PEPFAR's annual planning process is done either at the country (COP) or regional level (ROP).
PEPFAR's programs are implemented through implementing partners who apply for funding based on PEPFAR's published Requests for Applications.
Since 2010, PEPFAR COPs have grouped implementing partners according to an organizational type. We have retroactively applied these classifications to earlier years in the database as well.
Also called "Strategic Areas", these are general areas of HIV programming. Each program area has several corresponding budget codes.
Specific areas of HIV programming. Budget Codes are the lowest level of spending data available.
Expenditure Program Areas track general areas of PEPFAR expenditure.
Expenditure Sub-Program Areas track more specific PEPFAR expenditures.
Object classes provide highly specific ways that implementing partners are spending PEPFAR funds on programming.
Cross-cutting attributions are areas of PEPFAR programming that contribute across several program areas. They contain limited indicative information related to aspects such as human resources, health infrastructure, or key populations programming. However, they represent only a small proportion of the total funds that PEPFAR allocates through the COP process. Additionally, they have changed significantly over the years. As such, analysis and interpretation of these data should be approached carefully. Learn more
Beneficiary Expenditure data identify how PEPFAR programming is targeted at reaching different populations.
Sub-Beneficiary Expenditure data highlight more specific populations targeted for HIV prevention and treatment interventions.
PEPFAR sets targets using the Monitoring, Evaluation, and Reporting (MER) System - documentation for which can be found on PEPFAR's website at https://www.pepfar.gov/reports/guidance/. As with most data on this website, the targets here have been extracted from the COP documents. Targets are for the fiscal year following each COP year, such that selecting 2016 will access targets for FY2017. This feature is currently experimental and should be used for exploratory purposes only at present.
Per April09 Reprogramming activity zeroed.
NEW ACTIVITY
This activity, awarded through the new Communities & Corridors RFA, a full and open competition RFA
comprised of AB, C&OP and CT program area funds, will replace most discontinued sexual prevention and
counseling and testing activities previously managed by USAID. Priorities for this activity are region and
population-specific, epidemiologically responsive interventions and building Mozambican capacity to plan,
implement and evaluate quality Sexual Transmission Prevention (STP) and Counseling and Testing (CT)
programs. This activity, with the RFA award expected in late FY09, will allow strategically formed consortia
of partners, 50% of which is encouraged to be Mozambican, to promote behavior change, especially for
reduction of multiple and concurrent partnerships (MCP) at the individual, family, community, and social and
environmental levels; build capacity of local leaders and community agents of change to lead the response
to the epidemic; and support systems and services for CT.
Despite a multi-pronged approach to both prevention and treatment for a sustained period of time (10
years), few regions have experienced declines in HIV rates. Tete and Manica are the noted exceptions.
Other regions have experienced steep increases including Maputo, Gaza, Sofala and Niassa. There is also
new evidence from the recent Mozambique modes of transmission study, the 2006 SADC Southern African
epidemiological analysis and the 2007 sentinel surveillance survey that the key driver of Mozambique's
HIV/AIDS epidemic is the pervasive practice of MCP which, in Mozambique, primarily involves HIV
transmission amongst the general population's consenting adults (GCA) who are usually over the age of 25.
Experts agree that this is the main driver of the epidemic. There is growing consensus that the key
intervention to address this pervasive behavior is to tackle this problem through a direct and multi-tiered,
systematic prevention strategy which first and foremost directly takes aim at this particular contact pattern.
Geographically targeted community mobilization and behavior change communications (BCC) will focus on
"hot spots", corridors and the highest prevalence regions (Maputo and Gaza provinces; Beira and Nacala
corridors). The second highest prevention priority for USG assistance will be supporting and capacitating
long-term, well-organized, aggressive community-based approaches to the problem in the highest
prevalence regions and corridors noted above. One such program currently supported by USAID and other
donors is the ADPP war model which harnesses the talent and enthusiasm of young adults to battle the
epidemic in their own communities which have been nurtured by long-standing misinformation and weak
reproductive health services. Other models such as the FDC's work to mobilize faith based and political
leaders are working to change social norms.
