1. Overall goals and objectives This project implemented by the National Medical Stores will contribute to the national supply of Cotrimoxazole, HIV-related laboratory commodities and supplies in order to meet the care and diagnostic needs at Health Center (III) facilities and above in the country. Through this project, commodities will be purchased to meet the needs of public, NGO and faith-based health facilities throughout the country. The laboratory commodities and supplies which will be availed will include, but not limited to Cotrimoxazole, HIV test kits, laboratory reagents and supplies for opportunistic Infections (OI) diagnosis, Kits/reagents for performing routine sexual and reproductive health tests e.g. Syphilis, HB, Urinalysis; supplies for Early Infant Diagnosis (EID), reagents for CD4 and viral load tests. Overall, this project will support the functioning of prevention, basic care and support and treatment programs by ensuring the availability of commodities necessary to enhance services provision and uptake. Therefore the main objectives of this project are; a. Develop a sustainable and consistent supply of Cotrimoxazole, HIV related laboratory commodities and supplies to contribute to the projected national requirements in order to support HIV prevention, basic care and treatment services in health facilities throughout the country. b. Strengthen the capacity of the health systems at district and national levels to adequately forecast and utilize available commodities.

2. Target populations and geographic coverage HIV/AIDS commodities will be availed to all accredited government, FBO and NGOs facilities providing HIV/AIDS services throughout the country. Working in tandem with the "pull' system established in 2002 where districts are expected to plan and quantify their drugs and medical supply needs and using the credit line to draw down funds allocated to them. Funding allocations will be aligned to the statutory requirement that states that 20% of funds be allocated to JMS for faith-based PNFP health facilities while NMS retains 80% of the funding for public facilities. This will be the guiding principle for the sub partner relationship between NMS and JMS and through a Memorandum of Understanding, roles and responsibilities for each party in the sub partner agreement shall be elaborated.

3. Enhancing cost effectiveness and sustainability NMS was established in 1993 by the NMS Act (Cap 207 Laws of Uganda), to ensure equitable access by the population of Uganda to high quality efficacious and cost effective essential medicines. It is an autonomous not-for-profit organization designed to operate on sound commercial principles while maintaining equity of access to medicines. This project will utilize the already established systems of National Medical Stores for planning, forecasting and quantification of HIV/AIDS commodities as well as procurement, storage and distribution. To the extent possible, this project will be implemented through the existing human, material and financial systems available at NMS and JMS. Further, the project will leverage on initiatives that are ongoing or planned by the government and donor partners. For example, funded by the World Health Organization (WHO), The 3-Year Rolling Procurement Plan for Essential Medicines and Health Supplies, implemented through the MoH Pharmacy Division; The USG-funded upgrade of NMS's enterprise resource planning software - MACS and Sage provides opportunities for synergy with the capacity building efforts to improve LMIS. The project will also leverage SURE program which is harmonizing USAID's support relating to EMHS through technical interventions to identify options to correct policy and finance deficits, strengthen the supply chain systems at central and district levels, and develop human capacity to manage the reformed supply chain systems.

4. Health Systems Strengthening Project implementation will be through the existing government and faith based structures from national to the district level. NMS will advocate for Government of Uganda commitment for incremental direct budgetary allocation to medical commodities including HIV-related laboratory supplies. District health systems will be strengthened by addressing training for service providers in logistic and supplies management; improvement of the HIV-related laboratory requisition and reporting systems; supporting

the functioning of Logistics Management Information System (LMIS) and streamlining lines of logistics/commodities responsibilities and accountability. NMS will pilot the "last mile distribution" ie delivery of health commodities to end users at health facilities and implementation sites in a few districts to determine the feasibility of this approach as astrategy for health commodities distribution for the whole country.

5. Key issue The new mandate of NMS to directly manage all medicines and supplies' budget of the MOH may overwhelm existing capacity at NMS and directly impact the successful implementation of this program. An independent end-of-program evaluation will be conducted in year five to assess project achievements against set targets and objectives.

