UNICEF- Update on key activities and plans
IPC, 5th-6th June. 2014
Procurement in support of programmes- 2013
Total procured
Emergency
Procurement Services
$2,839
$127
Supplies and services for
134 countries and areas
Supplies to 33
countries and areas
$1,363
Supplies to 99
countries
Supplier and destination countries
Medicines: 2014 Activities
• Procurement strategies to address increasing demand for priority
medicines: ORS/Zinc, amoxicillin DT, gentamicin, CHX, dexamethasone
inj, IFA…
• Support work of UNCLSC and Pneumonia and Diarrhoea WG: Amoxi DT
ERP, availability of medicines and diagnostics, collaboration to increase
sources, country implementation including activities resulting from
GF/UNICEF MoU.
• Optimization of kits: iCCM (DRC), Diarrhoea kit, PEP Kit
• Partnerships to ensure availability of pediatric ARVs:
IATT Formulary development
Pediatric ARV WG
Pediatric ARV Procurement Working Group
• Controlled temperature shipments
• Improve internal process and supplier relations to provide optimal service
The market dashboard
Inspired from UNITAID Market dynamics Dashboard
The Dashboard monitors the market dynamics of more than 50 essential commodities for
women and children. It provides a qualitative assessment of the determinants of a healthy
market, including:
• Availability
• Affordability
• Competition
• Quality
• Acceptability
• Delivery
• Funding security
Published twice a year, aim is to encourage
internal and collaborative thinking on ways
to address gaps and achieve a more
balanced market
http://www.unicef.org/supply/index_70578.html
Introduction of optimal products
ORS/Zinc co-pack: 3 LTAs established, first procurement of over 200K packs
Chlohexidine 4% for umbilical cord care: collaboration through UNCLSC to
increase number of manufacturers and qualify gel formulations.
Amoxicillin DT: increase in demand and initiation of substitution of suspension
Treatments of 2,500 mg (millions)
12
10
250mg DT
8
Oral Suspension
6
4
2
0
2011
2012
2013
Kit delivery
In PGI value
$120,000,000
$100,000,000
$80,000,000
$60,000,000
$40,000,000
$20,000,000
$0
2007
2008
2009
Ind. Item
Majority are health kits
2010
Stand. Kit
2011
CO kit
2012
2013
Supply of commodities to manage sexual assault of
children and women in the context of emergencies
Challenges
•
•
•
•
•
Forecasting the need
Kit design not addressing diversity of situations where it is used (target, skills and care
services)
Repacking of kits at Country Office level to meet needs
• Split up kit contents to distribute to smaller health facilities
• Split up blisters/packs to dispense to patients
Specific needs of children usually not taken care of, e.g. paediatric dosages
Lack of specific Guidance
Proposed Response (for discussion with partners)
PEP Adults
Wound Care
PEP Children
Associated
Conditions
Psychosocial
Support
+ Guidance Documents
• Easy identification of the necessary items for management of sexual assault
• More flexibility in procurement of PEP for children
• Holistic response, Clear guidance
Guidelines to be reviewed 2014 (WHO)
Partnerships to ensure availability of optimal treatment
for HIV in children
Consolidate
regimens used
• Ensure pediatric ART guidelines are up to date
• Identify regimens and products that can be
phased out of formulary (eg. d4T, ddI)
Interagency Task Team
(IATT)/ Pediatric ARV
Working Group
Consolidate
formulations
used
Pediatric ARV
Procurement Working
Group/ Buyer
Consortium
Consolidate
formulations
used
• Review current procurement list for redundancies
• Explore areas for transition to optimal products
such as FDC’s and phase out suboptimal or
redundant formulations
• Coordinate pediatric ARV procurement amongst
partners
• Align both supply and demand to more efficient
products.
Health Technology Centre
Essential supplies for Health Programmes
FOCUS
Malaria Prevention
and Diagnostics
Long Lasting Insecticide treated bed nets ( LLIN’s),
Insecticides and Rapid Tests
Medical Devices and
Laboratory
Medical equipment and consumables, diagnostics tests
and clinical laboratory equipment
Immunisation
Devices
Injection safety devices, waste disposal.
Cold Chain
Cold chain equipment, refrigerators, waste disposal,
injection safety devices
Maternal and New born Health Issues
INNOVATION
Health Technology: 2014 Activities
• Optimization strategies defined for Health Technologies
Supply Chains,.i.e. Performance indicators, Forecasting, Shipments
optimization and Total Landed Cost options
• Quality policies prepared, harmonization with key partners
(IVD, High Risk Medical Devices, mapping high-risk products that
could be those correspond to class IIB and III of European MDD and
develop its risk mitigation protocol).