Building an army of committed HIV prevention leaders and service providers is quintessential to breaking
down misinformation and dangerous practices and to increasing risk perception and self efficacy. This
program will develop a strategy to take the national BCC program to the local levels. This activity will build
partnerships with local religious and traditional leaders and enlist them in advocating for the reduction of
multiple and concurrent partnerships in their communities. Community leaders will be trained in focused
messaging and counseling. Peer educators will also be trained in an effort to convey messages increasing
risk perception and the reduction of concurrent partnerships. This activity will reinforce the messages that
will be broadcast in the national and regional mass media program in an effort to saturate communities with
focused messages in an effort to change social norms on concurrent partnerships.
A survey on alcohol use and abuse in rural areas will be carried out by CDC which will provide critical
information on alcohol use and its effect on risky behaviors and violence in the family. Community based
counseling and testing will also be supported. A cadre of HIV counselors at HIV treatment sites and
outreach teams will be trained to provide support and prevention advice to HIV positive clients. These
counselors will supply condoms to clients that are sexually active and encourage testing by their partners.
New/Continuing Activity: New Activity
Continuing Activity:
Emphasis Areas
Gender
* Addressing male norms and behaviors
* Increasing gender equity in HIV/AIDS programs
* Increasing women's access to income and productive resources
* Reducing violence and coercion
Health-related Wraparound Programs
* Family Planning
Workplace Programs
Human Capacity Development
Estimated amount of funding that is planned for Human Capacity Development
Public Health Evaluation
Food and Nutrition: Policy, Tools, and Service Delivery
Food and Nutrition: Commodities
Economic Strengthening
Education
Water
Table 3.3.02:
implement and evaluate STP programs and quality CT program. This activity, with the RFA award
expected in mid FY09, will allow strategically formed consortia of partners, 50% of which is encouraged to
be Mozambican, to promote behavior change, especially for reduction of multiple, concurrent partnerships
(MCP) at the individual, family, community, and social and environmental levels; build capacity of local
leaders and community agents of change to lead the response to the epidemic; and support systems and
services for Counseling and Testing (CT).
Other regions have experienced steep increases including Maputo, Gaza, Sofala and Niassa. This activity
will target these high prevalence areas made more vulnerable by existing transport corridors. Specifically,
this activity will Intensify mobilization of communities in epidemiologically significant provinces and within
those regions at hot-spots with selected target groups amongst the most at-risk populations (MARPS) which
includes commercial sex workers and their clients, male and female prisoners, migrant workers, refugees
fleeing the on-going crisis in Zimbabwe, and the highly mobile truckers who move through and work in high
prevalence corridors, (Military, police and border guards are covered under the DOD prevention programs);
A key characteristic of this new approach is that it engages the Mozambican private sector and the GRM in
the next phase of a bold war on this deadly epidemic. This approach focuses uniquely on the drivers of the
epidemic including multiple partner and high risk behavior and on the geographic targeting of some MARPS
in "hot spot corridors" or regions with greater influxes of highly transient populations where high risk
behavior is most common, applies innovative use of host country organizations, and resources, the private
sector and known evidence-based practices in behavior change communications and the use of various
mass media channels, product specific social marketing with clear messages on male and female condom
use for GCAs and MARPS. The approach intends to build demand for safe and effective condom use and
discourage the social norms which sanction multiple partner behaviors. The new approach will build on the
best practices for broad community mobilization in the highest prevalence provinces and corridors.
counselors will supply condoms to clients that are sexually active and encourage testing by their partners. s
been identified in Moatize district in Tete province. Brazilian mining company, Vale do Rio Doce (Vale), one
of the largest companies in the world, will begin construction on transport and excavation facilities to extract
these deposits beginning in calendar year 2009. While recent surveillance shows that prevalence in Tete
has stabilized, a portion of the RFA, through a possible PPP with Vale, will ensure prevention services, as
part of Value to workers and families affected by this major project. Extraction of the coal coincides with
completion of the renovation of the Sena railroad which will link the Moatize coal region to the port of Beira.
