Jan to march 2015 quaterly news leter

Quarterly NewsletterJanuary 2015 - March 2015

5th Edition, January - March 2015

Making Health Rights And Health Responsibilities A Reality

HEPS empowered to influence: Capacity building for advocacy

Quarterly Newsletter

Detailers converge for a group photo after the training in data collecting at Pope Paul Memorial Hotel, HEPS Uganda is under contract from USAID Strengthening Health Outcomes through the Private Sector (SHOPS) and Clinton Health Access Initiative (CHAI) to provide services to improve treatment for early childhood diseases in the private retail sector.


Accountability Can Transform Health

There is an increasing interest in practical interven-tions that rebalance the relationships between state (policy makers, service providers, duty-bearers)

and clients (citizens, rights-holders, users of services). Some efforts strengthen the spaces and direct linkages between cit-izens to providers in the hopes of having a quicker impact on quality of services. Meaningful participation and access to these spaces requires individual and collective empowerment.

With funding from DFID, GOAL the main implementing partner sub granted HEPS Uganda to implement ACT health activities. The ACT Health project is based on the concept that increased accountability and responsiveness requires changes at many levels. .GOAL, HEPS and other partners will focus on changes in the state – society interface to contribute to the super goal of: Improved health outcomes for communities with a focus on women and girls in health centre catchment areas. HEPS Uganda, the National partner is leading the national advocacy activities.

Advocacy for Better Health (ABH)

Advocacy for better health was born out of the concern about inefficiencies in the health service delivery, and other weaknesses in the health system that negatively

impact on quality, accessibility and availability of health and social services. Advocacy for better health is grounded in the belief that if citizen’s knowledge and awareness of their rights and responsi-bilities were increased to stimulate collective consciousness, and if the capacity of CSOs was built to effectively empower and rep-resent communities, then citizens would believe and have confi-dence that they can hold their leaders accountable and influence them to change health and social policies in their favor.

It is being implemented in two cluster districts of Kiruhura and Ibanda as well as National level. It started in January 2015 and will implemented for 45 months starting. The overall goal of the project is to lead to improved quality, accessibility, and availabil-ity of health services in Uganda by fostering citizen demand and enhancing the capacity of CSOs to advocate for improved respon-siveness and accountability by decision-makers and service

Take Stock Campaign

Despite government’s new found commitment to the promotion of family planning and supply chain policy changes, Uganda’s public health care system remains

plagued by stock outs of contraceptives at the facility level. This lack of availability contributes to the low Contraceptive

Prevalence Rate (CPR) and high unmet need. Most important-ly, it limits a woman’s choice.

HEPS Uganda drawing from the larger Reproductive Health Supplies Coalition(RHSC) Stockout Initiative approach of gen-erating the passion and political will needed to meaningfully mobilize action around this critical issue is focusing on mobi-lizing communities to take action at the facility-level to address stock-outs, and then packaging evidence gathered at the local-level to be shared at the national level.

This project compliments and connects other RHSC activities taking place in Uganda. The evidence gathered at the local level will thus feed into advocacy activities that fall under the RHSC’s Commitments Initiative and will be carried out by a sub-grantee to be determined.

Project Profiles

HEPS UGANDA Program Officer,

Joan Kilande (C), Kiboga District

Hospital Medical superintendant

(with glasses) and right, The chair-

person of the Health Unit Man-

agemnt Committee of Kiboga Dis-

trict Hospital share views about

the quality of health services

during a talk show hosted on

Kiboga FM in March 2015. Left is

the Radio talk show host.

EMPOWERED TO INFLUENCE


HEPS Uganda in partnership with SEATINI and CEHURD have held a strategic stakehold-

ers’ dialogue aimed to raise awareness on the importance of extending the Trade Related Intellectual Property Rights for Uganda’s access to essential medicines for sustainable development.

The dialogue attended by various stake holders, including government officials and Members of Parliament, was moder-ated by Makerere University’s Professor Ndebesa Mwebesa.

At the meeting, stakeholders deliber-ated that Uganda needs to be given time to be able to develop a sound and viable technology capacity before implement-ing the Trade Related Aspects of Intellec-tual Property Rights (TRIPS).

The Deputy Executive Director of HEPS, Mr. Denis Kibira expressed concern over the need to exempt Uganda from imple-menting the TRIPS agreement in relation to pharmaceutical companies saying that this will worsen the access of essential medicines by the population.

