Linked to Activities 9333,9675,9362,9332,10204,10353. SUMMARY: This activity will guarantee the availability of rapid tests, other tests, and laboratory reagents and supplies needed for detection of HIV among pregnant women seeking prenatal care as well as the infants born to these women. The commodities for this activity include: (i) rapid and confirmatory test kits, (ii) rapid test kits for syphilis, (iii) CD4 tests to determine eligibility of HIV positive women for long-term ARV treatment and (iv) related drugs. The primary emphasis area for this activity is commodity procurement. This activity targets women of reproductive age and the newborn infants. The products are intended for all partner sites for the President's Emergency Plan for AIDS Relief (PEPFAR) in Haiti.

BACKGROUND: This project is part of a new initiative started in FY 2006 with PEPFAR funding which covers fifteen focus countries and three additional countries. Haiti is one of the first countries to have a fully-established PFSCM office. The activities are designed to assist the Haitian Ministry of Health (MOH) and other partners to reach the national objectives. The aim is to provide an uninterrupted supply of rapid test kits and related laboratory commodities to the target population in Haiti, in the appropriate amounts, in good condition, in a timely fashion, and at a fair price.

ACTIVITES AND EXPECTED RESULTS: Activity 1: FPCMS will procure and distribute laboratory tests and supplies to support HIV testing of pregnant women at prevention of mother-to-child transmission (PMTCT) sites. They will also provide technical assistance (TA) to the network of labs to assess and quantify their needs and assist in stock management. In FY07, PFSCM will assume responsibility for the procurement of all laboratory needs, including all the testing equipment. PFSCM will assist in confirming the projected needs and the quantities required. Goods to be procured under this activity include the following rapid tests: Determine, OraQuick, Capillus, Syphilis and CD4 tests. Procured goods will be stored and delivered to the sites by PFSCM.

Activity 2: Within this activity, PFSCM will operate single, coordinated commodity procurement and management plan with the other stakeholders (primarily the Global Fund) involved in procurement of HIV Rapid Test Kits and Laboratory commodities. Sharing of complete patient data from each individual treatment site, along with commodity budgets and procurement plans will improve the quality of available information and the management of the supply chain.

Linked to Activities 9674, 9675, 9362, 9332, 10204, 10353, 9314, 10126, 9326, 9318, 9269, 10109.

SUMMARY: This activity will guarantee the availability of drugs to treat opportunistic infections (OI) and other commodities for People living with HIV/AIDS (PLWHA) enrolled in care, including those on ARV. Three to five percent of those PLWHAs enrolled in care will be children. The list of drugs includes: (i) prophylaxis drugs, such as Isoniazid (INH), Vitamin B6, Cotrimoxazole and multivitamins; (ii) other antibiotics, antifungals and anti-parasitic drugs for treatment of common infections in HIV/AIDS patients; (iii) supportive drugs for symptoms such as fever, cough, diarrhea, headache, and pain. PFSCM will also procure commodities for safe drinking water, such as vessels and chlorine, and lab commodities for basic laboratory testing (Hgm, blood chemistry and cluster of differentiation 4 [CD4] counts) for PLWHAs enrolled in palliative care. The primary emphasis areas for this activity are commodity procurement and logistics. Specific target populations include PLWHAs, HIV-positive pregnant women, and HIV-positive infants and children. The activities will be carried out at all partner sites of the President's Emergency Plan for AIDS Relief (PEPFAR) in all ten geographical departments of Haiti.

BACKGROUND: This project is part of a new initiative, started in FY 2006 with PEPFAR funding, covering fifteen focus countries and three additional countries. Haiti is one of the first countries to have a fully-established PFSCM office. The activities are designed to assist the Haitian Ministry of Health (MOH) in reaching the national palliative care and support objectives. The aim is to provide an uninterrupted supply of OI and sexually-transmitted infection (STI) drugs, lab supplies and commodities and other basic commodities according to the national norms and guidelines. These commodities have been procured in the past by a different partner and through another mechanism. A more comprehensive care package as well as an extended list of drugs will be available through this funding to respond to the growing needs of palliative care for HIV-positive patients.

ACTIVITES AND EXPECTED RESULTS: Activity 1: Since 2004, PEPFAR and the Global Fund have been providing palliative care drugs and supplies for PLWHAs. Through intensive efforts and program expansion, a larger number of patients are receiving access to care and support. With improved tools for forecasting and assessing needs, more patients will benefit from this activity and a wider range of drugs will be available to address a standard list of health problems. We will also include INH prophylaxis for up to 41,600 persons as a target for the end of this year.