Table 3.3.03:
Under guidance from USAID's Procurement Management Office and Regional Legal Advisors, for COP 09,
USAID is discontinuing the majority of its agreements with its partners, including those implementing sexual
prevention programs. This activity, awarded through the new Communities & Corridors RFA, a full and
open competition RFA comprised of AB, C&OP and CT program area funds, will replace most discontinued
sexual prevention and counseling and testing activities previously managed by USAID. Priorities for this
activity are region and population-specific, epidemiologically responsive interventions and building
Mozambican capacity to plan, implement and evaluate STP programs and quality CT program. This
activity, with the RFA award expected late in mid to late FY09, will allow strategically formed consortia of
partners, 50% of which is encouraged to be Mozambican, to promote behavior change, especially for
reduction of multiple, concurrent partnerships (MCP) at the individual, family, community, and social and
to the epidemic; and support systems and services for Counseling and Testing (CT).
AB funding will target General Population Adults and some Youth (General Population: 66% of STP
activities under this RFA); C&OP funding will target key MARPs in select districts with promotion of condom
use and service uptake (MARPS 34% of STP activities under this RFA); and CT funding will provide for
facility and community-based CT and a national Quality Assurance in CT program to the Ministry of Health
(MoH).
Geographic locations for activities under the Communities & Corridors RFA will be in Maputo and Gaza
provinces and in districts and ‘hot spots' contained inside the Maputo, Beira and Nacala corridors. CT
services sites will concentrate in the Beira and Nacala corridors, with some services in Tete province.
Locations for MARP-focused activities will be guided by indicators and assessments for these populations,
namely, for CSWs- Cabo Delgado, Nampula City, Beira City and Maputo City; and for men-focused, work-
place programs, key districts in Sofala, Tete and Nampula through potential Public-Private Partnerships
(PPPs). Earmarked AB and C&OP funds to support potential PPPs include the Carr Foundation/Gorongosa
conservation reserve and National Park; the Vale do Rio Doce Coal Mining Project and CETA, a
Mozambican construction company. PPP prevention programs will target workers, their families and the
communities affected or displaced by these projects.
The primary focus of the AB component of this activity is on reduction of Multiple, Concurrent Partnerships
(MCP). Findings from the recent Mozambique modes of transmission study, the 2006 SADC Southern
African epidemiological analysis and the 2007 sentinel surveillance survey that the key driver of
Mozambique's HIV/AIDS epidemic is the pervasive practice of multiple concurrent partners (MCP) which in
Mozambique primarily involves HIV transmission amongst the general population's consenting adults (GCA)
who are usually over the age of 25. Experts agree that this is the main driver of the epidemic and there is
growing consensus that the key intervention to address this pervasive behavior is to tackle this problem
through direct and multi-tiered, systematic prevention strategy which first and foremost directly takes aim at
this particular contact pattern. Interpersonal Communications (IPC) prevention activities will address the
underlying socio-cultural factors that drive MCP and other risky practices and norms, as well as risk
perception, locus of control, and fatalism. Community prevention programs will be linked with services for
STI and HIV/AIDS treatment and care, including positive prevention. Community, school, work-place and
faith-based setting activities will align and reinforce activities under the Mass Media Prevention RFA. Youth
programs will follow recommendations from MEASURE/Evaluation and will focus on building life skills to
reduce risk. Programs targeting non-OVC 10-14 year olds focus on delay of sexual initiation but also
provide information on the protective factors of partner reduction for sexually active individuals.
In addition to General Population Adults activities outlined above, AB funds will support programs focused
on increasing male engagement in HIV prevention and responsible behavior as partners and as fathers in
the community and work place setting. Some bar-based interventions and programs focused on alcohol
abuse and risk behavior will be included in urban and/or work place settings.