1. Target populations and coverage of target population or geographic area This project will contribute to the Uganda national supply of cotrimoxazole supplies needed to increase demand and availability of HIV care and support services for adults testing positive for HIV. The procurement under this project is to fulfill commodities and supplies requirements at government and

faith based health facilities and few accredited NGO facilities. HIV/AIDS commodities and supplies to enhance services delivery are the central focus of this project. National Medical Stores (NMS) will have a sub partner relationship with Joint Medical Stores (JMS) that have product availability responsibilities for the faith based system. The partnership is guided by the national system for the procurement and distribution of essential health commodities of the Ministry of health. 2. Description of service delivery or other activity carried out The core mandate under this project is the development of sustainable and consistent supply of cotrimoxazole for adult care and the main activities for NMS and JMS include planning, forecast and quantification of cotrimoxazole commodities needs, procurement, storage and distribution of the same and strengthening the capacity of the health systems at district and national levels to adequately forecast and utilize available commodities. All the cotrimoxazole and other essential drugs supplies from the government system will be distributed in an integrated manner and following the national guidelines on the distributions of essential medicines and credit line commodities of the Ministry of Health. 3. Integration with other health activities The drug supply system in Uganda operates within a framework defined by the National Health Policy (NHP) and reflected in the Health Sector Strategic Plan (HSSP). The delivery of Essential Medicines and Health Supplies (EMHS) on which the PEPFAR commodities is tagged is dependent on a broad network of interdependent institutional entities which include NMS. 4. Relation to the national program NMS operates within a statutory and legal framework defined by the laws of the GoU and within a policy and procedural framework defined by the Ministry of Health and codified in the National Drug Policy and Authority Act (NDPAA) and other related Acts. NMS supports the core functions of the Ministry of Health of ensuring attainment of the goals and objectives of the NHP and that the population of Uganda has access to the Minimum Health Care Package (MHCP) as defined in HSSP II of 2005/06-2009/10. The MHCP defines the basic services at the various levels of the health care system. The delivery of this package is in part dependent on the availability of essential drugs for which NMS is charged with procurement and distribution. 5. Health Systems Strengthening and Human Resources for Health Project implementation is highly integrated in the management structures of NMS. All the staff at NMS are involved in the implementation of this project to variable extent, with the Project Director, Coordinator, Finance Controller, M&E and Laboratory Specialists exercising higher levels of efforts.

1. Target populations and coverage of target population or geographic area

This project will contribute to the Uganda national supply of HIV/AIDS test kits and related laboratory supplies needed to increase demand and availability of HIV Counseling and Testing services Country wide, but with special focus to commodities and supplies needed at government and faith based health facilities and few accredited NGO facilities. HIV/AIDS commodities and supplies to enhance services delivery are the central focus of this project. National Medical Stores (NMS) will have a sub partner relationship with Joint Medical Stores (JMS) that have product availability responsibilities for the faith based system. The partnership is guided by the national system for the procurement and distribution of essential health commodities of the Ministry of health. 2. Description of service delivery or other activity carried out The core mandate under this project is the development of sustainable and consistent supply of HIV test kits and related commodities and the main activities for NMS and JMS include planning, forecast and quantification of HIV test kits and related commodities needs, procurement, storage and distribution of the same and strengthening the capacity of the health systems at district and national levels to adequately forecast and utilize available commodities. All the HCT commodities and other essential drugs supplies from the government system will be distributed in an integrated manner and following the national guidelines on the distributions of essential medicines and credit line commodities of the Ministry of Health. 3. Integration with other health activities The drug supply system in Uganda operates with in a framework defined by the National Health Policy (NHP) and reflected in the Health Sector Strategic Plan (HSSP). The delivery of Essential Medicines and Health Supplies (EMHS) on which the PEPFAR commodities is tagged is dependent on a broad network of interdependent institutional entities which include NMS. 4. Relation to the national program NMS operates within a statutory and legal framework defined by the laws of the GoU and within a policy and procedural framework defined by the Ministry of Health and codified in the National Drug Policy and Authority Act (NDPAA) and other related Acts. NMS supports the core functions of the Ministry of Health of ensuring attainment of the goals and objectives of the NHP and that the population of Uganda has access to the Minimum Health Care Package (MHCP) as defined in HSSP II of 2005/06-2009/10. The MHCP defines the basic services at the various levels of the health care system. The delivery of this package is in part dependent on the availability of essential drugs for which NMS is charged with procurement and distribution. 5. Health Systems Strengthening and Human Resources for Health Project implementation is highly integrated in the management structures of NMS. All the staff at NMS are involved in the implementation of this project to variable extent, with the Project Director, Coordinator, Finance Controller, M&E and Laboratory Specialists exercising higher levels of efforts.