“Do we all get the medicines we need when we need them? Access to medicines is a global issue. According to World Health Organization (WHO), in Uganda access is about 50%. If you look at the new diseases we are getting, like Ebola, Nodding disease, and HIV, we still have a long way to go and Uganda has to find a balance between Intellectual Property Rights and public health interests.” He said.

This was echoed by Makindye east MP, Hon. John Ssimbwa who said that the TRIPS agreement not only protects the interests of the developed world phar-maceutical companies but also discour-ages local innovation. He also applauded government for having created a docket of science by creating a state ministry for science and technology. This he said will encourage more investors to open up medicine companies in Uganda.

Access to medicines is very critical for ensuring public health and human development in any country. However, it remains a challenge in many parts of the country which continue to regis-

ter growing number of people suffering from HIV and AIDS, TB and Malaria and other infectious diseases. Similarly, over the past 10 years, Uganda has consistent-ly registered medicine stock outs in up to 60% of the health facilities. This has been amidst dire poverty, food insecurity and malnutrition along with increasing popu-lation growth rate of about 3.24 in 2014.

The TRIPS agreement demands enforcement of strict intellectual proper-ty protection rights but Least Developed Countries like Uganda have been on an exemption not to implement certain pro-visions under the agreement particular-ly to do with pharmaceutical products (medicines).

The transition period ends in January 2016. The stakeholders’ dialogue there-fore was held to get a collective voice and raise awareness on the need for a further

extention of the World Trade Organisa-tion TRIPS transition period.

In his closing remarks, Mr. Wakaabu Siragi, an official from the Ministry of Trade Industry said that all the sugges-tions raised at the meeting would be given consideration by the ministry. He encouraged Civil Society organizations to always send their positions on various issues to all the MPs by email.

“It would be better that you send this information to all the Members of Parlia-ment too, so that it can inform their dis-cussions on the floor of Parliament”, he said.

CSOs call for extension to the TRIPS transition period

Do we all get the medi-cines we need when we need them? Access to medicines is a global issue. - DENIS KIBIRA - Deputy E.D, HEPS Uganda.

HEPS recruits and orients new staffIn a bid to strengthen organisation systems HEPS Uganda

recriuted a total of 12 new staff. A three day orientation workshop was organized for them to understand the

organization culture, values, and programming and be able to fit into the system.

The orientation took place at the HEPS secretariat from 25th–27th February 2015.

The new staff are part of the workforce for the new proj-ects of Advocacy for Better Health (Ibanda and Kiruhura) and Sexual Reproductive Health ( Kiboga, Kamuli, Mbarara and Isingiro).

The new recruits were given a general overview on HEPS key documents including the Strategic plan, Annual report, and Human resource manual to make them conversant with

the work of Heps Uganda. They were also facilitated on health advocacy, community empowerment, health responsibilities and rights and how to engage the community on such.

The New Staff include:Wakabi Eric – Communications OfficerJB Luyima - Programme OfficerNoeline Namugwanya – Program AssistantMutimba Jakie – Monitoring & Evaluation OfficerIsreal Tayebwa - Program Officer (Mbarara)Noeline Namugwanya - Program AssistantNaturinda Hannington - Program Assistant (Mbarara)Bangirana Moses - Program Assistant(Mbarara)Brian Wafiire - Program Officer (Eastern region)

Ms. Jackline MutimbaM&E Officer

Mr. Eric WakabiCommunications Officer

Ms. Noeline NamugwanyaProgram Assistant

Mr. Moses BangiranaProgram Assistant

Mr. Israel TayebwaProgram Officer, Mbarara

Mr. Naturinda HannningtonDistrict Field Coordinator,

Kiruhura

Ms. Twinimujuni PercyFinance&Admin Asst.

Mbarara

Mr. Narinda Darius.

Mr. Brian WafireProgram Officerl, Eastern Region


Uganda’s health care system needs overhaul

The level at which Uganda’s health system is dependent on donor aid is distressing. Like no other,

the health sector seems to have one of the highest components of donor funding in the country. In the 2014/2015 financial year for example, donor aid accounts for almost 26% of the health budget, covering essential areas like reproductive health, HIV/AIDS and immunization.

