This activity links with the Partnership for Supply Chain Management System (SCMS) activities in HIV Test

Kit procurement and Policy Analysis/Systems Strengthening, as well as with the Government of the

Republic of Zambia (GRZ), the Center for Infectious Disease Research in Zambia, Catholic Relief

Services/AIDS Relief, Zambia Prevention, Care and Treatment Partnership (ZPCT), University Teaching

Hospital, Churches Health Association of Zambia, Japanese Development Agency (JICA), the Global Fund

for AIDS, Tuberculosis and Malaria (GFATM), UNITAID, and the Clinton Foundation HIV/AIDS Initiative.

The purpose of this activity is to continue to strengthen and expand the supply chain system for HIV test kits

that are procured by the US Government (USG), GFATM, JICA, UNITAID, GRZ, and other partners.

USAID | DELIVER PROJECT, in cooperation with the Medical Stores Limited (MSL), will ensure a sufficient

supply of HIV test kits at service delivery and mobile sites through an efficient and accountable logistics

supply chain system. This activity was preceded by several key initiatives in FY 2005 and 2006 conducted

by JSI/DELIVER, and by The USAID | DELIVER PROJECT in FY 2007; which began to implement the

revised HIV test kit logistics supply system nationwide, and to coordinate and centralize the management of

HIV tests.

Specifically, the USAID | DELIVER PROJECT is centralizing the management of HIV test kit procurement

information and planning; providing technical assistance to GFATM Principal Recipients in development of

HIV tests Procurement and Supply Management Plans; conducting the national HIV tests supply chain

design; and training more than 1,000 laboratory technicians, counseling and testing (CT) counselors,

nurses, and district and provincial supervisory personnel. The training offered provides personnel with an

orientation to the new standard operating procedures for the recently designed HIV test kit supply chain

system. The USAID | DELIVER PROJECT is also updating the design of a software program that was

installed to manage the national HIV test kit inventory control and information system at the central level.

This computer program is placed at the newly formed Ministry of Health (MOH) Logistics Management Unit

(LMU); which is based at the MOH's central warehouse, Medical Stores Limited (MSL). This software

assists GRZ in collecting and analyzing national HIV test consumption data.

In FY 2008, The USAID | DELIVER PROJECT will expand efforts to strengthen the effectiveness, efficiency,

and sustainability of the national HIV test logistics system. Activities will include:

1. Coordinating HIV tests forecasting and procurement planning capacity at the central level, with special

focus on the LMU;

2. Quantifying required HIV tests, consistent with resources and policies for rapidly scaling-up CT

programs;

3. Reinforcing the standardization of HIV tests inventory control procedures at central, district, and service

delivery sites, including the documentation and dissemination of HIV tests logistics policies and procedures;

4. Developing and installing a software tool for laboratories and CT sites to collect and use for ordering HIV

tests. For laboratories the software development will be in conjunction with ZPCT, Centers for Disease

Control (CDC), and SCMS's efforts to develop a compressive laboratory management software package.

At a minimum, this software will allow the sites to print off a hard copy of the current manual form to fill out

manually at the site; but several sites will use the optimal process of downloading electronic reports

generated on-site and transmitting the reports to the MOH LMU central database.

5. Improving HIV tests logistics decision-making processes at the central level through the use of

aggregated data from laboratories and CT sites as provided through the national HIV tests logistics

management information system (LMIS);

6. Improving the warehousing conditions and practices at both the central and facility levels;

7. Monitoring and evaluating the HIV test supply chain and making improvements as needed; and

8. Collaborating with the SCMS project and other partners and stakeholders to address the broader area of

HIV/AIDS commodity security.

To complete these activities, The USAID | DELIVER PROJECT, in collaboration with the MOH, MSL, and

other partners, will train up to 1,000 additional key personnel (e.g., doctors, nurses, pharmacists, and

laboratory staff from governmental and non-governmental organizations) in the new national HIV test kit

logistics management system. Moreover, at the central level, The USAID | DELIVER PROJECT will

coordinate multi-year national HIV test forecasts and procurement plans with all key partners, including

GRZ and donors. The USAID | DELIVER PROJECT will also be an active member on appropriate national

technical working groups, such as the National HIV/AIDS/STI/TB Council's Voluntary Counseling and

Testing (VCT) and Home-Based Care Technical Working Group. Finally, The USAID | DELIVER PROJECT

will provide direct support to the GFATM Principal Recipients through participation in the Zambia GFATM

Steering Committee and provision of assistance in developing proposals and Procurement and Supplies

Management (PSM) Plans for GFATM/Geneva.