C&OP funds under the Communities & Corridors RFA will target, specficially, MARP populations of
commercial sex workers and clients, PLWHA and miners/migrant workers connected to potential Public
Private Partnerships. In addition to IPC BCC programs designed to target these different MARPs, C&OP
funded activities will include condom promotion, condom social marketing, and promotion of service uptake
for CT, STI and HIV treatment.
This activity has earmarked funds for possible PPPs with companies in the mining, tourism/conservation
and construction industries. One of the world's largest deposits of coal has been identified in Moatize
district in Tete province. Brazilian mining company, Vale do Rio Doce (Vale), one of the largest companies
in the world, will begin construction on transport and excavation facilities to extract these deposits beginning
in calendar year 2009. While recent surveillance shows that prevalence in Tete has stabilized, a portion of
the RFA, through a possible public-private partnership with Vale, will ensure prevention services, as part of
Value to workers and families affected by this major project. Extraction of the coal coincides with
C&OP and AB funds will also support expansion of Positive Prevention (PP) community-based activities by
providing PLWHA and sero-discordant couples focused messages and prevention packages in partnership
with USG home-based care activities. PP activities will also utilize CDC-managed PP training resources
and materials.
Male and female condom social marketing will deliver life saving products in places where MARPS
congregate. The program will ensure wide availability of condoms through large and small commercial
outlets and non-traditional outlets, interpersonal communications for risk reduction, mass media messages,
and design, production, and distribution of print materials for targeted high-risk populations. BCC messages
on radio will encourage sexually active adults to remain faithful to one partner and otherwise to make
consistent use of condoms. Young couples and sexually active youth will be encouraged to prevent
unwanted pregnancies and transmission of STIs/HIV through condom use. Female condoms will be added
to both the commercial and free distribution contraceptive product line.
CT funds for the Communities & Corridors activity will specifically fund facility based CT in Health and PICT
and community-based CT in Health services, training and support. Approximately 200,000 is earmarked to
support the MoH's efforts to begin a National Quality Assurance in CT program, following the Kenya model.
Activity Narrative: A July 2008 Interagency CT Technical Assistance Team assessed CT in MOzambique and provided
guidance and recommendations to PEPFAR's support of MoH's CT programs. Mozambique currently
does not have one National CT Guideline defining minimum standards for CT programs. This activity will
support the MoH to determine
minimum standards for all CT services, including standard definitions for 'confidentiality', 'consent', and
'counseling'; quality definitions for both counseling and testing; site standards and requirements for CT staff.
This activity, together with funding from the Mass Media RFA activity, will also support campaigns and
promotion for CT, with strong focus on men and couples. This activity will also ensure linkages with the AB
and C&OP activities of the Communites and Corridors activity, referring HIV negative clients to community
based BCC programs and referring HIV positive clients to positive prevention activities. This activity will
also have MARP specific CT activities in work place or community settings. Night clinics will ensure access
to sex workers and clients. Work place based CT will be integrated with the PPP activities.
Community based CT (mobile, satellite and to a limited extent, house to house) will also be supported under
this activity and all CCT sites will have formal relationships with facilities.
Provider-initiated CT (PICT) will be implemented in all facilities and PICT training provided to facility
HCWers.
Program Budget Code: 15 - HTXD ARV Drugs
Total Planned Funding for Program Budget Code: $13,541,522
Total Planned Funding for Program Budget Code: $0
Program Area Narrative:
The Ministry of Health (MOH) Center for Medicines and Medical Supplies (CMAM) is responsible for managing and implementing
logistics for all medicines and medical supplies, which includes the following HIV/AIDS program commodities: ARVs, OI, STI and
other palliative care drugs, rapid HIV test, and clinical laboratory reagents and consumables. The CMAM managed supply chain
is a fully integrated supply chain, which handles the essential drugs program and commodities for all priority programs such as
HIV, TB, and Malaria. CMAM currently reports to the MOH National Medical Care Department (DNAM), which in turn reports to
the MOH. CMAM is the main beneficiary of USG support in the area of commodity and logistics support. This support through
PEPFAR reinforces the efforts of the Presidential Malaria Initiative to ensure a reliable supply of anti-malaria drugs and test kits.
