UNICEF
involvement in
PSM – Case of
Ethiopia
PSM Consultants
Briefing Seminar
Copenhagen
30 Jan. – 2 Feb. 2005
Overview
1.
2.
3.
4.
5.
6.
7.
History of UNICEF involvement in PSM
UNICEF capacity for PSM assistance
Challenges faced by partner counties
Nature of UNICEF assistance
Impact of UNICEF assistance
Critical success factors
Remaining challenges
UNICEF is the leading agency
for children’s supplies
UNICEF Supplies
• UNICEF procures vaccines
for 40 per cent of children in
developing countries (2.5
billion doses a year)
• UNICEF is the world’s
largest buyer of mosquito
nets (15 million nets in
2005)
• UNICEF procures New ACTs
- effective medicines against
malaria ($7.6m in 2005)
UNICEF Supplies
• UNICEF has procured 40
million packets of Oral
Rehydration Salts in 2005
• UNICEF currently delivers
antiretroviral medicines to 44
countries ($33.5 million in
2005)
• During 2005, UNICEF reached
around $7.7 million worth of
test kits.
UNICEF Supplies
• During 2005, UNICEF played
key role in emergencies
• UNICEF has stock of ARVs in
Copenhagen for emergencies.
Role of UNICEF Supply Division
• Oversee UNICEF’s
global procurement and
logistics operation.
• Ensure that high
quality, good value
supplies reach children
and their families
quickly.
• Maintain the highest
ethical standards for
procurement.
• Provide technical support
to UNICEF offices and
Procurement Services
customers globally.
• Share procurement
know-how with
development partners.
• Innovate to find ever-
better supply solutions
for children.
Country Office Presence
• Active Procurement activities in support
of Governments and NGOs
• In-country logistics, for all commodities
• Capacity building in programming and
supply management
• Partnership building
UNICEF partner
constraints in PSM
An Overview of the System
The Supply Management
Framework
Principles
Rational
Use
Formulation
Legal
Framework
HR
Access
Supply
System
Financing
Research
Cost
Containment
The Supply Management
Framework
Location of constraints
in the Supply Cycle
Selection l e Quantification
Distribution
Definition of Responsibilities
 Identification of Coordination
Mechanisms
Procurement
Acquisition
Integration of Existing
Institutions & Programs
Case of Ethiopia
•
•
•
•
•
Long procurement lead time
(average 84 weeks)
Forex transfer difficulties
Serious constraints in
distribution system
Preparedness of treatment
sites
Limited HR capacity
General Characteristics
– Inaccurate quantification information due
to poor LMIS
– Non optimum drug availability => waste
and expiration
– Non-systematic inventory control
management systems
– Inadequate storage facilities
– Limited transport for distribution of drugs
– Non-optimum demand for commodities
Ethiopia UNICEF Involvement
• Procurement services
• Forex “transfer
facilitation”
• Overhaul of in-country
logistics system (in
process)
• Assistance with
commodity distribution
• Technical Assistance to
FMOH in logistics
management
Ethiopia UNICEF Involvement
Customs,
Registration, Quality &
Order verification
Selection, Quantification
Suppliers, Quality Monitoring
Delivery Times
Product quality, batch no,
Shelf life monitoring,
Environ. control, etc
Product
Receipt
Stock
Management
Ordering
Distribution
Allocation,
Transport,
Usage Evaluation
UNICEF PSM
support making a difference
Performance – Delivery of Products
Results for Ethiopia
• More than 3 million treatments of
Artemether-Lumefantrine to all regions of
Ethiopia
• Forecasting & procurement– 600,000 P.
falciparum malaria cases to be treated in
2005-6
• Largest distribution of ITNs in Ethiopian
history (3.5m nets)
• 1.8m RDTs distributed in 2005
• $ 6 m ARV procured and delivered in 6 mths
• System overhaul
The Case of ARV supplies
No. of Packs
Supplie
d
MATERIAL
1
Didanosine 100mg tabs/PAC-60
2
Efavirenz 200mg caps/PAC-90
3
pb
16,000
Current No. of
Packs in
Stock
Expiry Date
Reamining
shelf
life
(month
s)
No. of
Treatm
ents/m
th
Monthly consumption
16,000
7/6/06
10
1,600
0
pb
1,500
1/8/08
28
54
0
Efavirenz 200mg caps/PAC-90
pb
1,334
3/6/06
6
222
58
4
Efavirenz 600mg tabs/PAC-30
pb
5,893
2/7/07
17
347
5201
5
Lamivudine 150mg tabs/PAC-60
100,501
1/7/07
16
6,281
6932
6
Lamivudine oral sol.10mg/ml/BOT-240ml pb
3,864
7/6/06
10
386
0
7
Lamivudine oral sol.10mg/ml/BOT-240ml pb
13,164
5/7/07
20
658
527
8
Lamivudine oral sol.10mg/ml/BOT-100ml pb
3,000
11/6/06
14
214
0
9
Nelfinavir 250mg tabs/PAC-270
pb
15,500
15,500
6/7/07
21
738
0
10
Nevirapine 200mg tabs/PAC-60
gp
50,500
50,490
2/7/07
17
2,970
11
Nevirapine 200mg tabs/PAC-60
gp
5,075
6/6/06
9
564
0
12
Nevirapine oral sol.10mg/ml/BOT 100ml gb
2,163
6/9/06
9
240
1349
13
Nevirapine oral sol.10mg/ml/BOT-240ml pb
9,000
9,000
6/7/07
21
429
0
14
Stavudine 30 mg caps/PAC-60
gb
16,200
10,596
4/7/07
19
558
15
Stavudine 40 mg caps/PAC-60
gb
20,000
20,000
4/7/07
19
1,053
2779
16
Stavudine 40 mg caps/PAC-60
gb
13,575
5/6/06
8
1,697
0
17
ZDV + 3TC 300+150mg tabs/PAC-60
pb
11,182
11/7/07
26
430
10397
18
ZDV + 3TC 300+150mg tabs/PAC-60
pb
7,200
1/7/07
16
450
0
19
ZDV + 3TC 300+150mg tabs/PAC-60
pb
12,296
5/8/08
32
384
0
20
Zidovudine 300mg tabs/PAC-60
gp
7,138
11/7/07
26
275
32
21
Zidovudine 300mg tabs/PAC-60
gp
1,000
1,000
1/7/07
16
63
0
22
Zidovudine oral sol.10mg/ml/BOT-100ml pb
3,500
3,500
4/7/07
19
184
0
23
Zidovudine oral sol.10mg/ml/BOT-200ml pb
12,057
12/6/06
15
804
414
24
Zidovudine oral sol.10mg/ml/BOT-200ml pb
9,144
7/6/06
10
914
0
4,000
gp
12181
4,164
Critical success factors
• Technical expertise within the procurement
team
• Country specific intervention
• Stakeholder involvement
• Interpersonal and inter-institutional working
relationship
• Communication and information sharing:
SD-CO; CO-MOH; partner-partner
• Clear plan for in-country logistics
• Periodic review of PSM plans
Remaining challenges
• Human resource shortages
• Weak health system and
capacity in procurement
• Capacity building plan for
in country logistics
• Hands on PSM support
• Financing mechanisms
For every child…