The goal of the Supply Chain Management System project (SCMS) is to ensure an uninterrupted supply of HIV/AIDS prevention and treatment commodities to government and NGO facilities in Zambia.

SCMS activities and procurements benefit all nine provinces in Zambia. USG-funded ARV drugs, HIV rapid test kits, OI/STI drugs and laboratory commodities will be placed in the Government of the Republic of Zambia's (GRZ) central warehouse, Medical Stores Limited (MSL), where all public sector and accredited Non Governmental Organizations (NGO)/Faith Base Organizations (FBO) /Community Base Organizations (CBO)/work-place/private sector HIV/AIDS programs will have access to these critical supplies.

In September of 2009, the Office of the U.S. Global AIDS Coordinator announced its intention to make available up to $15 million to the President's Emergency Plan for AIDS Relief, Zambia Team (PEPFAR/Zambia) in FY 2010. PEPFAR/Zambia was chosen as one of the countries which could significantly improve the coverage of ARV prophylaxis, and change its regime from single dose nevirapine to more efficacious PMTCT regimens for mother and infant pairs. PEPFAR/Zambia has continued to make tremendous progress in counseling and testing coverage but lags behind in the provision of ARV prophylaxis for HIV positive women and their exposed infants. This plan therefore, demonstrates how these FY 2010 funds can assist PEPFAR/Zambia's advancement in reaching 80% of HIV positive pregnant women and their HIV exposed infants with more efficacious PMTCT regimens.

With an understanding of the need to strengthen efforts to reduce infections and the resource burden of the HIV/AIDS program in Zambia, in its Country Operational Plan (COP) 2010 presentation PEPFAR/Zambia indicated its intention to enhance the PMTCT program to further strengthen its prevention emphasis. PEPFAR/Zambia has achieved many successes in its PMTCT program, yet the impact on pediatric HIV infection has only been modest. There is fall-off in the cascade such that less than half of women enrolled in the program receive ARV prophylaxis. The PMTCT plus-up funds will be utilized to further jump start the expansion and strengthening of services required to sustain highly effective PMTCT. An effective PMTCT program will lead to significant reduction in the incidence of pediatric HIV cases, and consequently savings in costs due to a reduction in pediatric HIV care costs. Improved efficiencies in service delivery will be utilized to sustain an effective PMTCT program in future years, and will compensate for the additional initial increase in prophylactic ARVs.

This plan outlines, therefore, how SCMS will use these one-time funds, in order to achieve the following:-

Undertake a one-time procurement for ART commodities for the PMTCT program

Improving service delivery

Despite the successes of the PMTCT program, the majority of HIV+ women are reached with only single dose nevirapine. In order to meet the objectives of the plus-up funds, the USG program will improve the quality of the PMTCT services and promote integration with pediatric and adult ART, child survival, nutrition and reproductive health services. The activities planned under this strategy will initialize implementation of more efficacious regimens through strengthening logistic/supply systems, procurement of ARVs and other PMTCT supplies and specimen systems. Since this is a one-time funding activity, the costs of the initialization of these activities, will be factored into routine planning for subsequent years.

One time funding will be considered for the following:

4.1 Establishment of family centered services HIV/AIDS services;

4.1.1. Integration of ART in the PMTCT; and

4.1.2. Promotion of one stop center where HIV positive women can access more efficacious ARV prophylaxis and/or HAART through stationary or mobile services depending on the human resources or the level of the facility;

Activities to achieve this strategy will involve one time start up costs for commodities and supplies for a further 2 years.

4.2 Procurement of PMTCT commodities;

4.2.1. Laboratory reagents and supplies

Improving service delivery

Despite the successes of the PMTCT program, the majority of HIV+ women are reached with only single dose nevirapine. In order to meet the objectives of the plus-up funds, the USG program will improve the quality of the PMTCT services and promote integration with pediatric and adult ART, child survival, nutrition and reproductive health services. The activities planned under this strategy will initialize implementation of more efficacious regimens through strengthening logistic/supply systems, procurement of ARVs and other PMTCT supplies and specimen systems. Since this is a one-time funding activity, the costs of the initialization of these activities, will be factored into routine planning for subsequent years.

One time funding will be considered for the following:

4.1 Establishment of family centered services HIV/AIDS services;

4.1.1. Integration of ART in the PMTCT; and

4.1.2. Promotion of one stop center where HIV positive women can access more efficacious ARV prophylaxis and/or HAART through stationary or mobile services depending on the human resources or the level of the facility;

Activities to achieve this strategy will involve one time start up costs for commodities and supplies for a further 2 years.

4.2 Procurement of PMTCT commodities;

4.2.1. ARVs;