CMAM is responsible for forecasting needs, conducting procurement, coordinating importation, managing the central warehouses
in Beira and Maputo, and managing the distribution to the provincial warehouses and hospitals. CMAM assumed direct
responsibility for conducting procurement, distribution and central warehouse management in 2008. In September 2008, CMAM
was officially mandated to take over from the MOH Laboratory Section the responsibility for the forecasting, procurement, and
distribution of Laboratory commodities, including rapid HIV tests, reagents and consumables for clinical laboratories, including
those that support HIV care and treatment.
ARVs, OI and STI drugs financed by PEPFAR and procured by the Supply Chain Management Systems (SCMS) enter the CMAM
importation and distribution system and become MOH property upon arrival in Mozambique. Virtually all other donor support for
ARV procurement is managed by CMAM, which ensures complete coordination of all ARV procurement for Mozambique,
regardless of the source of financing.
USG support to the national ARV supply: In FY08, SCMS procured $10,138,020 worth of ARVs (representing 72% of the national
ARV drug procurement and supply), with Clinton Foundation/CHAI UNITAID donating almost 100% of the pediatric needs and
adult 2nd line regimens, and CMAM procuring the remainder of ARV drug needs using Global Fund and Common Fund sources.
In the past, other USG treatment partners have also procured and managed ARVs; however, since FY08 SCMS is responsible for
the procurement of all ARVs financed by PEPFAR in Mozambique
As of end August 2008, 115,665 patients were on ART nationally, including 8,112 children. According to official MOH data,
Mozambique is still on track to achieve the 2008 total target of 132,280 in treatment on December 31, including 8,855 children.
Estimated patients based on the MOH targets for end 2010 are 190,000 ART patients, of which approximately 18,000 will be
children. Although the country has faced challenges in recent years with scaling up pediatric treatment, the goal is to increase
pediatric treatment to at least 10% of total ART patients. With the revised WHO pediatric treatment guidelines and expanded
access to DBS PCR in FY08 and FY09, USG expects to reach the national goal.
As of May 2008, 99.4% of all ART patients were on a first-line regimen, of which 83% were on d4T+3TC+NVP. Only 6.4% of
patients were on an Efavirenz-based first line regimen. Given the low percentage of patients being switched to 2nd line-based
regimens and the insufficient capacity for scaling up HIV viral load testing in the near future, the National Therapeutic Committee
in October 2007 revised the percentage of patients switching to a 2nd line regimen downward from 2% to 1.4%. The proportion of
USG funds used for generic ARVs has increased substantially. In FY08, 95% of all ARVs procured by USG through SCMS were
generic.
During COP09 USG will provide $11,600,000 of funds to SCMS for the procurement of adult firstline ARVs, in line with the
national ARV supply plan. This 15% decrease in USG direct support for ARVs is part of a longer-term strategy to shift costs of
drug purchases to non-PEPFAR funding sources. The Clinton Foundation via UNITAID will continue to donate almost 100% of the
national need for pediatric formulations through December 2010, when responsibility will go to MOH using Global Fund resources.
UNITAID will also continue to donate 100% of national adult 2nd line regimens through December 2009 (last shipment to arrive in
Q1 of 2010). Although PEPFAR, through SCMS, will ensure no gap in drug availability during these transitions, PEPFAR and the
Government of Mozambique will continue efforts to solidify long-term drug funding through Global Fund and other donors.
The National Therapeutic Committee is responsible for ARV regimen selection based on National Treatment Guidelines and other
technical resources. The selection of pediatric formulations is based on the decision taken by the MOH Pediatric committee and
ART program. In September 2008, this committee decided that children under 14 kilos should be treated with pediatric specific
formulations and children above 14 kilos should be treated with regular adult formulations.
