This activity relates to HTXS (7213), HTXD (8170), HBHC (7187, 7177, 7165, 7160, 7163, 7191, 8144, 8718), HLAB (8189), OHPS (7218).

In FY 2006, the EP began its transition towards a consolidated approach for procurement of HIV-related commodities through the use of PFSCM and NRL as the primary procurement partners. In addition, the GOR is expanding the CPDS to include all HIV-related commodities, including OI drugs and diagnostics, test kits and CD4. During this transition year (FY 2006), PFSCM will support central-level quantification, procurement, storage and distribution systems in close collaboration with RPM+. RPM+ is leading the support to the CPDS, districts and sites.

In FY 2007, PFSCM will directly subcontract with CAMERWA for the procurement, storage and distribution of all HIV-related commodities, including laboratory. This consolidated approach to procurement will increase cost savings and improve efficiencies in procurement and distribution of commodities. In addition, PFSCM will take over the support to the CPDS to ensure smooth functioning of the CPDS system, quality data for quantification, and strong communication between sites, districts and CAMERWA. Partners will work in close collaboration through joint planning and workplan development, particularly for activities that support the LMIS and active distribution system.

This activity comprises three components: procurement of OI and preventive care drugs, TA, and procurement for HBC kits. For OI drug procurement, PFSCM will sub-contract with CAMERWA to procure, store and distribute OI drugs for 93,100 PLWHA at 175 USG-supported sites. Starting in FY 2006 and expanding in FY 2007, GFATM will cover membership to Rwanda's community-based health insurance scheme (Mutuelles) for a minimum of 100,000 PLWHA enrolled in care. USG funds through PFSCM will complement GFATM resources by covering the costs of drugs not included on the GFATM Mutuelles list, including preventive care drugs such as CTX, and more expensive OI drugs, such as Amphotericin B.

HIV and other diagnostic kits, reagents, supplies and equipment will be procured through PFSCM under HLAB.

PFSCM will also provide ongoing TA to CAMERWA and the CPDS for quantification, USG procurement regulations and for appropriate distribution of products to all sites. Product selection will also conform to GOR's minimum list of preventive care, OI and other palliative care medications, as well as to WHO standards for QA. PFSCM will support CAMERWA and the NRL to conduct quality assurance of OI medication arriving in country through Thin-Layer Chromotography (TLC) and use of mini-labs. As OI drugs will be integrated into the CPDS, PFSCM will provide TA and support to the relevant committees of the CPDS to develop a procurement and distribution plan for OI and palliative care drugs, to conduct quantification, monitor consumption patterns and stock levels, and to provide regular reports to donors.

In collaboration with RPM+, PFSCM will work closely with GFATM, MOH, CAMERWA, and districts to ensure the continuous availability and management of drugs covered by Mutuelles. This will be done through the use of a Mutuelles membership card and register, participation in the revision of Mutuelles policies and guidelines, and TA in collaboration with RPM+ to sites, district pharmacies and CAMERWA for monitoring, reporting and ordering essential medicines. PFSCM will review and revise the plan for M&E of HIV/AIDS pharmaceutical management, including any revision as necessary of pharmaceutical indicators related to consumption and use of OI drugs as well as ARVs and other HIV/AIDS-related commodities.

Finally, PFSCM will leverage donations for HBC kit contents and additional palliative care medications and supplies from CHAMP through CHAMP's cost-sharing agreement with DRI. PFSCM will procure drugs and supplies included in the nationally defined HBC kits on an as needed basis. PFSCM will also work with CHAMP, CAMERWA and the MOH to review and revise tools to support the storage, distribution, and tracking of HBC kits from CAMERWA to the community level.

This activity addresses the legislative area of wrap around through leveraging funds from the GFATM for membership coverage of PLWHA for the community-based health insurance

schemes. This will increase access to essential OI medicines for PLWHA. It also directly supports the Rwanda EP five-year strategy for ensuring sustainability by improving commodity forecasting, procurement procedures, storage and distribution, and information systems.

