Detailed Mechanism Funding and Narrative

Details for Mechanism ID: 12491
Country/Region: Uganda
Year: 2010
Main Partner: Not Available
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $0

National Medical Stores (NMS) is an autonomous government corporation established in 1993 to procure, store and distribute essential medicines and medical supplies to government heath facilities throughout Uganda. National Medical Stores has developed a countrywide distribution supply chain for essential medicines and supplies as well as for the HIV/AIDS-related Laboratory materials provided through PEPFAR funding. Health facilities and HIV Counseling and Testing Centers can access these commodities through the established laboratory credit line system, at both NMS and Joint Medical Store (JMS) a subsidiary partner. REDACTED.

NMS has had previous PEPFAR support under the cooperative agreement: "Purchase, Distribution and Tracking of Supplies to Support HIV/AIDS- Related Laboratory Services in the Republic of Uganda". This cooperative agreement focused on establishment and procurement of a national list of 28 commodities and six rounds of HIV-related laboratory reagents and supplies; implementation of a national credit line laboratory logistic system; design and distribution of logistics data collection tools; and training of health facility and district laboratory staff in health commodity logistics system and management.

National Medical Stores will work to further strengthen its services with particular focus on system strengthening; sustainability; M&E; and capacity building. On top of program implementation, NMS will develop methods to create and build the capacity of its own and other organizations responsible for HIV laboratory commodities. In particular NMS will work with MOH (pharmacy division and the Central Public Health Laboratory) and other organizations to build district capacity for forecasting, procurement, and distribution of HIV laboratory commodities and Cotrimoxazole. NMS will also identify mechanisms of working with districts to strengthen systems for delivery of supplies from district stores to lower level health facilities.

Further more NMS will foster development and implementation of its own budgeting and financial system to ensure a sustainable program through annual budget allocation. ?and will seek to establish incremental government commitment and solicitation of additional funding for its own support and governance as well as enhanced management, responsibility and authority for HIV related laboratory commodities and services.

NMS will demonstrate efforts to promote sustainability of supply of identified commodities and supplies in collaboration with MOH and other USG and non-USG organizations, including a documented plan for continued, high-quality interventions and services at the end of the 5 year PEPFAR funding. NMS will develop, maintain capacity for and implement a robust program monitoring and evaluation system, and use the results for ongoing improvement of program performance.

Also NMS be supported to expand and sustain the procurement and distribution of HIV related laboratory supplies and services in the context of existing national policies and strategies including the National Drug Policy, the Public Procurement and Disposal of Public Assets (PPDA) Act and other national policies that promote procurement and distribution activities. The procurements and supplies will also supports the implementation of the Uganda National HIV/AIDS Strategic Plan 2007/8-2011/2012 and Health Sector Strategic Plan II. The objectives of this program are to; 1. Contribute to the availability of the national requirement of HIV test kits and related laboratory supplies to support Opportunistic Infections (OI) diagnosis, HIV counseling and testing (HCT) as well as Prevention of Mother to Child Transmission (PMTCT) services country wide. These commodities include: HIV test kits, Routine Reproductive Health tests e.g. Syphilis, HB, Urinalysis; supplies for Early Infant Diagnosis (EID), reagents for CD4 tests and OI diagnosis, including tuberculosis. 2. Contribute to a sustained supply of cotrimoxazole to support HIV basic care and treatment services in health facilities through out the country. 3. Contribute to building capacity of district health systems to adequately forecast and utilize available commodities. 4. Establish concrete governance, finance and accountability systems to ensure program sustainability. 5. Demonstrate increase in soliciting and obtaining Government of Uganda direct budget support.

Funding for Care: Adult Care and Support (HBHC): $0

The procurement and distribution of cotrimoxazole by the National Medical Stores will be a supportive function to the basic care and treatment program areas. Cotrimoxazole enhances both adult and pediatric care and support activities/services and complements ARV treatment programs. Distribution and utilization of cotrimoxazole is guided by the Ministry of Health through a cotrimoxazole access and utilization policy and care and treatment guidelines. NMS will procure and distribute cotrimoxazole to eligible health centers to support care and treatment for HIV+ persons. Currently there are over 980 health facilities in the country accredited to distribute cotrimoxazole, most of which access their supplies form the National Medical Stores (NMS).

REDACTED. These activities will continue to contribute to the success of HIV care and support and treatment programs by ensuring continuous supply of needed medicines to HIV+ patients.

NMS will also be supported to base its forecasts, quantifications and tendering processes for the cotrimoxazole requirements on clear procurement plans and will have a number of contract frameworks to enable it have alternative sources of products. Additionally NMS will work to improve its procurements and distribution mechanisms by supporting management staff training in supply chain management and building district capacity to forecast and utilize products.

Funding for Testing: HIV Testing and Counseling (HVCT): $0

The Uganda National HIV/AIDS Strategic Plan of 2007/8 2011/12 recommends for universal access to HIV counseling and testing for the population. The UDHS of 2006 and UHSBS 2004/5 showed a 70% unmet needs for HCT. In an attempt to increase demand for HCT, Uganda is currently using several strategies to HIV testing including; Voluntary Counseling and Testing (VCT), Provider Initiated Counseling and Testing (PICT) and Home Based Counseling and Testing (HBCT). Over 980 health facilities and 60 organizations across the country provide counseling and testing services to the population. These facilities and organizations require HIV/AIDS related laboratory commodities and supplies and HIV test kits to facilitate their activities and the national Medical stores and its subsidiary the Joint medical Stores have been mandated to ensure the availability of essential medicines supplies including Counseling and testing commodities and requirements. The National Medical Stores will therefore be supported to perform procurement and distribution functions to support services provision in government health facilities and faith based facilities/organizations to perform HIV counseling and testing.

REDACTED. These activities will continue to contribute to the success of HIV prevention, care and support and treatment programs.

NMS will also be supported to base its forecasts, quantifications and tendering processes for HIV/AIDS related laboratory commodities and supplies and HIV test kit requirements on clear procurement plans and will have a number of contract frameworks to enable it have alternative sources of products. Additionally NMS will work to improve its procurements and distribution mechanisms by supporting management staff training in supply chain management and building district capacity to forecast and utilize products.

Funding for Care: Pediatric Care and Support (PDCS): $0

The procurement and distribution of cotrimoxazole by the National Medical Stores will be a supportive function to the basic care and treatment program areas. Cotrimoxazole enhances both adult and pediatric care and support activities/services and complements ARV treatment programs. Distribution and utilization of cotrimoxazole is guided by the Ministry of Health through a cotrimoxazole access and utilization policy and care and treatment guidelines. NMS will procure and distribute cotrimoxazole to eligible health centers to support care and treatment for HIV+ persons. Currently there are over 980 health facilities in the country accredited to distribute cotrimoxazole, most of which access their supplies form the National Medical Stores (NMS).

Using the MOH principles on the distribution of essential medicines under the national credit line, 20% cotrimoxazole procurement and distribution will be through JMS for faith-based and mission health facilities, NGOs and the private sector and 80% of the allocations will support cotrimoxazole procurement and distributions to government health facilities. These activities will continue to contribute to the success of HIV care and support and treatment programs by ensuring continuous supply of needed medicines to HIV+ patients.

NMS will also be supported to base its forecasts, quantifications and tendering processes for the cotrimoxazole requirements on clear procurement plans and will have a number of contract frameworks to enable it have alternative sources of products. Additionally NMS will work to improve its procurements and distribution mechanisms by supporting management staff training in supply chain management and building district capacity to forecast and utilize products.

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $0

The Ministry of Health (MOH) has accredited a number health facility laboratories to perform PMTCT HIV testing and other associated laboratory tests such as urinalysis examinations, stool examinations, blood hemoglobin concentration and syphilis tests for antenatal services. At least eight hundred and thirty (830) health facilities currently provide PMTCT services throughout the country. Seventy three percent (73%) of these facilities have received PEPFAR support in the past years. A lot of emphasis is being made on making PMTCT services available and accessible to more mothers who require them. To that effect, The National HIV/AIDS Strategic Plan 2007/8 2011/12 advocates for expanding HCT for pregnant mothers and their partners as a mechanism to reduce mother to child and identification of HIV + woman and men in need of treatment. In essence PMTCT programs will complement the uptake of other HIV/AIDS services of basic care and treatment. The facilities providing these services will therefore require consistent and regular supply of quality PMTCT commodities to ensure uninterrupted service provision and uptake. The National Medical Stores and the subsidiary Joint Medical Stores will be supported to procure and distribute PMTCT HIV test kits and associated commodities.

NMS will receive PMTCT HIV test kit orders prepared by individual PMTCT testing sites and ensure that packaging and delivery to District stores are done. The distribution of theses supplies will be integrated with the commodities that support the other program areas of laboratory commodities, HCT test kits and supplies, and cotrimoxazole for adult and pediatric care and support. Faith based health facilities, NGOs and the private sector will access PMTCT commodities through the JMS system.

Funding for Laboratory Infrastructure (HLAB): $0

The National Medical Stores will be funded to avail HIV/AIDS related laboratory reagents and commodities to enable health centers perform HIV testing and patient monitoring. Eligible functional laboratories in public, NGO / FBO and armed forces health facilities across the country will receive these commodities from the National Medical Stores and Joint Medical Stores (JMS) the mandated organizations for the distribution of essential medicines and supplies for government and the faith based health systems. Currently there are over 1,300 functional laboratories that are accredited to perform HIV/AIDS testing and patient monitoring. The HIV/AIDS related laboratory testing will support prevention, care and treatment programs.

Using an established laboratory credit line mechanism which allows for Health Centers IIIs, Health Centers IVs, and Hospitals including the Armed Forces to access commodities, NMS and JMS will procure and distribute laboratory commodities according to approved requisition levels/needs. Currently the approved laboratory credit line commodities list include HIV/AIDS/TB reagents, gram staining reagents, malaria reagents, complete blood count reagents, clinical chemistry reagents, HIV test accessories, blood collection materials and laboratory waste management materials. Other commodities that support STI testing for HIV+ patients, infant test commodities and accessories and CD3/CD4/CD8 remunerations are also included. In addition both NMS and JMS will support training of their management and support staff in order to build internal human resource capacity to improve the supply chain system.