Acitivity 2: Due to the nature of the health problems addressed by these drugs and the fact that the pathologies associated with these conditions can be found in non-HIV patients, the procurement planning, inventory tracking and utilization monitoring of the drugs becomes more complex. PFSCM will take every step possible to ensure adherence to PEPFAR principles in making the purchased products available only to intended program recipients. Also, we will coordinate with our Global Fund counterparts in terms of timing of orders and quantities of purchase. The continuing activity will provide palliative care and OI drugs, taking into account Global Fund stocks, for 80,000 patients by September 2007 ad 100,000 patients by September 2008.

Activity 3: Within this activity, PFSCM will operate a single, coordinated commodity procurement and management plan with the other stakeholders involved in procurement of OI drugs procurement, primarily the Global Fund. Sharing of complete patient data from each individual treatment site, along with drug budgets and the procurement plan will improve the quality of available information and the management of the supply chain. PFSCM will provide technical assistance and periodic formal training in logistics and stock management with emphasis on HIV commodities. We will also conduct continuous on site training, follow-up assistance to training and supervision of stock activities. These activities will encompass public (MOH) and non-governmental organization (NGO) operated sites. PFSCM will provide computerized projections of commodity needs at the national level and for each site, including all commodity sources. This activity will contribute to improved palliative care and treatment services throughout all PEPFAR-supported partner sites.

Activity 4: PFSCM will procure and distribute laboratory test kits and related supplies to provide testing for PLWHAs enrolled in care through the network of labs located in the ARV and palliative care sites. PFSCM will assist in confirming the projected commodities

and quantities needed. Goods procured will be stored and delivered to the sites by PFSCM, which will work closely with MOH and other partners to provide technical assistance to the selected laboratories.

TARGETS: Purchase OI drugs for up to 100,000 people, Purchase INH prophylaxis for up to 41,600 people, Purchase laboratory tests and supplies for 100,000 people: CD4 manual tests and controls, Hematology tests and Urinalysis, Train 100 persons in logistics management.

Need to add narrative and targets

Table 3.3.06:

SUMMARY: This activity will guarantee the availability of purified protein derivative (PPD) tests and other laboratory related supplies to test 60,000 individuals for Tuberculosis (TB). Laboratory commodities needed for this activity include PPD test kits for TB testing and general supplies to carry out these tests. The primary emphasis area for this activity is commodity procurement. The specific target population is People living with HIV/AIDS (PLWHA) detected through Counseling and Testing (CT) and Prevention of Mother To Child Transmission (PMTCT) services. This activity will be carried out at all sites providing these services.

BACKGROUND: This project is part of a new initiative started in FY 2006 with the President's Emergency Plan for AIDS Relief (PEPFAR) funding, covering fifteen focus countries and, so far, three additional countries. Haiti is one of the first countries to have a fully-established PFSCM office. The activities are designed to assist the Haitian Ministry of Health (MOH) in reaching the national palliative care and support objectives. The aim is to provide an uninterrupted supply of TB tests and related supplies for the sites.

Through September 2008, the United States Government (USG) expects to provide palliative clinical care to 100,000 PLWHAs. This care will include TB prophylaxis with isoniazid (INH) according to the national norms. PPD tests are critical to detect those individuals who are eligible to receive INH prophylaxis. The USG expects to test 60% (60,000) of the total of PLWHAs (100,000) enrolled in clinical care. PFSCM will be responsible for the procurement and distribution of these tests and related supplies to all counseling and testing (CT), palliative care and PMTCT sites.

ACTIVITES AND EXPECTED RESULTS: Activity 1: PFSCM will purchase PPD tests and related supplies to test 60,000 PLWHAs. In addition, PFSCM will be responsible for ensuring appropriate storage of the test kits and for the distribution of the tests to the different sites. The storage and distribution system for these tests will be integrated with existing systems for storage and distribution of all other PEPFAR-related supplies and commodities.

Activity 2: PFSCM will work with different stakeholders, particularly the MOH and partners involved in providing clinical based services (CT, PMTCT, Palliative care), to assess and quantify the needs for each of these sites.

Activity 3: PFSCM will link the distribution of tests to lab infrastructure activities and training and quality assurance/quality improvement (QA/QI) of the National Network of Labs to ensure that each site has the capacity to store the commodities and perform the PPD testing.

Linked to Activities 9674, 9333, 9675, 9332, 10204, 10353, 9365, 9309, 9267, 9258, 9363, 9275, 9280.