• Innovation – ARIDA project ( pneumonia diagnostics ), in
collaboration with WHO, Malaria Consortium, BMGF
• Partnerships LLIN procurement – GF, UNDP, DfiD, PMI,
• Partnerships POC technology – UNITAID, CHAI, 7 countries
2014 Activities
• Ensure a cold chain for all TTSPP …. 
•
•
•
•
•
•
Scale up of old vaccines …….
Scale up of new vaccines ……
Scale up of new versions such as IPV ….
Healthy market for innovative cold chain equipment
Supply Chain integration – Oxytocin, Insulin
Cold chains for lab samples, blood banks, test kits …
• Immunization devices available for all
•
•
•
•
Optimizing immunization shipments/cost per device delivered
Untangling the web of quality requirements
Waste management for immunization, diagnostic testing ?
Aligning with WHO PQS for injection safety devices procurement and
providing feedback on evaluation protocols and technical specifications
• Contribute to the updating of WHO guideline of injection safety.
UNICEF-CHAI
Project: Accelerate Access to Innovative Point of Care (PoC) HIV Diagnostics: CD4, Early Infant Diagnosis, and Viral Load
Funded by UNITAID
Targets: 7 focus countries
Zimbabwe, Tanzania, Kenya, Ethiopia, Uganda, Mozambique, Malawi
Programmatic and Supply coverage:
•
CD4 testing, which is used for staging and monitoring HIV patients prior to initiation onto
antiretroviral therapy (ART).
•
Early Infant Diagnosis (EID) testing for infants less than 18 months of age (this technology can be
performed on viral load platforms as well).
•
Viral Load (VL) testing, which is mainly used for monitoring HIV patients following initiation to ART
UNICEF Quality Policy for procurement of IVDs consulted with WHO, CDC, MSF and fully harmonized
with Global Fund.
Phase 1
Phase 2a
Phase2b
Nov 2012-December June 2014 US$ 20million
Project proposal approved and MOU currently under negotiations
Period July 2014 –Dec 2015 US$ 35million
Project ending 2018 funding remains subject to UNITAID board approval
UNICEF has a key role in vaccine procurement, procuring immunization
supplies on behalf of around 100 countries annually
Vaccines Supplies: US$ 1, 285 million
2013
2.79
billion doses
2,185
shipments
Source UNICEF Supply Division
Immunization Supplies
Vaccines
BCG , DTP, TT/Td/DT, Measles
containing, OPV, HepB, YF,
DTP-HepB, DTP-HepB/Hib,
DTP/Hib, Hib, MR, Meningitis,
MMR, PCV, RV IPV, HPV etc.
Safe Injection equipment
Cold Chain Equipment
Countries UNICEF procures
on behalf of
Full schedule
Partial schedule
Source: UNIICEF Supply Division
Vaccines: 2014 Activities*








Support to countries / on-going operations: Coordination internally and support to countries for high
number of new vaccine introductions (79 new vaccine introductions (13 IPV) in GAVI supported countries
in 2014; 123 (59 IPV) in 2015) , and continuing programmes; specific innovative projects follow up: VAR,
Visual Vaccines; KPIs
Continued/increased support to MICs and GAVI graduating countries through procurement
practitioners forum to support countries moving to self-procurement, review VII and other financing
mechanisms, engagement with partners and countries, MIC tender for new vaccines
Polio eradication – IPV tender concluded in Q1 2014 and operationalized during the year; OPV supply
and demand planning for vaccines and funding; strategy for type 2 withdrawal
Timely completion of tender activities and additional awards (JE, Mening, penta, HPV, PCV, Rota);
develop consolidated strategy for achieving price goals
Provide more useful and accessible information for countries, manufacturers and partners (eg, update
website, pricing data, procurement contexts, market updates)
Continue to strengthen supplier relationships, including at least 1 visit to each of the top 10 suppliers
and visit to China
Follow-up with DRC and Nigeria on supply chain optimization projects
Coordination with partners, including GAVI, BMGF, WHO, GPEI, etc
*Key activities, not all inclusive
Endgame
Major
Objectives
Last wild polio case
2013
2014
2015
Virus detection &
interruption
Wild virus
interruption
RI strengthening &
OPV withdrawal
RI strengthening &
OPV2 pre-requisites
Last OPV2 use
2016
Certification
2017
Outbreak response
(esp. cVDPVs)
Introduce
IPV
OPV2
withdrawal
Containment &
certification
Finalize long-term
containment plans
Complete containment
& certification globally
Legacy Planning
Consultation &
strategic plan
Initiate implementation of
legacy plan
Source: WHO
2018