1. Target populations and coverage of target population or geographic area

This project will contribute to the Uganda national supply of cotrimoxazole supplies needed to increase

demand and availability of HIV care and support services for children testing positive for HIV Country

wide, but with special focus to commodities and supplies needed at government and faith based health

facilities and few accredited NGO facilities. HIV/AIDS commodities and supplies to enhance services

delivery are the central focus of this project. National Medical Stores (NMS) will have a sub partner

relationship with Joint Medical Stores (JMS) that have product availability responsibilities for the faith

based system. The partnership is guided by the national system for the procurement and distribution of

essential health commodities of the Ministry of health.

2. Description of service delivery or other activity carried out

The core mandate under this project is the development of sustainable and consistent supply of

cotrimoxazole for pediatric care and the main activities for NMS and JMS include planning, forecast and

quantification of PMTCT commodities needs, procurement, storage and distribution of the same and

strengthening the capacity of the health systems at district and national levels to adequately forecast and

utilize available commodities. All the cotrimoxazole supplies and other essential drugs commodities from

the government system will be distributed in an integrated manner and following the national guidelines

on the distributions of essential medicines and credit line commodities of the Ministry of Health.

3. Integration with other health activities

The drug supply system in Uganda operates with in a framework defined by the National Health Policy

(NHP) and reflected in the Health Sector Strategic Plan (HSSP). The delivery of Essential Medicines and

Health Supplies (EMHS) on which the PEPFAR commodities is tagged is dependent on a broad network

of interdependent institutional entities which include NMS.

4. Relation to the national program

NMS operates within a statutory and legal framework defined by the laws of the GoU and within a policy

and procedural framework defined by the Ministry of Health and codified in the National Drug Policy and

Authority Act (NDPAA) and other related Acts. NMS supports the core functions of the Ministry of Health

of ensuring attainment of the goals and objectives of the NHP and that the population of Uganda has

access to the Minimum Health Care Package (MHCP) as defined in HSSP II of 2005/06-2009/10. The

MHCP defines the basic services at the various levels of the health care system. The delivery of this

package is in part dependent on the availability of essential drugs for which NMS is charged with

procurement and distribution.

5. Health Systems Strengthening and Human Resources for Health

Project implementation is highly integrated in the management structures of NMS. All the staff at NMS

are involved in the implementation of this project to variable extent, with the Project Director, Coordinator,

Finance Controller, M&E and Laboratory Specialists exercising higher levels of efforts.

1. Target populations and coverage of target population or geographic area

This project will contribute to the Uganda national supply of HIV/AIDS test kits and related laboratory

supplies needed to increase demand and availability of PMTCT services Country wide, but with special

focus to commodities and supplies needed at government and faith based health facilities and few

accredited NGO facilities. HIV/AIDS commodities and supplies to enhance services delivery are the

central focus of this project. National Medical Stores (NMS) will have a sub partner relationship with Joint

Medical Stores (JMS) that have product availability responsibilities for the faith based system. The

partnership is guided by the national system for the procurement and distribution of essential health

commodities of the Ministry of health.