Forecasting and Procurement Planning: USG through SCMS provides ongoing technical assistance and support to CMAM staff in
forecasting. Quantification and forecasting for ARVs is done in a multilateral and coordinated manner with CMAM, SCMS, and
Clinton Foundation. Future consumption is based on a scaling-up model using MOH-reported actual patients and MOH program
goals, which were based on targets set during the Round 8 Global Fund Proposal development process. Mozambique
coordinated procurement was recognized as a best practice at the USAID State Of The Art conference in Johannesburg and
Implementer's conference in Kigali in 2007.
SCMS Mozambique staff provides technical assistance in the forecasting, supply planning, monitoring, ARV LMIS and
management of the incoming ARV pipeline and distribution of ARVs in country. In 2007 and 2008 coordinated procurement
enabled adjustments to supply plans that ensured a full supply of ARVs when the MOH was having financial management
problems that prevented them from procuring these commodities on time. SCMS has worked closely with CHAI and CMAM to
improve the forecasting methodology for pediatric ARVs. Forecast accuracy for adult formulations is generally high in
Mozambique.
Donor Coordination: USG is an active player in the health commodities sector in Mozambique and has recently been nominated
as co-chair of the Technical Working Group for Medicines (GTM), a sub-group of the SWAP Health Partners Donor Coordination
mechanism. Through the GTM, USG will have an opportunity to work with other donors and the Government to leverage funding
and support for implementation of critical activities to strengthen the entire supply chain system.
Current challenges: Warehousing operation and distribution: Currently, the country is facing significant warehousing and
distribution challenges, for which the USG through SCMS is providing substantial technical assistance and financial support.
CMAM assumed direct management of the central warehouses under challenging circumstances (inexperienced staff and
inadequate physical infrastructure, processes, and systems). In FY08, SCMS supported CMAM to consolidate Maputo
warehousing at an interim, rented warehouse while the MOH completed construction on a modern central warehouse being built
in Zimpeto, to be completed at the end of 2008. USAID currently funds the rent for the interim warehouse through the
USAID/DELIVER PROJECT. A September 2008 Warehousing and Distribution Needs Assessment conducted by SCMS has
identified a series of urgent and follow-up activities to enable the new Zimpeto warehouse systems and equipment to be ready for
implementation, as well as steps leading up to the preparation of a 3-5 year Pharmaceutical Logistics Master Plan, that will cover
the policy, infrastructure, supply-chain, and financial needs of CMAM that will be needed to achieve lasting improvements in
HIV/AIDS commodity security.
In addition, the transportation of commodities is one of the greatest bottlenecks facing distributions, and the country is facing a
funding shortage for distribution; warehouse space is filling up requiring shipments to be delayed. This situation is affecting all
commodities in the country. The USG is working closely with the Government to identify a short-term solution while a plan is
developed for longer-term sustainable financial management.
Procurement: Procurement capacity at CMAM is in its development stage and lacks systems for good procurement practices.
CMAM procures products on an annual basis through binding contracts, which does not allow for flexibility in supply plan
updating, changes in consumption, or changes in treatment regimens or the national formulary. With the current warehouse and
distribution challenges, this has led to an overstock of product that expires.
LMIS: The USG through JSI/DELIVER has invested heavily in developing and implementing an Integrated Pharmaceutical
Management System (SIGM) at several Provincial Warehouses. The goal of SIGM was to allow for an integrated LMIS that was
linked from the Provincial Warehouses to CMAM, and is used for both HIV and non-HIV medicines. In 2008, the Situational
Analysis of the SIGM followed by the Warehouse and Distribution Needs Assessment identified the need for an alternative
logistics management information system that responds to the needs of today's CMAM. With the modernization of the central
warehouses, and the future PLMP, a warehouse management system that supports key functionality required for modern
warehouse management, such as fluid bin location and bar-coding, will need to be implemented.