Through the continuing development of the National HIV Test Logistics System and skills transfer to the

MOH and non-governmental staff, it is anticipated that these activities will contribute significantly to the

MOH's capacity to efficiently manage the National HIV Test Logistics System.

All FY 2008 targets will be reached by September 30, 2009.

This activity relates to activities with the Partnership for Supply Chain Management System (SCMS)

activities Antiretroviral (ARV) Drug Procurement and Other Policy/Systems Strengthening, Government of

the Republic of Zambia (GRZ), Center for Infectious Disease Research in Zambia, Catholic Relief

Services/AIDS Relief, Churches Health Association of Zambia, University Teaching Hospital, Zambia

Prevention, Care and Treatment Partnership, Global Fund for AIDS, Tuberculosis and Malaria (GFATM),

UNITAID and the Clinton Foundation HIV/AIDS Initiative.

The purpose of this activity is to expand assistance for ensuring that ARV drugs procured by the US

Government (USG), GFATM, and other partners are in sufficient supply and provided to Zambians at

service delivery sites through an efficient and accountable logistics supply chain system. This activity was

preceded by several key initiatives in FY 2005 and 2006 conducted by the JSI/DELIVER project, and by the

USAID | DELIVER PROJECT in FY 2007. Their scope of work was to implement the revised ARV drug

logistics supply chain nationwide and to coordinate and centralize the management of ARV drugs.

Examples of previous activities include: centralizing the management of ARV procurement information and

planning; providing technical assistance to GFATM Principal Recipients in development of ARV drug

Procurement and Supply Management Plans; and training more than 700 warehouse staff, pharmacists,

and other key personnel in the management of ARV drug procurement and logistic systems.

The USAID | DELIVER PROJECT is also updating a specially designed software program that was installed

to manage the national ARV drug inventory control and information system. This computer program is

placed at the Ministry of Health (MOH) Logistics Management Unit (LMU) based at the MOH's central

warehouse, Medical Stores Ltd. (MSL). This software assists GRZ to effectively manage the national ARV

logistics system though the collection of essential logistics data, and management of stock levels at every

service delivery site.

In FY 2008, the USAID | DELIVER PROJECT will expand efforts to strengthen the effectiveness, efficiency,

and sustainability of the national ARV drug logistics system. Activities will include:

1. Supporting the MOH in coordinating ARV drug forecasting and procurement planning capacity at the

central level, with special focus on the LMU.

2. Quantifying required ARV drugs, consistent with resources and policies for rapidly scaling-up

antiretroviral therapy (ART) programs.

3. Reinforcing the standardization of ARV drug inventory control procedures at central, district, and service

delivery sites, including the documentation and dissemination of ART logistics policies and procedures.

4. Developing and installing a software tool for ART sites to collect and use for ordering ARV drugs;

significantly reducing the time and effort required for ordering and reporting. At a minimum, this software

will allow the sites to generate the current manual form from the computer on-site; with the optimal process

being used at selected sites, where the sites download the reports and transmit them electronically to the

MOH LMU central database.

5. Improving ART logistics decision-making processes at the central level through use of aggregated data

from ART sites as provided through the national ART logistics management information system (LMIS).

6. Improving the warehousing conditions and practices at both the central and facility levels.

7. Monitoring and evaluating the ART supply chain and making improvements as needed; and.

8. Collaborating with the SCMS project and other partners and stakeholders to address the broader area of

HIV/AIDS commodity security.