While National Medical Stores takes the third highest share of the health sector budget, inadequacy in the drug supplies continue to drag down quality service delivery to the people. The frequent stock-outs of essential medicines in health facil-ities is a significant indicator of the sorry state of our health system.

Coupled with low funding to essential areas like hygiene, sanitation and health research, there is no way we are going to have effective health promotion and a fully functioning health system in Uganda. Gov-ernment needs to realize this before it is too late. The ministry of health should put more emphasis to the proper functionality of existing health facilities by equipping them with essential medicines and avoid-ing the frequent stock-outs instead of build-ing more facilities with poor services.

National Medical Stores needs to increase its level of transparency too. They should start publishing credit lines for districts and health facilities in the media and public hospital notice boards so that we all know what is being availed and what is not.

A survey conducted by ACODE in 2010/11 showed that most health facilities including Local Government officials were not aware of their credit lines at NMS. Some health facilities reported that their requisi-tions were not consistent with NMS sup-plies.

On another footing, despite increase in the health sector budget over the last financial years, and the Ministry of Health putting into place maternal mortality reforms which include improving family planning servic-es, contraceptive prevalence rates are still very low. Efforts by the ministry of health to purchase mama kits to be supplied by NMS are outdone by the over 1.5 million babies are born every year. As a result, most of the mothers have to take their own items for delivery. Government therefore needs to increase spending on family planning commodities as stipulated in the reproduc-tive health commodity security strategy. It

is also important that government also pro-cures family planning commodities used by men, especially condoms and surgical kits for vasectomy.According to the National Health Investment Plan 2011-2015, about 940 billion is required to cover the national need for pharmaceuticals, health supplies and commodities annually, of this; essen-tial medicines take only a meagre12%.

There is limited appreciation of Palliative Care (providing care to the terminally ill persons with severe pain, especially those with HIV/AIDS and Cancer) among some health facility managers. This coupled with inadequate funding to meet the training needs, required medicines, scale-up and monitoring and support supervision makes palliative services nonexistent most health facilities.

A National Household Survey conduct-ed by Uganda Bureau of Statistics shows that inadequacy of drugs at health facilities increased from 2005/07 to 11% in 2009/10. In addition, the ‘push system’ has increased waste of medicines that are sent but not required at various health facilities while creating shortages of no- basic, but essential medicines that are required at the facilities.

As a matter of fact, the availability of essen-tial medicines at health facilities should not be played around like a ball between NMS publicists and the public, government needs to address this issue head on.

-The writer is the Communications -Officer of HEPS Uganda-

While National Medical Stores takes the third highest share of the health sector budget, inade-quacy in the drug supplies con-tinue to drag down quality service delivery to the people. The fre-quent stock-outs of essential medicines in health facilities is a significant indicator of the sorry state of our health system.

HEPS Uganda Deputy ED, Denis Kibira and Programme Officer for Advocacy and Networking, Kenneth Mwehonge in March 2015 attended Aids Vaccine Advocacy Coalition Fellowship in Johannes-burg, South Africa.

The HIV Prevention Research Advocacy Fellowship pairs emerg-ing leaders in advocacy and activism with existing organizations to develop and execute creative, context-specific projects focused on HIV prevention research.

Fellowship projects focus primarily on advocacy around biomedi-cal HIV prevention research (such as clinical trials of vaccines, micro-bicides, pre-exposure prophylaxis) or rollout of male circumcision for HIV prevention. Fellowship projects may also focus on “test and treat” or ARV treatment as prevention strategies, which are under active dis-cussion in many contexts. Fellows receive training, financial support, and technical assistance to plan and implement a targeted one-year project within host organizations focused on HIV/AIDS.

HEPS-Uganda staff attend HIV prevention fellowship in South Africa

HEPS Uganda together with other CSOs has been implement-ing the CAD project of promoting Safe Male Circumcision (SMC) in eastern Uganda. In the last quarter, HEPS managed to attain the average performance percentage of over 50% which qualified the organization for 75% funding from STAR E. This was revealed during a meeting held on 12th February 2015 at Mount Elgon Hotel, Mbale.

The meeting which was organized by STAR E had all the 11 CSOs implementing the CAD project and was purposed to discuss the continuation of business in the No Cost Extension (NCE).

The Grants Manager, Star E called upon all the CSOs on the project to do more mobilization for SMC and collaborate with the SMC teams in the respective districts for maximum results.