Human Resources: In 2005-06, the MOH underwent a series of human resource reforms that resulted in a new team of staff at
CMAM early 2006. Previously, CMAM was staffed primarily with contractors on salaries that were competitive with the private
sector; throughout the MOH, however, most contract employees have been replaced with civil servants in the interest of
sustainability. New staff, inexperienced in supply chain management, was assigned to all levels of CMAM in 2006-07, with new
staff turnover in 2008 as some key CMAM employees with close to 2 years experience were reassigned to new areas of the MOH.
During the last 2 years, the technical assistance provided by PEPFAR through SCMS has been critical to ensure availability of key
HIV/AIDS commodities such as ARVs, OI and STI medicines, rapid HIV test kits and other laboratory reagents and consumables.
In FY08, updated SOPs for management of ARVs, OI and STI drugs, rapid HIV tests were completed with support of SCMS, and
will be rolled out nationally in 2009 with COP 08 funding.
Key activities during FY2008-FY2010
Given the significant challenges faced by the country in delivering and managing the commodities, SCMS through USG support,
will provide significant technical assistance and capacity building to support the entire system. The support provided by SCMS to
strengthen the MOH pharmaceuticals and medical supplies systems also complements and reinforces the efforts of the
President's Malaria Initiative to ensure a reliable supply of anti-malarial drugs and test kits, as well as support for contraceptive
commodities. Activities highlighted below will be initiated during late 2008, and will continue through COP09.
Pharmaceutical Logistics Master Plan (PLMP): SCMS will develop a 3-5 year PMLP to ensure that essential drugs and health
commodities of approved quality will be readily available to public sector health facilities for use in the prevention, diagnosis, and
treatment of priority health problems and in adequate quantities and at the lowest possible cost. The PMLP looks at the whole
supply chain and the external factors influencing the quality and performance of this supply chain. This plan covers procurement,
warehousing, distribution, finances, coordination and harmonization, policy and legislation, and human resource management.
Many of the activities during the next few years will be guided by the results of the PLMP. USG will work with all donors through
the donor coordination mechanism to garner support for the financing and implementation of this PLMP.
Warehousing Infrastructure and Management Systems: Given the weak state of CMAM's infrastructure, systems, and staff
capacity, USG will focus its technical support and systems strengthening on all areas of warehouse management with the goal of
establishing good warehousing practices at CMAM, tracked by key performance indicators. Additionally, USG will strengthen its
technical support by placing technical advisors to work along side CMAM staff to conduct systems building and mentoring in the
key technical areas of warehouse management, material handling and operations, IT systems, procurement, and process
development. These advisors will be key contributors to the PLMP and drivers of its implementation. Substantial funding for
COP09 has been allocated to a program of major infrastructure renovation and construction projects, which will include upgrading
and extending the Beira warehouse and, (subject to study), increasing warehouse capacity in the Northern Provinces.
Distribution and Transportation: A main area of focus for the PLMP is to assess and redesign a distribution network to improve the
effectiveness and efficiency of transportation of medicines, lab reagents and other medical consumables throughout the health
system in Mozambique.
Procurement: USG will support the strengthening of CMAM's procurement systems with the end goal of enabling CMAM to
manage procurement for all commodities in the future. SCMS will conduct an assessment of CMAM's procurement systems in
early 2009 and will develop a procurement capacity building plan to support supply-chain improvements. A particular focus will be
given to the overlap of procurement financing mechanisms, management of lead time, and procurement methodologies to support
supply planning and good warehouse management practices.
Provincial Focus: USG will expand its current central level support to increased support at the provinces in logistics management,
including funding provincial pharmaceutical and laboratory advisors through clinical partners in FY09. Additionally, SCMS will
provide additional reinforcement and support to these advisors and the provincial warehouses by building the capacity of these
advisors, as well as the provincial warehouse managers, and provincial health management teams to provide training,
supervision, and monitoring of logistics management for HIV/AIDS commodities and other medicines.
Table 3.3.15:
