The Supply Chain Management System (SCMS) was established to strengthen or establish secure, reliable,

cost-effective and sustainable supply chains to meet the care and treatment needs of people living with or

affected by HIV and AIDS. In collaboration with in-country and international partners, SCMS works toward

deploying innovative solutions to assist programs to enhance their supply chain capacity; ensuring that

accurate supply chain information is collected, shared and used; and providing quality, best-value, health

care products to those who need them.

The Ministry of Health, with support from the Abbott and Boehringer donation program has expanded

PMTCT coverage to all districts in Uganda currently reaching 90% of health center 4's, and 20% of health

center 3's with a plan to reach 100% of health center 4's and 35% of health center 3's by the end of 2008.

With plans to scale-up program activities, and the introduction of the new PMTCT guidelines, it is important

to ensure that commodities are available to sustain the program growth. We are currently working with the

Ministry of Health (MOH) to revise the logistics system to incorporate new treatment policies and the

additional commodities required to implement them, and will continue this support in FY 2008. This will

involve redesigning the logistics system, training MOH trainers in the new system, support supervision visits

together with MOH to provide continuous training and improvement of logistics data quality, refining

quantification procedures, introduction of improved quantification tools, and provision of procurement

services when requested. SCMS will continue to provide support and capacity building in logistics data

capture and management, forecasting, procurement planning, and coordination of emergency responses to

product shortfalls. The continuation of technical assistance started in FY 2007 to National Medical Stores

into FY 2008 will strengthen the inventory management and distribution of commodities. Building capacity in

the above areas, will help programs forecast and cost their program needs for budget planning, gap

identification, and hence target setting. SCMS will also procure selected PMTCT commodities as needed for

Inter-Religious Council of Uganda(IRCU) and Northern Uganda Malaria, AIDS and Tuberculosis(NUMAT)

supported programs.

SCMS is worked closely with MOH pharmacy department to build capacity in logistics management of

HIV/AIDS commodities through training, and advocacy work, and will support additional human resources to

strengthen the pharmacy department in FY 2008. Under PMTCT the ministry estimated that at total of

67,600 mothers and children will be provided with treatment.

In FY2008, SCMS will strengthen coordination of the Ministry of Health AIDS Control Program (MOH/ACP)

through the anti-retroviral therapy (ARV) Services program and support, pooling of the procurement of

drugs for opportunistic infections (OIs) which is likely to become economical. SCMS will support the

quantification and procurement of OIs where necessary. The OI Drugs requirements for IRCU and NUMAT

will continue to be procured through SCMS if proven to be economical.

SCMS will continue to support the forecasting for OIs both for the ministry of Health as well as for other

PEPFAR partners. Training in logistics system for the management of will be key to ensuring commodity

security for OIs. The SCMS Supervisory Team, working in close collaboration with government, will

continue to provide support supervision to the facilities, as well as data management. SCMS provides

assistance to the technical working group that sets national guidelines and determines drug selection for

defined regimes. This support will continue in FY08 and subsequent years. In FY 2008, SCMS will be

offering secretarial support to the Commodity Security Committee.

Training of MoH and NGO staff at facilities in Information systems will be link to the training for OI

commodity security. Coordination between the Commodity Security Committee and ACP as part of the

ARV Services (Coordination program) will strengthen the overall commodity security for OI drugs.

The Supply Chain Management System (SCMS) was established to strengthen or establish secure, reliable,

cost-effective and sustainable supply chains to meet the are and treatment needs of people living with or

affected by HIV and AIDS. In collaboration with in-country and international partners, SCMS works toward

deploying innovative solutions to assist programs to enhance their supply chain capacity; ensuring that

accurate supply chain information is collected, shared and used; and providing quality, best-value, health

care products to those who need them.

In Uganda, SCMS provides technical assistance to the Ministry of Health in strengthening the TB and HIV

programs. SCMS continues to strengthen logistics information system through formal training and on-going

training during supervisory visits, along side Ministry of Health personnel.