WHA endorsement in 2013 of Endgame Strategy require
IPV introductions in 123 countries globally within 20 months
Sufficient supply secured to meet projected demand
through UNICEF at affordable prices, but planning needed
• 20 countries requiring supply in 2014, with 7 planned introductions
• A total of 75 countries to introduce in this period, and two continuing
countries
• 20 LMIC/MIC countries to continue or introduce sourcing through UNICEF
• Flexibility required with regards to product preferences, number of shipments
per year, delivery of buffer stocks, month of introduction, registration
requirements
UNICEF support to the tOPV/bOPV switch
• Global synchronized switch from tOPV to bOPV
requires careful planning at global and country
level
• Engagement with partners, countries, and
industry to ensure smooth transition and no
shortages of any product
• Protocols and strategies under development for
operationalization of a switch
ViVa (Visibility for Vaccines)
Vaccines stock monitoring and
projection tool…
…Enabling identification and
communication of upcoming
potential constraints linked
to supply through graphs.
From May to August 2014:
Pilot phase with EPI in DRC,
Niger and Senegal.
Next:
Feedback interest survey and
decision on continuity and
scaling-up.
Supporting Middle Income Countries to Access New Vaccines
• Aggregate MIC demand forecasts
for new vaccines to provide better
visibility to industry.
• Pool MICs’ vaccine procurement to
improve demand predictability,
reduce transaction costs and
improve pricing.
MIC Pooled
Procurement
•Coordination of MIC support
with global/regional partner
activities:
•Global MIC Task Force
•Vaccine Product, Price and
Procurement (V3P) Project
•EMRO Pooled Vaccine
Procurement (PVP) initiative
•GAVI support for access to
appropriate pricing for
graduates & other LMICs
Strategic
Partnerships
Information
Access
•Sharing of knowledge of (i) the
vaccine market, (ii) Vaccine Security
and underlying elements of
forecasting, funding and
appropriate contracting, (iii) vaccine
procurement.
•Issue market analyses.
•Publish Reference Prices to
serve as a benchmark for selfprocuring MICs.
Capacity
Building
Technical
Assistance
• UNICEF Vaccine Procurement
Practitioners Forum (Q4 2014)
• EURO Inter-country Vaccine
Procurement Workshop 2013
• Transition planning for GAVI
graduating countries
• Vaccine Procurement System
Assessments
For additional information on UNICEF’s MIC New Vaccine Procurement Initiative see
http://www.unicef.org/supply/index_67101.html
Some countries where we are already working with the govt to
strengthen the supply chain and develop capacity
DRC
Immunization and
Essential Medicines
Zambia
Essential Medicines
Nigeria
Sierra Leone
Malawi
Immunization
All Health Commodities
All Health Commodities
Afghanistan
Madagascar
Cote d’Ivoire
Immunization
Essential Medicines
Bednets
Eritrea
Ethiopia
Education
Essential Medicines
Niger
Essential Medicines and
Nutrition
Mozambique
All Health Commodities
Kenya
Essential medicines
Myanmar
All Health Commodities
Tanzania
Essential Medicines
2014 Activities
 Support to development and implementation of national supply chain
strategies
 Global networking and collaboration (GAVI, Global Fund, RBM etc.)
 Communication strategy and advocacy tools to raise awareness
internally and externally
 Research to increase understanding of national supply chain models
and promising practices
 Guidelines for capacity development with a supply chain toolkit for
COs and partners (including a SC health check and performance
monitoring tools)
 Roster of consultants for technical assistance
 Support development of the supply community technical skills
framework and professional development plan
 Develop the Global Learning Centre Strategy including the initial
curriculum (starting with vaccines, bednets and nutrition)
 South to south exchanges
What does success look like in 2017?
 Increased use of national supply chains, from determination of need through to
delivery to the last mile, across all programmes and including monitoring
 Increased number of countries actively implementing national supply chain
strategies, led by government
 Strong networks created with increased collaboration, sharing and co-ordination
in capacity development and supply chain systems strengthening initiatives at
global, regional and country level
 At least 20 government supply chains strengthened and optimized for targeted
products