This is a new activity in FY08.

In FY07, the Supply Chain Management System (SCMS) provided a small amount of technical assistance

(TA) for OI drug procurement and distribution. This cost was covered under the funding to SMCS for ARV

Services. However, this year the amount of OI drugs is substantially increasing, and thus the TA cost is

substantially increasing. We are producing a separate activity narrative, with a separate budget, for this

activity in FY08.

SCMS will support the PEPFAR Vietnam 5-year strategy to provide palliative care to PLWHA, through the

provision of OI medications and procurement and distribution of methadone. SCMS will support the

following objectives in the procurement of OI drugs and methadone by the government of Vietnam (GVN)

(see Palliative Care Basic section): 1) Capacity building by enhancing the ability of governmental,

specifically the new Ministry of Health/Vietnam Administration for HIV/AIDS Control (MOH/VAAC) drug

management unit, international and local partners to systematically identify, prioritize and address

pharmaceutical management issues to improve access to and use of quality OI drugs and methadone; 2)

SCMS will also strengthen the pharmaceutical management of health facilities to ensure an uninterrupted

supply of quality pharmaceuticals to treat opportunistic infections and drug dependence; 3) Provide

technical assistance to VAAC and Ho Chi Minh City Provincial AIDS Committee (HCMC PAC) to monitor

and evaluate procurement, distribution and storage of OI drugs through collection of site-level data, and

development of quarterly reports that inform all partners about use of OI drugs, situation at clinical sites in

terms of drug supplies, actual use of clinical protocols and projections of future patients to allow strategic

planning for the government in terms of drug supplies and future procurement.

Specifically SCMS will: 1) Provide TA to enhance decision-making at the VAAC and HCMC PAC for

pharmaceutical and commodity management such as in-country forecasting and drug management and

play a coordinating role with partners' organization on pharmaceutical issues; 2) Work with the PEPFAR

care and treatment technical working group to provide TA to GVN partners to develop an approved list of OI

drugs to be procured and oversee and manage procurement, importation, storage, distribution and supply of

quality OI drugs and develop a distribution plan for implementation sites; 3) Closely collaborate and support

the VAAC pharmacy unit to build capacity and move towards coordination of procurement and distribution of

all OI drugs; 4) Strengthen drug management information systems to provide timely accurate information

regarding procurement, distribution, and use of OI drugs and methadone supplied by all partners; 5)

Develop and implement standard operating procedures (SOPs) at appropriate levels, train and supervise

their effective implementation; 6) Train pharmacy personnel on commodity management of HIV medicines,

methadone and commodities; 7) Provide TA to GVN to develop a monitoring and evaluation system based

at the site level in support of the national drug management monitoring and evaluation plan; and 8) Assist

GVN to disseminate information about drug management to partner organizations and implementation sites,

and share lessons learned with the broader community.

This is a continuing activity from FY07. Early funding is requested.

The Supply Chain Management System (SCMS) will support the following three objectives described in the

program narrative: 1) capacity building by enhancing the ability of governmental, specifically the new

Ministry of Health/Vietnam Administration for HIV/AIDS Control (MOH/VAAC) drug management unit,

international and local partners to systematically identify, prioritize and address pharmaceutical

management issues to improve access to and use of quality ARVs supported by the national treatment

guidelines. SCMS also strengthens the pharmaceutical and laboratory management capacity of referral,

provincial, district, and other facilities to ensure an uninterrupted supply of quality HIV/ AIDS pharmaceutical

and other commodities at ART service delivery sites; and 2) procurement and distribution of ARVs, on

behalf of all USG civilian and Department of Defense ART implementation sites to support 22,000 patients

by September 2009. All pediatrics formulations will be provided in coordination with the Clinton HIV/AIDS

Initiative (CHAI) which will be purchasing the entire supply for Vietnam, while SCMS will pay the

importation, storage and distribution costs for all sites, both PEPFAR and non-PEPFAR; and 3) information

sharing, as part of monitoring and evaluation functions, through collection of site-level data, and

development of monthly reports that inform all partners about uptake of ARV patients, the situation at

clinical sites in terms of drug supplies, actual use of clinical protocols, projections of future patients, and

international trends in ARV medicines which allow strategic planning for the PEPFAR team in terms of drug

supplies and future expansion for the PEPFAR program.

Specifically SCMS will: 1) provide technical assistance (TA) to enhance decision-making at VAAC, other

central agencies, and donors for HIV/AIDS-related pharmaceutical and commodity management such as in-

country forecasting and drug management, and play a coordinating role with partners' organizations on

pharmaceutical issues; 2) provide TA to partners and sites to clarify the implications of changes in treatment

guidelines, various funding scenarios, and changes in the market; manage procurement, importation,

storage, distribution and supply of quality ARVs, consistent with USAID procurement guidelines, based on

available funding, and develop a distribution plan for implementation sites; 3) closely collaborate and

support the VAAC pharmacy unit to build capacity and move towards coordination of procurement and

distribution of all ARVs; 4) strengthen drug management information systems to provide timely accurate

information regarding procurement, distribution, and use of ARVs supplied by all partners; 5) develop and

implement standard operating procedures (SOPs) at appropriate levels, and train and supervise their

effective implementation; 6) train pharmacy personnel on commodity management of ARVs and related

medicines and commodities; 7) operate a monitoring and evaluation (M&E) system based at the site level in

support of the national drug management M&E plan in close coordination with the PEPFAR SI technical

working group (TWG); and 8) disseminate information about ARV drug management to partner

organizations and implementation sites, and share lessons learned with the broader community.

This is a continuing activity from FY07. Early funding is requested.

The Supply Chain Management System (SCMS) will support the PEPFAR Vietnam 5-year strategy to

provide 22,000 persons with ART. SCMS will support the following three objectives: 1) capacity building by

enhancing the ability of governmental, specifically the new Ministry of Health/Vietnam Administration of

HIV/AIDS Control (MOH/VAAC) drug management unit, international and local partners to systematically

identify, prioritize and address pharmaceutical management issues to improve access to and use of quality

ARVs supported by the national treatment guidelines. SCMS will also strengthen the pharmaceutical and

laboratory management capacity of other health facilities to ensure an uninterrupted supply of

pharmaceutical and other commodities at ART service delivery sites; 2) procurement and distribution of

ARVs, on behalf of all USG civilian and Department of Defense ART implementation sites to support 22,000

patients by September 2009. All pediatric formulations will be provided in coordination with the Clinton

Foundation who will be purchasing the entire supply for Vietnam, while SCMS will pay the importation,

storage and distribution costs for all sites, both PEPFAR and non-PEPFAR; and 3) information sharing, as

part of monitoring and evaluation functions, through collection of site-level data, and development of

monthly reports that inform all partners about uptake of ARV patients, situation at clinical sites in terms of

drug supplies, actual use of clinical protocols, projections of future patients, and inform partners of

international trends in ARV medicines which allow strategic planning for the PEPFAR team in terms of drug

supplies and future expansion for the PEPFAR program.

Specific activities supported by these funds will include: 1) ongoing provision of pharmaceutical site

readiness at new and continuing PEPFAR-supported sites through training of pharmacy staff, site

monitoring, and on-going quality assurance (QA) and supportive supervision. SCMS will directly train 200

pharmacy staff at clinical sites; 2) SCMS will develop new standard operating procedures (SOPs), and

implement existing SOPs developed in previous years with PEPFAR funding, at the site level for

dispensers, at the pharmaceutical storage (CPC#1) warehouse, and at the ministry level; 3) SCMS will also

develop a pre-service training program in collaboration with Ho Chi Minh City School of Pharmacy. By

training the students in HIV/AIDS, medications related to treatment of HIV/AIDS and modern dispensing

practices, SCMS will help ensure that there are on-going human resources to support HIV treatment

programs in Vietnam. At the HCMC School of Pharmacy 100 pharmacy students will be trained; 4) SCMS

will also support procurement, management and distribution of CD4 reagents and laboratory supplies, which

will include visits to treatment sites, training of laboratory specialists at sites in commodity management,

and participation in a team of laboratory specialists within PEPFAR Vietnam. ARV service funding will go to

support procurement of CD4 reagents for FACS count machines for non-military ART sites, in accordance

with Vietnamese National Standard treatment guidelines and USAID procurement regulations. DOD will

procure CD4 reagents for military sites though a separate mechanism.

This is a new activity in FY08.

The Supply Chain Management System (SCMS) will support provincial and district antiretroviral service

delivery sites by ensuring the sites are provided with uninterrupted supplies of quality laboratory equipment,

reagents, and the materials that are necessary to diagnose diseases related to HIV/AIDS. While many of

these items are readily available domestically, materials needed to conduct molecular diagnostic tests must

be purchased on the international market. However, neither SCMS, nor Vietnam's Ministry of Health, have

permission to engage in import activities. SCMS will therefore have to use local vendors, who have the

proper import licenses, to procure the needed items. In order to avoid potential supply interruptions, these

funds will be used to cover any additional charges levied by third-party vendors.