Overview of Supply Chain of Anti-TB MedicinesOverview of Supply Chain of Anti-TB Medicines Francis...
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Overview of Supply Chain of Anti-TB Medicines
Francis Aboagye-Nyame Program Director USAID Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program
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Improved Access. Improved Services.
Better Health Outcomes.
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Is SCM important?
Source: http://www.geekyboy.com
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High Budgetary Impact: Global Fund Expenditures—2012
$160,000,000
$230,000,000
$370,000,000
$510,000,000
$550,000,000
$600,000,000
$600,000,000
$1,000,000,000
$1,200,000,000
$1,900,000,000
$390,000,000
$2,500,000,000
$2,700,000,000
$- $500,000,000 $1,000,000,000 $1,500,000,000 $2,000,000,000 $2,500,000,000 $3,000,000,000
Other
TA
Overheads
Communication materials
monitoring and Evaluation
Living support to clients
Planning and Administration
Infrastructure and other equipment
Training
Human resources
Procurement and Supply Management Costs
Medicines and pharmaceutical products
Health products and health equipment
$5.59 Billion 44%
Source: GFATM Annual Report 2012
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Health Care System
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Treatment Outcomes
As tuberculosis progresses, patients suffer drastic weight loss Credit: WHO/Jean Chung http://www.pbs.org/newshour/multimedia/tb/15.html
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Supply Chain Management (SCM) Defined
• Encompasses the planning and management of all activities involved in sourcing and procurement, conversion, and all logistics management activities
• Is an integrating function with
primary responsibility for linking major business functions and business processes within and across companies into a cohesive and high-performing business model
Source: Council of Supply Chain Management Professionals (CSCMP)
Source materials Supplier
Production
Distribution
Client Consumer
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Source: MSH/CPM
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Logistics Cycle
Source: USAID|DELIVER
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National TB Supply Chains: Multiple Players – Multiple levels
LEVELS PRIVATE SECTOR PUBLIC SECTOR PARTNERS
International International Procurement Agencies / GLC / GDF
GDF
National
Government Supply Services National TB Program Third-Party
Payers
Regulatory Agencies
Wholesalers TB Institutes
Regional Regional Facilities
District
Private Prescribers
Community
District Facilities
Primary Care Facilities
TB Patients (intensive / continuation phases)
Local Manufacturers
Multinational Suppliers
Distributors
Shops, Pharmacies
CMS system flow Alternative flow Information flow
Donors/ Global Fund, PEPFAR
NGOs
NGOs
NGOs
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Supply Chain Functions
Forecasting and Supply Planning
Procurement
Warehousing and Inventory Control
Distribution and Transportation
Information Management
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Issues in Quantification of Anti-TB Medicines • Changes in the recommended regimens
– Updates in international recommendations and national standard treatment guidelines
• New medicines and novel treatment regimens in the pipeline
• Expansion of MDR-TB treatment • Lack of appropriate tools for quantification
of anti-TB medicines • Relatively short shelf life for second-line
drugs (SLD) • Quality of information for quantification
– e.g., stock on hand, pipeline, consumption, treatment regimens distribution data
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Issues in Procurement of Anti-TB Medicines • Global mechanisms for procurement of anti-TB
medicines (Global Fund, Global Drug Facility) • Internationally quality assured anti-TB medicines
not always available on local markets – Not registered, domestic preferences, etc.
• Fixed-dose-combination (FDC) and pediatric anti-TB medicines rarely available on the local markets
• Financial constrains—SLDs are still expensive • Dependence on donors for procurement of anti-TB
medicines leads to concerns about sustainability
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Issues in Distribution of Anti-TB Medicines
• Distribution system for anti-TB medicines often parallel and isolated from the general distribution system
• Insufficient budgets and funding for supply chain management
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Adequate Infrastructure and MHE
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Poor Storage
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Lack of Shelves – Spilled TB Stains
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Major Cracks in Store Rooms
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Good Storage
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Challenges—Transport Management
• Poor fleet management • Inadequate transport resources
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Data. Data. Data.
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Finally—a Good Supply Chain should… • Maintain a constant supply of medicines • Keep medicines in good condition
throughout the distribution process • Minimize medicine losses caused by
spoilage and expiry • Maintain adequate inventory records • Rationalize medicine storage points • Use available transportation resources
as efficiently and effectively as possible • Reduce theft and fraud • Provide information for forecasting
needs • Incorporate a quality assurance program
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Access to Medicines. A Focus on Pharmaceutical Services?
Source: MSH/CPM
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Improved Access. Improved Services.
For Better Health Outcomes.
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Thank you for your attention