-7 December 2005 1.Health structures Multiple funding channels and coordination mechanisms 2.PSM plan Consensus and participative generation Commitment from top level Can be used as baseline for M&E 3.Selection of OI medicines 4.Quantification & Forecasting 5.Storage and Distribution Need for logistical expertise Transportation Organisation of health systems as whole, not only HIV/AIDS-relate supply

14. 14 SUPPLY DIVISION Key challenges to the ARV supply chain lie in quantification of demand and security of receipt and distribution Demand Creation Supplier Agreements Financing Receipt, Storage, Distribution Forecasting Quality Assurance Effective Use Product Procurement Product Selection Monitoring Security Quantification UNICEF/HQ96-1172/GIACOMI PIROZZI

15. 15 SUPPLY DIVISION Recommendations for country level PSM Working Group –PSM problem analyses –GAP analyses –Division of labour –Existing assessments –Advocate for PSM –ART planning and monitoring WHO/AMDS prepared TOR for working group

16. 16 SUPPLY DIVISION Recommendations for country level BASELINE ASSESMENT Existing assessments Roles and responsibilities of partners Map out completed TA and lessons learned Map out ongoing/planned TA Lessons learned Coordination Avoid duplication of efforts Synergies amongst partners

17. 17 SUPPLY DIVISION Recommendations for country level PSM PLAN - LIVING DOCUMENT ‘ Three ones ’ national PSM plan Procurement and distribution plan Scale up plan Identification of bottle necks Roles and responsibilities Include TA and capacity building plan Review regularly Monitor progress Update

18. 18 SUPPLY DIVISION Resources needed- consultants training in CPH January 2006 Need to expand consultants roster for PSM Training organised in by WHO and AMDS partners in SD to improve capacity in PSM HIV/AIDS, malaria and TB -synergies Brief on WHO’s normative guidance in treatment access Share technical tools Create a network of PSM professionals- potential consultants

19. 19 SUPPLY DIVISION PSM activities started: Bolivia Ethiopia Guinea Bissau (GIST) India Malawi Mali Nepal Niger (GIST) Nigeria (GIST) Russia Somalia Zimbabwe (GIST)

20. 20 SUPPLY DIVISION PSM Group Proposes: Cameroon Central Africa Republic Liberia Nigeria – WHO/TCM Sudan Uganda

21. 21 SUPPLY DIVISION Upcoming Training Activities: Consultants Training Copenhagen Jan 06 Consultants Training Dakar Feb 06 PSM Workshop Nairobi Feb 06 PSM Workshop Moscow March 06

22. 22 SUPPLY DIVISION THANK YOU

23. 23 SUPPLY DIVISION UN Consolidated Technical Support Plan for AIDS UNICEF the lead agency in Procurement and Supply Management (PSM) – role: Single entry point for requesting TA on country level Coordination and facilitation of TA Brokering role Country owned and driven process of TA that builds on existing support frameworks

24. 24 SUPPLY DIVISION UNICEF/HQ00-0354/ALEJANDRO BALAGUER Continuous monitoring of demand Comprehensive supply plans Delivery arrangements Stockpiling Key elements to consider in starting capacity building

25. 25 SUPPLY DIVISION Over 2.1 million children under 15 are estimated to be living with HIV/AIDS, with 700,000 in need of ARV treatment

26. 26 SUPPLY DIVISION UNICEF/HQ98-0910/GIACOMI PIROZZI ■ Paediatric ARV dosing schedules are not available for some drugs ■ Most available paediatric ARV formulations require children to take frequent doses of unpalatable syrups ■ Many need cold chain storage, have limited shelf life and stability ■ No FDCs specifically available for paediatric use

27. 27 SUPPLY DIVISION Both originator and generic ARV manufacturers have given positive signals for developing appropriate paediatric formulations UNICEF met with 15 manufacturers 12 September to discuss the situation of paediatric formulations Various types of developments underway for both single products and FDCs Soluble tablets, granules, melts, scored tablets are some of the initiatives Target of having WHO pre-qualified products by mid-2006

28. 28 SUPPLY DIVISION Due to a better access to treatment, more people are willing to undertake HIV testing Number of patients on ARVs increased to 10,000 by Dec. 2004 in 24 sites. By end-2005, 40,000 patients to be on treatment in 59 health facilities MALAWI UNICEF/HQ02-0566/GIACOMI PIROZZI UNICEF/HQ02-0519/AMI VITALE

29. 29 SUPPLY DIVISION GIST Global Problems Solving and Implementation Team  Rapid assistance to countries  Solve bottlenecks  Assist in implementation  Monthly meetings UN agencies and GFATM  Countries participate via video conferences  Action agreed

30. 30 SUPPLY DIVISION Supply