Coordination between the TB and HIV/AIDS programs needs to be strengthened. While there is a great

deal of coordination within the TB program, the coordination between the TB and HIV/AIDS program will

need to be strengthened. This is addressed in part under ARV services - coordination. Joint TB/HIV

program meetings will be supported in part through this activity and partly thought the ARV services

program

Assessment of the logistics system for the National TB program will be conducted during FY2008.

Representative sample of districts will be selected for the assessment. SCMS will provide support for this

assessment in the design and implementation.

Staff training will continue in logistics and information systems for the TB program in FY2008. Staff

competence in the use of existing forms will be strengthened through targeted training and re-enforced by

support supervision. Coordinated support supervision will be done with the HIV/AIDS program to strengthen

the collaboration between the two programs.

The Supply Chain Management System (SCMS) was established to strengthen or establish secure, reliable,

cost-effective and sustainable supply chains to meet the care and treatment needs of people living with or

affected by HIV and AIDS. In collaboration with in-country and international partners, SCMS works toward

deploying innovative solutions to assist programs to enhance their supply chain capacity; ensuring that

accurate supply chain information is collected, shared and used; and providing quality, best-value, health

care products to those who need them.

The Ministry of Health, with support from the PEPFAR program and the Abbott donation program has

expanded HIV counseling and testing from ~2.5 million people tested in 2007 to a target of 4.3 million

people tested in FY 2008. Additional support from Global Fund (GFATM) is expected to begin in September

2007.

With plans to scale-up program activities, and the introduction of routine counseling and testing, it is

important to ensure that commodities are available to sustain the program growth. We are currently working

with the Ministry of Health (MOH) and central public health laboratory (CPHL) towards integration of the HIV

test logistics system into the existing lab logistics system, and will continue this support in FY 2008. This will

involve making adaptations to the HIV test logistics system, training MOH trainers in the changes,

sensitization of district officials and health care workers, support supervision visits together with MOH to

provide continuous training and improvement of logistics management & data quality, refining quantification

procedures, introduction of improved quantification tools, and provision of procurement services when

requested. SCMS will continue to provide support and capacity building in logistics data capture and

management, forecasting, procurement planning, and coordination of emergency responses to product

shortfalls. The continuation of technical assistance started in FY 2007 to National Medical Stores into FY

2008 will strengthen the inventory management and distribution of commodities, which has been a

challenge. Building capacity in the above areas will help programs forecast and cost their program needs for

budget planning, gap identification, and hence improved target setting based on available funding.

Inadequate funding commitments to meet national targets, as well as delays in release of committed funds

have been a major issue in the national program. SCMS will work with programs and the pharmacy

department to ensure forecasts and gap analysis are shared and used for decision making.

SCMS has worked closely with MOH pharmacy department to build capacity in logistics management of

HIV/AIDS commodities and will continue in FY 2008 through training, and advocacy work, as well as

supporting additional human resources to strengthen the pharmacy department in FY 2008. Targets: for

HIV test kits the target for the MOH program is 4, 320,000 persons of test kits for FY 2008 where quantified

with an estimation of 360,000 tests per month

Partnership for Supply Chain Management (SCMS) works toward deploying innovative solutions to assist

programs to enhance their supply chain capacity; ensuring that accurate supply chain information is

collected, shared and used; and providing quality, best-value, health care products to those who need them.

In FY2008, SCMS will continue to provide technical assistance to the Ministry of Health (MOH), Joint

Medical Stores (JMS), and National Medical Stores (NMS) as well as some PEPFAR programs. SCMS will

continue to provide procurement services for the Inter-Religious Council of Uganda (IRCU), and the

Northern Uganda Malaria AIDS and TB program (NUMAT). SCMS will strengthen logistics information

system through formal and on-going training during supervisory visits.