2. Description of service delivery or other activity carried out

The core mandate under this project is the development of sustainable and consistent supply of PMTCT

commodities and the main activities for NMS and JMS include planning, forecast and quantification of

PMTCT commodities needs, procurement, storage and distribution of the same and strengthening the

capacity of the health systems at district and national levels to adequately forecast and utilize available

commodities. All the PMTCT commodities and other essential drugs supplies from the government

system will be distributed in an integrated manner and following the national guidelines on the

distributions of essential medicines and credit line commodities of the Ministry of Health.

3. Integration with other health activities

The drug supply system in Uganda operates within a framework defined by the National Health Policy

(NHP) and reflected in the Health Sector Strategic Plan (HSSP). The delivery of Essential Medicines and

Health Supplies (EMHS) on which the PEPFAR commodities is tagged is dependent on a broad network

of interdependent institutional entities which include NMS.

4. Relation to the national program

NMS operates within a statutory and legal framework defined by the laws of the GoU and within a policy

and procedural framework defined by the Ministry of Health and codified in the National Drug Policy and

Authority Act (NDPAA) and other related Acts. NMS supports the core functions of the Ministry of Health

of ensuring attainment of the goals and objectives of the NHP and that the population of Uganda has

access to the Minimum Health Care Package (MHCP) as defined in HSSP II of 2005/06-2009/10. The

MHCP defines the basic services at the various levels of the health care system. The delivery of this

package is in part dependent on the availability of essential drugs for which NMS is charged with

procurement and distribution.

5. Health Systems Strengthening and Human Resources for Health

Project implementation is highly integrated in the management structures of NMS. All the staff at NMS

are involved in the implementation of this project to variable extent, with the Project Director, Coordinator,

Finance Controller, M&E and Laboratory Specialists exercising higher levels of efforts.

1. Target populations and coverage of target population or geographic area This project will contribute to the Uganda national supply of HIV/AIDS laboratory supplies and reagents necessary to increase demand and availability of Laboratory services that provide support functions for the various HIV program areas, but with special focus to commodities and supplies needed at government and faith based health facilities and few accredited NGO facilities. HIV/AIDS commodities and supplies to enhance services delivery are the central focus of this project. National Medical Stores (NMS) will have a sub partner relationship with Joint Medical Stores (JMS) that have product availability responsibilities for the faith based system. The partnership is guided by the national system for the procurement and distribution of essential health commodities of the Ministry of health. 2. Description of service delivery or other activity carried out The core mandate under this project is the development of sustainable and consistent supply of laboratory reagents and related commodities and the main activities for NMS and JMS include planning, forecast and quantification of laboratory commodities needs, procurement, storage and distribution of the same and strengthening the capacity of the health systems at district and national levels to adequately forecast and utilize available commodities. All the laboratory commodities and other essential drugs supplies from the government system will be distributed in an integrated manner and following the national guidelines on the distributions of essential medicines and credit line commodities of the Ministry of Health. 3. Integration with other health activities The drug supply system in Uganda operates within a framework defined by the National Health Policy (NHP) and reflected in the Health Sector Strategic Plan (HSSP). The delivery of Essential Medicines and Health Supplies (EMHS) on which the PEPFAR commodities is tagged is dependent on a broad network of interdependent institutional entities which include NMS. 4. Relation to the national program NMS operates within a statutory and legal framework defined by the laws of the GoU and within a policy and procedural framework defined by the Ministry of Health and codified in the National Drug Policy and Authority Act (NDPAA) and other related Acts. NMS supports the core functions of the Ministry of Health of ensuring attainment of the goals and objectives of the NHP and that the population of Uganda has access to the Minimum Health Care Package (MHCP) as defined in HSSP II of 2005/06-2009/10. The MHCP defines the basic services at the various levels of the health care system. The delivery of this

package is in part dependent on the availability of essential drugs for which NMS is charged with procurement and distribution. 5. Health Systems Strengthening and Human Resources for Health Project implementation is highly integrated in the management structures of NMS. All the staff at NMS are involved in the implementation of this project to variable extent, with the Project Director, Coordinator, Finance Controller, M&E and Laboratory Specialists exercising higher levels of efforts.