The Star E capacity building specialist Lydia Murungi advised that CSOs are to obtain condoms from their respective district stores for distribution to different centers.

CAD Project: HEPS Attains average performance


HEPS Uganda is under contract from USAID Strengthening Health Out-comes through the Private Sector (SHOPS) and Clinton Health Access Initiative (CHAI) to provide

services to improve treatment for early childhood diseases in the private retail sector. This will entail provision of medical detailing services for a period of eight months. The project began with training of detailers in Kampala at the end of January 2015.

The intervention targeting 10,000 drug retailers and private clinics is focused in rural areas across at least 101 districts in Uganda except Karamoja and Island regions. 150 pharmaceutical wholesalers in upcountry trading centres are being targeted.

Detailers collect data from retail and wholesale outlets on each visit. The detailers are equipped with tablets logged in a Customer Relationship Management (CRM) platform to be provided by CHAI/SHOPS.

Each detailer is overseeing approximately two dis-tricts covering all drug shops in the districts. Detail-er supervisors also visit three to four wholesalers in the two districts. There are a total of 58 detailers and 8 regional supervisors. The regions for the interven-tion include; West Nile, Northern, Mid-Western, South Western, Central 1, Central 2, East-Central, Eastern.

Each drug shop and clinic should will be visited at least once a month but more frequently in the first quarter of project. The Supervisors visit wholesalers in their area on a bi-weekly routine.

The visits will be used to conduct direct mer-chandizing and education outreach to the retailers and wholesalers. These merchandizing visits will include distribution of POSM, continuing medical education, reinforcement of product benefits, and provision of supply information. The detailers will coordinate with wholesalers and partners to ensure delivery of high-priority products to retailers.

Improving treatment of early childhood diseases in the private retail sector

HEPS UGANDA undertook the Advocacy for Scaling Up Lifesaving Commodities, Programs, and Services for Women, Newborns, and Children project. It was funded by PATH under the UN Commis-sion on Life Saving Commodities. Below are the activities and achievements of the project.

HEPS-Uganda made great strides to ensure that Pharmacy Division of Ministry of Health (MoH) institutionalizes a monitoring framework for

Essential Medicines (EM) within the next National Phar-maceutical Sector Strategic Plan (NPSSPIII) by December 2016. The objectives of the project were achieved through support from stakeholders, in particularly MoH, WHO and civil society partners. MoH appreciated the support HEPS provided through the project. In particular the project helped kick-start the process of developing the (NPSSPIII) and review of the National Medicines Policy (NMP) which expired in 2012. The project supported the development of a roadmap to complete the above stra-tegic documents and the coordinator of the project was selected on the national taskforce to lead the document development process.

Four meetings were held with CSO partners; two meetings of the Uganda Coalition on Access to Essential Medicines were held in July and August 2014 at HEPS offices in Kampala to agree on a position paper on CSO priorities/ key issues needed to be addressed in next pharmaceutical strategic plan. The paper was endorsed by CSOs and circulated. Two meetings were held at Piato restaurant in Kampala in March 2015, one to share findings of the medicines monitoring mapping (below) and another to disseminate MoH roadmap on develop-ment of strategic plan.

In a meeting with MoH, The Assistant Commissioner for Pharmacy acknowledged CSO concerns and prom-ised to address them.

Meeting with CSO partners

Meetings with development partners (e.g WHO, UNFPA) More than a dozen meetings were held mainly with WHO. The UNFPA medicines logistics advisor at MoH also participated in majority of meetings with MoH. The meetings were aimed at gaining support for the project. WHO provided overwhelming support and leadership during the project and committed to help MoH complete the two documents in 2015.

Meetings with development partners

At least 10 meetings were held with PD during project period. Initial meetings were for MoH to provide support for the project and to develop ToRs for consult to under-take mapping exercise and lead development of the monitoring framework. Consequent meetings were held to review report from consult, CSO position paper and development process for NPSSP and NMP.

Currently, HEPS has been taken on as key partner in the development of both NPSSPIII and NMP, taking part on taskforce for this process and asked to convene CSO meetings with consultants to develop these strategic documents. The EM mapping report was disseminated to MoH medicines procurement and management tech-nical working group (TWG) on 18th February 2015.