SUMMARY: This activity will guarantee the availability of rapid tests, other tests, and reagents and supplies needed by the laboratory in detection of HIV among the adult population. The list of commodities needed includes: (i) rapid and confirmatory test kits, (ii) rapid test kits for syphilis, and (iii) test kits, reagents and supplies for quality control and quality assurance. Emphasis will be placed on the procurement of supplies and commodities which are essential for an effective CT program component. This activity targets the general population, with an emphasis on men and women of reproductive age. An active distribution system of these commodities, in coordination with the existing anti-retroviral (ARV) drug distribution system, will be implemented at all partner sites for the President's Plan for AIDS Relief (PEPFAR) in Haiti.

BACKGROUND: This project is part of a new initiative, started in FY 2006 with PEPFAR funding, which covers fifteen focus countries and three additional countries. Haiti is one of the first countries to have a fully-established PFSCM office. The activities are designed to assist the Haitian Ministry of Health (MOH) and other partners to reach the national objectives. The aim is to provide all PEPFAR sites in Haiti with an uninterrupted supply of high-quality rapid test kits and related laboratory commodities in the appropriate amounts, in good condition, and at a fair price.

ACTIVITES AND EXPECTED RESULTS: Activity 1: PFSCM will purchase test kits and related commodities and supplies for HIV rapid tests and syphilis testing for 198,000 individuals. In addition, PFSCM will be responsible for ensuring proper storage and distribution of the tests to the different sites. The storage and distribution system for these tests will be integrated with existing systems implemented for all other PEPFAR-related supplies and commodities.

Activity 2: PFSCM will work with different stakeholders, particularly the MOH and partners involved in providing clinical-based services (CT, prevention of mother-to-child transmission [PMTCT], Palliative care), to assess and quantify the needs for each site.

Activity 3: PFSCM will coordinate the distribution of tests with lab infrastructure activities and training and quality assurance/quality improvement (QA/QI) of the National Network of Labs to ensure that at each site has the capacity to store the commodities and perform the HIV testing.

Linked to Activities 9674, 9333, 9675, 9362, 10204, 10353, 8162.

SUMMARY: Activities are carried out to provide best quality anti-retroviral (ARV) drugs and other HIV commodities through assessment of needs, forecasting, purchasing, shipping, warehousing and distribution of the commodities. Infrastructure, technical assistance and capacity building of clinics in logistics management complete the scope of activities. The primary emphasis areas for these activities are commodity procurement, logistics and infrastructure. Specific target populations include people living with HIV/AIDS, HIV positive pregnant women, HIV positive infants and children, public and NGO health workers, pharmacists and nurses. The activities will be carried out at selected sites across the country in all ten geographical departments.

BACKGROUND: This project is part of a new initiative started in FY 2006 with PEPFAR funding covering the 15 focus countries and three other bilateral country programs to date. Haiti is one of the first countries to have a fully established PFSCM office. The activities are keyed to assist the Ministry of Health (MOH) in reaching the national ARV treatment objectives by ensuring an uninterrupted supply of ARVs and related HIV commodities. In September 2006, 32 sites, divided between nongovernmental organization (NGO) sites and public hospitals, were distributing ARVs in Haiti. In six of the USG-supported sites, first-line regimens are procured by the Global Fund and SCMS provides the second-line and third-line regimens and pediatric drugs. In all other sites, the USG provides all of the ARV drugs, most through SCMS with drugs for four sites procured by CRS under the AIDSRelief Track 1 mechanism. A thorough drugs assessment was carried out in collaboration with the Global Fund in early 2006 and a determination of future procurement of ARVs and their timing has been completed. Constant monitoring of stocks and needs is on-going and SCMS has been able to respond to two Global Fund stock-outs with available product because of sufficient buffer stock in-country. Major purchases will occur during FY 2007, observing the approved national guidelines for care and treatment.

ACTIVITES AND EXPECTED RESULTS: Activity 1: PFSCM will procure ARVs and will contribute to national drug forecasting efforts to ensure an uninterrupted supply of ARVS for people living with HIV/AIDS (PLWHA). In 2004, PEPFAR joined in the procurement effort of ARVS and since has become a major ARV supplier to Haiti's PLWHA along with the Global Fund. The constant supply of most regimens ensured a better scale up rate and increased the chances of reaching the nationally set objectives. Some partners are still using a large spectrum of regimens making procurement planning and inventory tracking more complicated. PFSCM will procure only those drugs included in the national treatment guidelines and will make every effort to coordinate timing and quantities of ordering with the Global Fund counterparts. The Global Fund plans to centralize all ARV procurement away from its sub-recipients to a single purchase and distribution system and, in FY 2007, will work with PFSCM towards a unique, national forecasting and purchasing. PFSCM will continue to purchase second and third-line regimens for all sites, including the sites for which Global Fund will procure first-line regimens. Additionally, in FY 2007, PFSCM will take over the procurement of all ARV drugs for the USG-supported sites run by CRS AIDSRelief that were previously receiving ARVs supplied directly by AIDSRelief under the Track 1 funding mechanism. This consolidation of procurement will facilitate planning, procurement and reduce double purchasing, thus decreasing MOH and donor redundancy. PSCM also will purchase ARVs for pediatric patients and those PMTCT drugs that are not donated through the Axios Foundation PMTCT Program. The national norms for both these categories have been completed permitting better forecasting based on approved national norms. All ARVs will have to be approved or pre-approved by the Food and Drug Administration (FDA) in order to be purchased by PSCM. This funding will go specifically to support procurement of ARV drugs to adults, children and pregnant women. This activity will build on USG's FY 2006 success in maintaining a stock of ARVS sufficient for the needs of PLWHA without interruption. The continuing activity will take into account Global Fund stocks.

