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Transcript of Helen Tata: WHO-TBS 4 November 2010 1 |1 | WHO Technical Briefing seminar Geneva, 01 – 05 November...
Helen Tata: WHO-TBS 4 November 20101 |
WHO Technical Briefing seminarGeneva, 01 – 05 November 2010.
Access Framework & Challenges in Medicines Supply Systems
Mrs Helen Tata (WHO/EMP)
WHO Technical Briefing seminarGeneva, 01 – 05 November 2010.
Access Framework & Challenges in Medicines Supply Systems
Mrs Helen Tata (WHO/EMP)
Ensuring access to essential medicines - framework for collective action
Ensuring access to essential medicines - framework for collective action
ACCESS
1. Rationalselection & use
2. Affordableprices
3. Sustainablefinancing
4. Reliablehealth systems
Helen Tata: WHO-TBS 4 November 20104 |
Assessment of medicines supply systemsAssessment of medicines supply systems
2007 AFRO/EDM and HQ/EMP developed tools to support countries in this activity
1st stage – Map partners supporting medicines procurement and distribution– Financial flows– Warehousing– Distribution
2nd stage
Look at issues around the medicines supply management cycle:– Selection– Procurement– Storage/stock management– Distribution– Financing– M & E
Source Of Funds
Procurement Agent/Body
Point of 1st warehousing
Point of 2nd warehousing
MEDICAL STORE
Medicines supply systems in TANZANIA. 2007
PRIMARY HEALTH CARE FACILITYDISTRICT STORE
ZONAL MEDICAL STORE
ESSENTIAL MEDICINES
ARVs MALARIA TB OIARVs Ped
REAGENT Blood safety(+ HIV test)
VACCINES CONDOMS CONTRACEPTIVESMEDICALSUPPLIES
REGIONAL/DISTRICT VACCINE STORE
HEALTH FACILITY
GOVERNMENT
MULTILATERAL DONOR
BILATERAL DONOR
NGO/PRIVATE
AXIOSTEC &CC
T
CRS IMA CUAMMHOSPITAL COLUMBIA HOSPITAL
TEC &CC
T
HEALTH FACILITY
HEALTH FACILITY HOSPITALTEC &CC
T
ZONAL BLOOD SAFETY CENTRE
Point of Distribution
GOVERNMENT
WBGLOBAL
FUND
SIDA
PEPFAR
USAID
UNICEF
WHO
ABBOTT
CSSC
COLUMBIA
PFIZER
JICA
CLINTON
CIDA
CDC
GAVI
CUAMM
HAVARD
NORAD
HOSPITAL
TEC&
CCT
CLINTON
HAVARD
MEDICALSTORE
CRS
SCMS
EGPAF
MOH& SW
AXIOS
UNICEF
JICA
CDC
COLUMBIA
ABBOTT
GAVI
CUAMM
CROWNAGENTS
USAID
TMAP
AXIOS
United Republic of Tanzania
PATIENT
Sources de
Financement
Structure d'appro-
visionnement
1er point de stockage
2ème pointde stockage
Structure dispensatrice
ETAT
BMFONDS
MONDIAL
CAMEBU
DFID
UE
USAID
FNUAP
IPPF
MSF
OMS
GFA
CEPBU
GVC
UNICEF
CLINTON
GTZ
GDF
CTB
CAMEBU
IPA
ACF
CONCERN
CAMEBU PNLOMSFPNLT CICR CEPBU
IMC BPS GVCACF CORDAID
Systèmes d'approvisionnement des produits pharmaceutiques au BURUNDI. Juillet 2007
Site de prise en charge
CDSSNT/CNT CDT/CT COCOLSBPS CPLS CDV Détaillants
CDSSite de prise en charge
PNSR CPLSGrossiste Privé
CNTSCDV
PNSR ACF CORDAIDIMC GVC CONCERNPEV PSI
PDM
CICR SEP/
CNLS
PNLT
PSI
UNICEF
OMS
FNUAP
MSF
ACF
PDM
CICR
CEPBU
CORDAID
GVC
GTZ
CLINTON
UNITAID
GDF
CTB
CONCERN
GAVI
KFW
IPPF
PSI
MEDICAMENTS ESSENTIELS
ARVs PALUDISME TB IOARVs Ped
REACTIFS sécurité du sang
(+ test HIV)VACCINS Préservatifs Contraceptifs
DispositifsMédicaux
CORDAID
SEP/CNLS
ABUBEF
PRISONHÔPITAUX
République du BurundiMinistère de la Santé Publique
Etat
Bailleurs multilatéraux
Bailleurs bilatéraux
ONG/Privé
PATIENT
Helen Tata: WHO-TBS 4 November 201011 |
Challenges (1)
Selection:– Supply outside the EML/STG still exists– Procurement of non registered medicines in countries
still exists
Quantification: – CMS not always involved in forecasting/procurement– No coordination in quantification between MoH, CMS,
partners resulting in:• stock-outs or• overstocking• expired products
– Inadequate logistic information system
Helen Tata: WHO-TBS 4 November 201012 |
Challenges (2)Challenges (2)
Procurement:
– Managed by various partners present in country.
– National system hardly involved in program procurement
Storage/stock management:
– Inadequate storage capacity due to lack of coordination in procurement planning
– Different stock management tools for the same product originating from different partners
Distribution:
– Inadequate funds for distribution.
– Uncoordinated distribution between different programs leading to high operational costs for all programs.
Helen Tata: WHO-TBS 4 November 201013 |
Challenges (3)Challenges (3)
Financing: – Funds available mainly for 3 disease programs – Other areas under funded – Financial figures not always available– Logistic support is under- funded
Monitoring-Evaluation:– Each program may have a stand alone M&E – Different reporting tools– Burden of work for scare human resource at
periphery high
Helen Tata: WHO-TBS 4 November 201017 |
BenefitsBenefits
Platform for dialogue, information sharing Platform for dialogue, information sharing and coordinationand coordination
Joint M & E and reportingJoint M & E and reportingReduced workloadReduced workloadHealth System strengtheningTimely delivery of medicines to target
populationCost savingsCost savings
Helen Tata: WHO-TBS 4 November 201018 |
ExpectationsExpectations
Adequate funding to medicines for priority disease to support distribution of all other categories of medicines
Stock management tools for medicines from various sources streamlined
No stock outs in any health facility
Un-interrupted access to medicines!
Helen Tata: WHO-TBS 4 November 201019 |
RecapRecap
Coordination, dialogue, information sharingCoordination, dialogue, information sharingJoint M & E and reportingJoint M & E and reportingReduced workloadReduced workloadHealth System strengtheningTimely delivery of medicines to target
populationCost savingsCost savings