This activity relates to activities in HVTB (7266, 7169).

In FY 2007, PFSCM will be responsible for the procurement of all EP commodities through direct support to CAMERWA. PFSCM will provide TA and funding for procurement, storage and distribution of all medicines, equipment and laboratory supplies for TB and other EP program areas.

In FY 2007 CDC will provide support to the MOH to establish histology and pathology services at the CHK laboratory to improve the prompt diagnosis of extrapulmonary TB through TA, training and equipment. This laboratory will also serve as a referral center for the district of Muhima, which reported the second highest number of ETB cases in 2005.

PFSCM will procure necessary equipment and supplies to carry out the above activities, including one microtome, waterbath, tissue processor, IPOX, microscopes, consumables for TB diagnosis, fluorescence microscope, auramine stain, centrifuge, biosafety cabinets, and hood.

This activity contributes to the Rwanda EP five-year strategy goal of integrating TB and HIV services by strengthening TB diagnostic capacity at one of Rwanda's major reference hospitals.

This activity relates to activities in HVCT (7178, 7231, 7261, 8164, 8165, 8166, 8168, 8169, 8732), HTXD (8170), HTXS (7213), OHPS (7212).

In FY 2006, the EP began its transition towards a consolidated approach for procurement of HIV-related commodities through the use of PFSCM and NRL as the primary procurement partners. In addition, the GOR is expanding the CPDS to include all HIV-related commodities, including OI drugs and diagnostics, test kits and CD4. During this transition year (FY 2006), PFSCM will support central-level quantification, procurement, storage and distribution systems in close collaboration with RPM+. RPM+ is leading the support to the CPDS, districts and sites.

In FY 2007, PFSCM will directly subcontract with CAMERWA for the procurement, storage and distribution of all HIV-related commodities, including laboratory. This consolidated approach to procurement will increase cost savings and improve efficiencies in procurement and distribution of commodities. In addition, PFSCM will take over the support to the CPDS to ensure smooth functioning of the CPDS system, quality data for quantification, and strong communication between sites, districts and CAMERWA. Partners will work in close collaboration through joint planning and workplan development, particularly for activities that support the LMIS and active distribution system.

In FY 2007, PFSCM will directly fund CAMERWA for the procurement, storage, and distribution of rapid test kits and supplies (gloves, lancets, filter paper) for 176 EP-supported health facilities, to target all CT and PMTCT clients. In addition, PFSCM will procure additional test kits for GFATM sites, continuing EP's ongoing support to GFATM, begun in FY 2005.

Test kits will be procured in line with the national testing protocol, which includes Determine, First Response, Unigold, Capillus, OraQuick and others that may be incorporated into the national algorithm. PFSCM will coordinate and regularly communicate with USG partners to ensure they have adequate information for the quantification and distribution of test kits, as well as to discuss issues related to test kit procurement, distribution and management. As CPDS increasingly expands to include other commodities, PFSCM will work closely with CPDS to ensure appropriate integration of kits into the system, including development of a procurement plan that integrates test kits, support for national quantification in collaboration with NRL and other members of the Quantification Committee and integrated distribution to sites.

PFSCM will work closely with RPM+ to ensure appropriate integration of test kit information into LMIS at all USG-supported sites and district pharmacies, and to ensure appropriate stock management of test kits. As the country continues to strengthen its CT strategy and implementation, PFSCM will work with CAMERWA and RPM+ to analyze and report on district pharmacy and health facility stock levels on a regular basis to monitor for trends, potential stock outs, and make any revisions to procurement plans and projections.

This activity relates to HBHC (8716), HVTB (8664), HVCT (8167), HLAB (8189), HTXS (7161, 7174, 7213, 7246, 8172, 8735, 8737), and OHPS (7212).