To complete these activities, the USAID | DELIVER PROJECT, in collaboration with MOH, MSL, and other

partners, will train up to 50 additional key personnel (e.g., doctors, nurses, pharmacists, from the MOH and

non-governmental organizations) in both the manual and newly automated ART logistics management

system. Moreover, at the central level, the USAID | DELIVER PROJECT will coordinate multi-year national

ARV drug forecasts and procurement plans with all key partners, including GRZ and donors. The USAID |

DELIVER PROJECT will also be an active member on appropriate national technical working groups, such

as voluntary counseling and testing (VCT)/ Home-Based Care; Treatment, Care, and Support; and ART

Implementation working groups. Finally, USAID | DELIVER PROJECT will provide direct support to the

GFATM Principal Recipients through participation in the Zambia GFATM Steering Committee and provision

of assistance in developing proposals and Procurement and Supplies Management (PSM) Plans for

GFATM/Geneva.

Through the continuing development of the national ARV drug logistics system and skills transfer to MOH

and non-governmental staff, it is anticipated that these activities will contribute significantly to the MOH's

capacity to efficiently manage the national ARV drug logistics system.

All FY 2008 targets will be reached by September 30, 2009.

This activity relates to activities with the Partnership for Supply Chain Management System (SCMS)

activities Antiretroviral (ARV) Drug Procurement and Other Policy/Systems Strengthening, Government of

the Republic of Zambia (GRZ), Center for Infectious Disease Research in Zambia, Catholic Relief

Services/AIDS Relief, Churches Health Association of Zambia, University Teaching Hospital, Zambia

Prevention, Care and Treatment Partnership, Medical Stores, Limited (MSL), Global Fund for AIDS,

Tuberculosis and Malaria (GFATM), UNITAID and the Clinton Foundation.

The purpose of this activity is to improve the availability and distribution of opportunistic infection (OI) drugs

as part of the overall treatment of HIV/AIDS patients. Currently ARV drugs and HIV tests are managed

through vertical logistics management information systems (LMIS) and inventory control systems, while

being integrated into the Medical Stores Limited (MSL) transportation/distribution system of essential drugs

to districts and hospitals. For products such as opportunistic infection (OI), malaria, pain relief and TB

drugs, there is an integrated essential drug system that is currently very weak. The essential drug system

has no functioning logistics management information system to collect usage data from the service delivery

points and therefore suffers from poor forecasting and procurement planning. For many of the products

there is a severe shortage of funds for sufficient procurement to meet needs (a full supply system). The

lack of data has made it difficult to estimate what the true needs might be.

In order to improve the supply situation for OI drugs, in addition to the USG procurement that will occur

through the SCMS project, the essential drugs logistics system needs to be developed into an effective and

efficient supply chain. As part of a multi-year system development strategy, the first year objectives would

be the following:

1. Establish a formalized system for national quantification of needs.

2. Establish a transparent management system at the central level for forecasting needs and for effective

procurement planning.

3. Produce an ABC/VEN analysis of products at the national level and formalize a priority product list.

4. Design a new national Essential Drug logistics system.

Upon receipt of funding, the USAID | DELIVER PROJECT will undertake the following key activities in order

to achieve the above objectives:

1. Assess key components of the national system for supplying essential drugs with an emphasis on OI,

pain relief drugs, and condoms.

2. Provide technical assistance to MSL for proper storage and distribution of essential drugs (ED), including

staff skills training out of Zambia

3. Conduct national discussion on setting priorities for procurement of products (ABC/VEN analysis). This

will include provincial stakeholder meetings and a high level conference/ workshop.

4. Conduct national stock-taking exercise to determine current stock levels for all ED products in the

Ministry of Health's (MOH) national system.

5. Conduct national quantification exercises for key product categories.

6. Design and implement a central level ED pipeline monitoring and procurement planning system using

available software, to track key products identified in the ABC/VEN analysis.

7. Assist the MOH, working closely with the director of the drug budget line, to coordinate procurements of

OI drugs from the various funding sources.

8. Conduct a national transportation study to explore the feasibility of deliveries from MSL to the health

center level, to better ensure that drugs are delivered to all service delivery sites.

9. Design and implement a two-week comprehensive supply chain management course targeted for the

various program managers and technical officers in the MOH (including the LMU) concerned with the key

product categories. (The number of key personnel to be trained is 25).

10. Conduct a national logistics system design workshop.

For all of these essential drug improvement activities, the USAID | DELIVER PROJECT will take advantage

of the synergistic activities taking place in the other commodity areas in which it and the SCMS project will

be working: ARVs, HIV Rapid Tests, Contraceptives, Cotrimoxazole, Malaria, and Laboratory Supplies.