Activity 2: PFSCM will operate a single coordinated commodity procurement and management plan with the other stakeholders involved in ARV procurement, mainly the Global Fund. Sharing of complete patient data for each individual treatment site, along with drug budgets and procurement plans will improve the quality of available information and the management of the supply chain. PFSCM will provide technical assistance to the

MOH at the National AIDS Control Program for ongoing coordination of procurement planning and stock management. PFSCM will provide periodic formal training in logistics and stock management with emphasis on HIV commodities, and will also continue to conduct continuous onsite training, assistance follow up to training and supervision of stock activities. These activities will encompass public sector (MOH) sites, NGO-operated sites with an objective of 41 sites across the country by September 2008. PFSCM will provide computerized reports of commodity needs projections for each site, and for the national level, including all commodity sources. PFSCM will update commodity needs forecasting quarterly based on monthly stock and patient data. This activity will contribute to improved ARV supply chain and treatment services throughout all treatment centers countrywide. New technological solutions developed by Voxiva, a member of the PFSCM, will be pilot-tested during FY 2007 to improve speed, accuracy of the reporting process and better information sharing on patients and stocks. Pharmacists, nurses, and health workers in the public and NGO-sector will receive formal training in HIV commodity management as well as training in a computerized inventory management system.

Activity 3: PFSCM will refurbish selected sites across the country as well as the provide necessary equipment and furniture to warehouses and dispensing areas. The central warehouse will incur additional improvements and/or additional space to accommodate the increasing volume of stocks and the variety of the products. All physical improvements will ensure a constant and reliable power supply, safe and controlled environment as well as adequate cold chain equipment.

Lilnked to Activities 9674, 9333, 9675, 9362, 9332, 10204, 10353, 9282, 9268, 9313, 10203.

SUMMARY: Activities are carried out to guarantee the availability of all tests used in the protocols for care and follow up of all HIV patients receiving ARV drugs, up to 20,000 patients. It also includes the related general laboratory supplies needed to carry on all the proposed testing. Most patients have at least one blood work done every year according to the national norms. The recommended list of test includes Cluster of Differentiation 4 (CD4) tests and controls; hematology reagents and controls; blood Chemistry and controls; tuberculosis (TB) testing: purified protein derivative (PPD); clinical microscopy, syphilis, urinalysis and other specialty testing; and general supplies needed to carry on those tests.

BACKGROUND: This project is part of a new initiative started in FY06 with the President's Emergency Plan for AIDS Relief (PEPFAR) funding covering the 15 focus countries and three other bilateral country programs to date. Haiti is one of the first countries to have a fully established PFSCM office. The activities are keyed to assist the Ministry of Health (MOH) reach the national objectives of care and support to anti-retroviral treatment (ART) patients. The aim is to provide an uninterrupted supply of the required tests and related supplies for the sites that are ART designated sites.

ACTIVITES AND EXPECTED RESULTS: Activity 1: PFSCM will procure laboratory tests and supplies. The Centers for Disease Control (CDC)/Haiti has been responsible for assessing the needs, quantifying, and procuring, distributing and providing technical assistance for the laboratory departments within the health centers across the country. For FY07, PFSCM will take over the procurement activity of all laboratory needs excluding only the testing equipment. PFSCM will assist in confirming the projected needs and the quantification, and will provide an uninterrupted supply of tests and related laboratory commodities in the right amounts, in the right condition, delivered to Haiti at the right time and for the right cost. Procured goods will be delivered to the United States Government (USG) Team to offer delivery services and technical assistance to the selected laboratories.

Linked to Activities 9674, 9333, 9675, 9362, 9332, 10204, 9311, 9283.