Meetings with MOH departments

Meetings with MOH departmentsA meeting of a technical team from HEPS, MoH, WHO, UNFPA and other

experts was held on 9th and 10th March in Jinja to review report on Review of monitoring of EM within NPSSP and provide way forward. The technical team felt that a monitoring framework would be developed after completion of priorities for NPSSP and instead developed a road map to develop NPSSPIII. CSO concerns were acknowledged and CSO expert included on taskforce to help coordinate CSOinput into the process. The results were shared, reviewed and endorsed by a wide stakeholder group in Jinja on 11th March 2015 and with CSOs in Kampala on the same day.

Advocacy for Scaling Up Lifesaving Commodities, Programs, and Services for Women, Newborns

One of the detailers of the Private Sector Activation project talks to a drug shop retailer about the availability of Zinc and ORS medicines which help combat diarrhea in children.


HEPS projects’ newsCSOs contribute to National Pharmaceutical Strategic Plan

Uganda Coalition on Access to Essen-tial Medicines (UCAEM) which is coordinated by HEPS Uganda has been working to improve access to

essential medicines through advocacy, stake-holder engagement and analysis. As the draft-ing of the National Pharmaceutical Sector Stra-tegic Plan III got underway, the undersigned civil society representatives and organizations under the umbrella UCAEM met with con-sultants from the Ministry of Health to chat a way of including the position of civil society in regards to the contents of the NPSSSP III in the first week of April 2015.

Consultants from Ministry of Health and World Health Organisation (WHO) met with civil society members under UCAEM and conducted a Q&A session with the coalition members on what improvements have been observed in the last 5 years and what needs to be improved in the next 10 years in-regard to access to essential medicines at health facilities.

The consultants deliberated to forge a way and get the civil society suggestions and voice into the NPSSP III. The consultants challenged

civil society organizations to take up the role of supporting the community in terms of capac-ity building and proving public information on essential medicines and the health sector in general.

In March 2015, the Pharmacy Division of Min-istry of Health, with support from HEPS-Ugan-da and WorldHealth Organisation (WHO), embarked on the process of revising and updat-ing the National Drug Policy, which expired in 2012, as well as the National Pharmaceutical Sector Strategic Plan(NPSSP), which expires in June 2015.

As part of this process, MOH Pharmacy Divi-sion convened a series of meetings with experts and with key stakeholders at Hotel Paradise in Jinja on 9th – 11th March 2015. Dissemina-tion meetings were also held for CSOs at Piato restaurant in Kampala. The meetings were supported by HEPS-Uganda and chaired by Ministry of Heath Acting Commissioner Phar-macy Division, Mr. Morries Seru. The stake-holders were drawn from Ministry of Health, WHO, UNFPA, Uganda Health Supplies Chain Project, implementing partners, warehouses/

medicine distribution institutions, local med-icine manufacturers, professional bodies and the civil society.

The meetings undertook a process mapping, identifying activities/tasks, identified members of the Task Team and their terms of reference, drew up the process of identi-fying the consultants and their terms of ref-erence; identified the policy documents to be reviewed in analysing the national situation; identified the stakeholders to be engaged at the different stages of the process; drew up timelines.

MoH and WHO consultants discuss with UCAEM members during the consultative meeting held at the HEPS UGANDA secretariat (Photo by Eric Wakabi)

-There’s over prescription in the private sector for profit gains and MoH needs to check it.

-There should be more financing for essential medicines in the budget

-Government needs to support the local pharmaceuti cal industry

-There is need to invest in disease preventive measures.-There should be increased availability of information on

essential medicines to the public-MoH needs to make sure we utilize the global space to

collaborate with international companies and institu tions to improve the sector

-There should be available psychosocial support especially for PLWHs-NDA should put a mechanism for feedback from the

end users of the medicines-NMS needs to put information sharing platforms to improve on delays in delivery and other glitches that hinder access to medicines

-Improvement in medicine financing-Improvement in the coverage of NMS distribution chains

and areas of reach-Increase of public trust in health centres in regard to access

to essential medicines-Better quality of medicines on the market as sub-standard

products being kicked out.-Improving delivery and monitoring mechanisms deployed

by NMS-More essential medicines have been made available at

health facilities albeit with shortages

What needs to be done in the next 10 years:

What has improved in the last five years

COME project registers milestones

Citizen Engagement to Stop Medicine Stock outs ( COME) project aims to foster action, engagement

and participation of community based (VHTs, HUMCs, Private sector players, community leaders), District and national level citizen representatives. These citizens belong to the various HEPS Uganda coalitions that serve as advo-cates for the right to access essential medicines and contrib-ute to reduction of stock outs for medicines at public health facilities in the two districts of Lira and Kiboga. Their com-bined voice and interaction with duty bearers foster visi-bility of community voices that are committed to securing quality affordable essential medicines for all people in their communities. Below are some of the milestones registered in the last quater in both Kiboga and Lira.LIRAAccording to the In-charge of Barapwo HCIII, there is

continued dialogue among health workers and patients. Patients have been educated about other services that are offered at the health facility, like daily antenatal, immuni-zation which is done every Wednesday, family planning services offered daily, TB treatment and adolescent repro-ductive services. Originally patients would only come for OPD services only.

Due to empowerment, the community monitors and sub county of Barapwo lobbied for a bore hole from Devine Waters an NGO and it was constructed. It is the only source of water for the healthy facility and the neighboring com-munity.

Monitors and sub county leadership of Barapwo managed to lobby for a bore hole from Devine Waters an NGO oper-ating from Lira. This is now the only source of water for the facility and the neighboring community people.

KIBOGACommunity Health monitors and health workers now

plan together, which was never the case before the inter-vention of COME project in Kiboga District.

A number of health workers have uniforms due the advo-cacy undertaken by community workers. This is true with Kiboga District Hospital where now health workers have name tags for easy identification and just in a patient needs to lodge a complaint when he or she feels mistreated by the health provider.

The problem of drug stock outs particularly essential med-icines has reduced. For example at Kiboga District Hospital as reported by Musawo Namuli, the community monitors have persistently fought the problem of drug stock outs particularly essential medicines to the point that at times Kiboga District Hospital supplies medicine to other lower health centers when needed


Last quarter in pictures...

New and old staff attending orientation at the HEPS secretariat early March 2015. HEPS recruited more staff to sttregthen organisa-tion systems and increase human resource capacity.

A HEPS social worker distributes free condoms to locals during a community out reach in Pallisa District, eastern Uganda.

HEPS UGANDA Executive Director, Ms. Rosette Mutambi talks to one one Mbarara Municipal Authorities during the inception visits for

the Take Stock Project

Detailers converge for a group photo after the training in data collect-ing at Pope Paul Memorial Hotel, HEPS Uganda is under contract from USAID Strengthening Health Outcomes through the Private Sector (SHOPS) and Clinton Health Access Initiative (CHAI) to provide services to improve treatment for early childhood diseases in the private retail sector.

HEPS Staff on the streets of Jinja during a health survey

One of the detailers of the Private Sector Activation project talks to a drug shop retailer about the availability of Zinc and ORS medi-

cines which help combat diarrhea in children.


ABOUT HEPS UGANDAHEPS – Uganda is a health and human rights organization that advocates for health rights and health responsi-bilities, with a special focus on access to essential medicines and rational use of medicines.

HEPS – Uganda focuses on addressing bottlenecks that hinder access to quality healcare for the majority of Ugandans. HEPS believes that more preventive and curative means are paramount to good health and that they should be designed from a health consumer’s perspective.

A just and fair society in which all Ugandans can exercise their health rights and healthy responsibilities

OUR VISION

To enable Ugandans attain equitable access to health services with emphasis an access to medicine especially on access to medicine policy advocacy and community empowerment.

OUR MISSION

STRATEGIC OBJECTIVESObjective 1: Advocate for health consumer friendly laws, policies and health packages and their implementation at all levels in Uganda. Objective 2: Empower health consumers in Uganda with Knowledge and skills to claim their right to health and ex ercise their health responsibilities. Objective 3: Strengthen the capacity of HEPS– Uganda and Civil Society partners to meet her set objectives

CONTACT USHEPS-UGANDA HEADQUARTERS, PLOT 351A, BALINTUMA ROAD– NAMIREMBE, P.O. BOX 2426, KAMPALA, TEL: +256 414-270970, E-MAIL: [email protected] r.ug, WEBSITE: www.heps.or.ug, FACEBOOK: HEPS-UGANDA

CONTACT US

Jan to march 2015 quaterly news leter

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Transcript of Jan to march 2015 quaterly news leter