As part of supporting MOH efforts to expand anti-retroviral therapy (ART) services to rural health centers,

SCMS will provide support for National quantification of anti-retroviral drugs (ARVs) and laboratory supplies,

as well as quantification and procurement for IRCU and quantification for NUMAT. Training in logistics and

information systems will be provided to accredited ART sites, including support supervision and on job

mentoring of health workers. Technical support will continue to be provided to Global Fund (GFTAM) third

party procurement agents (WHO&UNICEF). The program will provide support to JMS to strengthen its

warehousing management system and support to strengthen NMS will continue.

The program will provide technical support to National Drug Authority (NDA) in information system

strengthening and provide equipment and training to expedite drug registration and renewals of registration,

drug testing on arrival in country so as to speed up entry into warehouse systems and speed up and

streamline distribution.

SCMS will continue to provide technical support in the redesigning of the ART logistics system for MOH

program and will continue to play a key role in the proper implementation of the new system and role out

process as well as ensuring the system runs smoothly. Challenges include refining Forecasting,

Procurement Harmonization and averting stock outs as a result of delayed release of funds for procurement

by some funding institutions; Warehousing, enhanced training in Drugs management, and strengthening of

the Distribution System. SCMS will continue to work closely with government to develop a logistics Strategy

Plan, and will provide secretarial support to the Commodity Security Group.

SCMS will procure ARV drugs and prevention of mother to child transmission commodities for 6,000

patients estimated to receive ART under IRCU in FY2008 and 5,000 patients under NUMAT as well as

procure emergency supplies to cater for emergency stock-outs in MOH ART sites.

The SCMS Supervisory Team, working in close collaboration with government, will continue to provide

support supervision to the facilities, as well as data management. SCMS provides assistance to the

technical working group that sets national guidelines and determines drug selection for defined regimes.

This support will continue in FY08 and subsequent years. Training of MOH and NGO staff at facilities in

Information systems as well as developing procedures manuals which will help national staff to undertake

future training will continue. The need to strengthen district stores in warehouse/inventory management

and on-going support to NMS and JMS, and district stores have been identified as key areas for support.

This activity will support the National Anti-Retroviral Treatment Committee under the Ministry of Health

(MOH) to develop and disseminate treatment guidelines, monitoring and evaluation framework including

activities to measure quality of ART programs including cohort reporting, consolidation of procurement

mechanisms for ARVs and CD4 machines, and build capacity of local partners in supply chain management

of HIV/AIDS commodities.

The Ministry of Health in collaboration with development partners are in the process of scaling -up access to

comprehensive HIV/AIDS services including care and treatment with ARV. This will involve a greater

number of clients, facilities, health care providers and drugs and supplies. Coupled with the anticipated

expansion of the information system required to handle this scale-up, it is imperative that the coordination of

the program requires a bust in support to maintain and improve on the current level of coordination.

Through technical support to the National ART Committee and placement/secondment of technical staff to

the MOH AIDS Control program (MOH/ACP), SCMS will ensure that coordination is strengthened.

The National ART committee and its eight sub-committees (Policy, Adult ART Management, Pediatric ART

Management, Finance and Logistics, Human Resource and Capacity Building, Laboratory, Quality

Assurance and M&E, and HIV Drug Resistance) will be revitalized and made functional. The sub-

committees will meet once a month, and on a quarterly basis, report to the parent national policy committee.

This will be coordinated by a secretariat based at the MOH/ACP offices.

The coordination will be done through scheduled meetings, supervisory visits, close door sessions to

develop/review policy documents and standards, and the provision of updates on developments to all

centers and partners. The expected deliverables will include, but not limited to: effective and functional

coordination mechanism being in place; inter-site coordination meetings held, and referral linkages within

and between facilities and the communities developed and implemented; ART policy reviewed periodically;

guidelines developed/updated and implemented; framework for adherence monitoring developed and

implemented; site accreditation process improved and accelerated; ART resource tracking system

developed (internal and external support for HIV activities tracked and disseminated; status of commodity

security tracked through the commodity security committee; data collection tools standardized across

programs and HIV information shared with all programs.