SUMMARY: This program will guarantee the availability of laboratory equipment and commodities including, but not limited to, Cluster of Differentiation 4 (CD4) tests and controls, Hematology reagents and controls, Murex, Enzyme-Linked ImmunoSorbent Assay (ELISA) and Western Blot HIV test kits, and the corresponding supplies needed to carry out these integrated lab procedures. The list of commodities needed include: (i) test kits, (ii) reagents and supplies for confirmatory testing and quality control (QC) and quality assurance (QA), and (iii) basic items for laboratory infrastructure improvement. These basic items include refrigerators, inverters, batteries, solar panels, lab furniture, air-conditioning units and storage cabinets as well as lab refurbishing. The primary emphasis area for this activity is commodity procurement. This activity targets the laboratory network that consists of the Ministry of Health's (MOH) National Public Health Laboratory (NPHL), specialized labs (with advanced HIV-testing capacity) such as Haitian Group for the Study of Kaposi's sarcoma and Opportunistic Infections (GHESKIO), five regional labs and approximately 80 peripheral labs. All these facilities are participating in HIV testing with support from PEPFAR and the Global Funds.

BACKGROUND: In FY 06, the University of Maryland (UMd) has been responsible for assessing and quantifying laboratory needs, procuring lab commodities and equipment, and providing technical assistance to the lab network. The International Training and Education Center for HIV (I-TECH) has been responsible for storage and distribution of commodities to the different labs. Through UM, the United States Government (USG) has been able to procure required test kits and related supplies for HIV testing as well as equipment and commodities to support QA/QI at the NPHL and basic testing at the regional and peripheral sites. .

In FY07, PFSCM will take over the responsibility for procurement of all lab supplies, commodities and equipment; while UMd will focus only on providing technical assistance. The PFSCM project is part of a new initiative, started in FY 2006 with PEPFAR funding, covering the fifteen focus countries and three additional countries. Haiti is one of the first countries to have a fully-established PFSCM office. With ‘07 resources, PFSCM will build on UM efforts to provide the NPHL with test kits and related commodities and supplies for QA/QI and confirmatory testing, including CD4 testing. PFSCM will also provide NPHL with additional equipment for dried blood spots, ELISA QA/QC testing, and western blot testing; refrigerators; freezers; inverters; batteries; solar panels; lab furniture; air-conditioning units and storage cabinets, as well as lab refurbishing. PFSCM will continue to support the enhancement of infrastructure at the regional and peripheral labs. At least 20 labs will be provided with equipment for basic testing and with minor refurbishing, based on needs assessments.

ACTIVITES AND EXPECTED RESULTS: Activity 1: PFSCM will work with MOH and key stakeholders to assess and quantify needs in order to procure necessary supplies, commodities, and equipment at the NPHL, regional and peripheral labs located at the CT, PMTCT, palliative care and ARV sites supported by the USG. The resources to procure test kits will be provided under each program activity, while PFSCM will procure the tests and related supplies for QA/QI. This activity will be closely coordinated with the Global Fund, which provides limited resources for procurement of laboratory supplies and commodities.

Activity 2: PFSCM will assume responsibility from I-TECH for implementing a system of storage and distribution of supplies and reagents. This system will be integrated with existing systems other PEPFAR-related supplies and commodities. Procured goods will be stored and delivered to the sites by PFSCM, who will work closely with CDC/Haiti and other related partners, to provide technical assistance in forecasting needs and stock management at the network of laboratories.

Activity 3: PFSCM will enhance infrastructure and equipment throughout the network of labs. At the NPHL level, the focus will be on providing additional equipment needed to perform QA/QI and confirmatory testing, western blot testing, and protein 24 (P24) testing, as well as refrigerators, freezers, inverters, batteries, solar panels, lab furniture, air-conditioning units and storage cabinets. At the regional level, PFSCM will procure equipment for P24 testing at two labs. They will also support basic equipment for hematology, blood chemistry and other routine testing at approximately 20 peripheral

labs, based on needs assessments. PFSCM will also provide equipment for manual CD4 testing at 5 labs and for fast-count CD4 testing at one lab.

Activity 4: PFSCM will collaborate with the voluntary counseling and testing (VCT), PMTCT, ARV and TB programs to buy reagents required for each program's activities. PFSCM will also collaborate with GHESKIO, CDC and Association of Public Health Laboratories (APHL) to provide technical assistance (TA) to the NPHL for QA/QI and to perform advanced HIV testing such as Dried Blood Spot (DBS), Deoxyribonucleic acid (DNA), and Polymerase Chain Reaction (PCR) for pediatric diagnosis. They will also coordinate with Global Fund in supporting lab programs to avoid duplication of activities and resources.