In FY 2006, USG began its transition towards a consolidated procurement system for HIV-related commodities through PFSCM and NRL. PFSCM will support CAMERWA to further strengthen warehousing, procurement, management and distribution. RPM+ will support the CPDS, district pharmacies and the PTF. In FY 2007, USG will procure all commodities, including laboratory supplies, through PFSCM in order to increase cost savings and improve efficiencies. In addition, PFSCM will extend its support to the CPDS to ensure proper functioning of the CPDS system, availability of quality data for quantification, and improved information sharing between sites, district pharmacies and CAMERWA. PFSCM, RPM+, DELIVER and PMI will coordinate their activities in support of the LMIS and active distribution system.

In FY 2007, funds for this activity will support three components. Under the first component, PFSCM will directly sub-contract with CAMERWA for the procurement, storage, and distribution of USG-financed ARVs procured through the CPDS for 136 EP-supported ART sites and 36,621 patients, including 3,662 pediatric patients. Through CAMERWA, PFSCM will also procure ARVs for the revised PMTCT bi-therapy regimen for 4,056 HIV-positive pregnant women.

Under the second component, PFSCM will continue to provide TA to CAMERWA for procurement, warehousing, storage, active distribution. Implementation of the LMIS between districts and CAMERWA will be supported in collaboration with RPM+, DELIVER and PMI. PFSCM will fund one position at CAMERWA to assist in timely monitoring, analysis and reporting on stock levels to the CPDS and to PFSCM.

PFSCM will be the lead TA agency to the CPDS. This will include continued funding of one position in CPDS responsible for coordinating between and reporting to the GOR, donors and implementing partners, and conducting data analysis of pipelines and stock movements. PFSCM will provide technical support and supervision to the QFC and increasingly shift responsibility for quantification to the QFC (quantification exercises are currently led by USG partners). In addition, PFSCM will provide technical support to the Resource Management Committee (RMC) and the Implementation Committee to ensure optimal use of funds. PFSCM will continue to participate in quarterly data quality control visits with TRAC, RPM+ and the districts.

Finally, PFSCM will collaborate with RPM+ to strengthen QA systems. It is critical that all drugs reaching patients are safe, effective and meet quality standards. PFSCM will work with RPM+, the NDA, CAMERWA and the CPDS to ensure prudent supplier and product selection and certification, and other components of the WHO Certification Scheme. PFSCM will support the establishment of Thin-Layer Chromatography (TLC) and mini-labs in collaboration with the NDA, University of Butare and the NRL to test the quality of ARVs.

This activity relates to activities in HLAB (7263, 7172, 7224).

In FY 2007, PFSCM will be responsible for the procurement of all EP commodities through direct support to CAMERWA for the procurement, storage and distribution of all medicines, equipment and laboratory supplies. This consolidated approach to procurement will increase cost savings, and improve efficiencies in procurement and distribution of commodities. PFSCM will also take over the support of the CPDS and LMIS activities to ensure smooth functioning of the CPDS system, quality data for quantification, and strong communication between districts and CAMERWA.

PFSCM will conduct all commodity procurement for 100 EP-supported site laboratories (67 existing and 33 new laboratories), including equipment, supplies, and reagents for biochemistry, hematology, parasitology, and biosafety. PFSCM will procure all CD4 kits and supplies for the estimated 175,000 tests needed in FY 2007 for EP-supported patients. National ART treatment guidelines call for viral load testing in cases of suspected treatment failure. PFSCM will procure viral load reagents sufficient to cover the estimated needs of 6,000 EP-supported patients. In addition to this site-level laboratory procurement, PFSCM will procure equipment, supplies and reagents for specific central-level activities and functions, such as an estimated 6,000 PCR kits and supplies for the national infant diagnosis program, an estimated 1,000 additional viral load kits and associated supplies for the laboratory component of the national ART program impact evaluation, test kits and supplies for continuing HIV serology and CD4 testing QA systems, PCR equipment, supplies and reagents for expansion of PCR capacity to CHU Butare, supplies and reagents for OI diagnosis, as well as supplies for ongoing parasitology and other OI diagnostics for regional and district-level trainings.