The program will also develop mechanisms for responding to emergency stock outs of ARVs in public

health facilities. This will include procurement of a buffer stock of ARVs. The program will also support MOH

in developing a surveillance mechanism for HIV-drug resistance. In FY2008 SCMS will develop and roll-out

an anti-retroviral therapy dispensing tool (ADT) and a structured patient tracking system. Progressively the

program in collaboration with National ART Committee of the Ministry of Health, will explore possibilities of

introducing a Smart Card for patients on ART.

In FY2008, SCMS in collaboration with WHO, UNAIDS, Global Fund and other stakeholders will continue to

provide technical support to Ministry of Health (MOH) to strengthen laboratory services and enable the

ministry to assume stewardship of the national Health Laboratory network with the structure from National

referral, Regional referral, district hospital, health sub - district (HCIV) and the lowest being HC III. This is

expected to substantially improve the laboratory support especially to HIV/AIDS activities.

Plans are in advanced stages to strengthen the central coordination capacity of the Central Public Health

Laboratory (CPHL), and enable it to develop the necessary policy and guidelines on quality assurance and

control, proficiency testing, safety and equipment management. However additional resources are needed

to operationalize these policies and guidelines for MOH /CPHL to coordinate the National Health Laboratory

services. In FY2008, SCMS will provide technical support to MOH to establish an effective management

structure in MOH and District; develop policy and guidelines for laboratory services; carry out support

supervision of laboratory services; monitor and evaluate performance, ensure quality control/quality

assurance in laboratory services, and coordinate procurement and management of laboratory commodities

to positively impact the ability of national systems to sustain care and treatment of people living with

HIV/AIDS.

In FY2007, the number of HIV/AIDS Counseling and Testing (HCT) sites has increased from 340 to 547 in

just over one year. With the availability of test Kits it is estimated that 600,000 tests per month can be

performed therefore the projection for one year baseline number is 7,200,000 tests. In FY2008, 4,5000,000

tests will be procured under Global Fund while PEPFAR will provide over 2 million tests and Clinton

Foundation 4,500 tests. With the scaling up of rapid testing activities more staff will be trained in HIV rapid

testing techniques. In collaboration with the National laboratory committee, SCMS will continue to provide

technical support to CPHL to prepare specifications and quantification for laboratory supplies and

equipment such as CD4, Chemistry and hematological analyzers.

With support from the Global Fund, MOH will procure 40 CD4+ machines bringing the total of CD4+

machines under MOH to 52. Prior to this procurement, the country had 62 CD4+ machines with 50

machines owned by NGOs and research organizations. Available data indicate that approximately 100,000

patients are currently on treatment, 200,000 patients currently in care, 60,850 projected new patients to

enter treatment, and 95,316 projected new patients to enter care. Uganda will therefore need to carry out

744,757 total CD4 tests over the next one year. PEPFAR, Global fund and Clinton Foundation will only

cover 35 percent of the country's CD4+ needs. In direct response to the limited resources, SCMS will

provide technical support to MOH to design and develop a new logistics system for automated equipments

for easy distribution of supplies to avoid expiries and train 360 laboratory staff.

Currently, there is no laboratory strategic plan and funding is required to support MOH develop a five year

a national public-health laboratory strategic plan that will help CPHL to know what the laboratory needs

are, where do want t to be in five years, how to get there. Following the institution of the laboratory supplies

Credit line program, the number of working laboratories increased from 579 over 1000 faculties for both

NGO and Government in the previous year and half. Collection of data on laboratory activities has

commenced. SCMS will analyze the data to improve service provision and provide regular training of health

unit laboratory personnel in laboratory management with emphasis on logistics and data management in the

new districts and new staff.

SCMS will provide technical support to strengthen the Laboratory Information Management System (LIMS)

to ensure a regular flow of information to the districts and the center for monitoring and evaluation of system

performance.

Staff will be trained and program implementation plan developed based on the strategic plan. Laboratory

staff across regional and district hospital as well as health facilities will continue to be trained in procedures

and safety techniques, and also in the use and maintenance of new equipment.