National Medical Stores (NMS) is an autonomous government corporation established in 1993 to procure, store and distribute essential medicines and medical supplies to government health facilities in Uganda. In October 2010, CDC awarded NMS a five year grant for the procurement storage and distribution of Cotrimoxazole and HIV/AIDS related laboratory supplies in Uganda.

The overall goal of the project is to sustain a supply chain for HIV test kits and related laboratory supplies and reagents for other HIV- related test as well as Cotrimoxazole. These supplies are intended to contribute to the care and treatment needs at public health facilities in Uganda.

NMS supplies public health facilities from Health Center (HC) III level and above including: one national referral institute, three national referral hospitals, 13 Regional referral hospitals, 57 general hospitals, 160 HC IVs, and 855 HC IIIs. NMS also serves the needs of 21 NGO and Community Based Organisations (CBOs) and two HC IIs accredited to provide HIV/AIDS treatment. The total number of health facilities served by NMS is 1,112.

NMS intends to reach all the eligible health facilities with project supplies by the end of FY 2013 and minimize laboratory commodity stock outs from the current 20% to 5% or less. This will be achieved through health systems strengthening efforts in collaboration with MoH and implementing partners to ensure accurate and timely submission of orders to NMS and also through the last mile delivery of supplies to the beneficiary facilities.

Global Fund / Programmatic Engagement Questions

1. Is the Prime Partner of this mechanism also a Global Fund principal or sub-recipient, and/or does this mechanism support Global Fund grant implementation? Yes2. Is this partner also a Global Fund principal or sub-recipient? Principal Recipient3. What activities does this partner undertake to support global fund implementation or governance?

Budget Code Recipient(s) of Support Approximate Budget Brief Description of ActivitiesHTXD 0 Warehousing and distribution of Global Fund supplies including ARVs, ACTs and HIV test kits

The National Medical Stores (NMS) is mandated to procure, warehouse and distribute health commodities and supplies for all public health facilities in Uganda. In FY 2013, PEPFAR will support the Government of Uganda (GOU) to further expand access to adult HIV care, support and treatment services with the goal to achieve universal access by 2015. Over the next 12 months, the national and PEPFAR targets for provision of HIV positive adults with clinical care services and maintenance on ART is at least 739,820 and 426,324 adults respectively. Working on the well-established ware houses and the last mile distribution system, NMS will warehouse and distribute HIV commodities including cotrimoxazole, ARV drugs, laboratory reagents and accessories procured by PEPFAR procurement mechanisms as a contribution to the achievement of these targets.

Essential laboratory tests for the delivery of HIV prevention, care and treatment services include testing for HIV, CD4, hemoglobin assessment and viral load estimation for suspected treatment failure amongst adults on treatment. Current estimates show that only 60% of individuals in pre-ART care are able to access CD4 testing, this has been a major challenge to treatment scale up nationally. In addition, CD4 access for ART client monitoring is also less the optimal. Increasing access to CD4 assessment among pre-ART and ART clients in line with MoH guidelines is a priority. PEPFAR working with MoH/Central Public Health Laborator (CPHL) and other stakeholders will work to improve CD4 coverage the current 60% to 100% over the next 12 months. Laboratory reagents for CD4 testing and other tests required for HIV care and treatment services for the set targets have been fully funded, and NMS will warehouse and distribute to health facilities in the public sector.

As a national distribution entity, NMS will work with the Ministry of Health (MoH)/Pharmacy division and AIDS Control Program, Joint Medical Stores, Supply Chain Management Systems, SURE and Medical Access Uganda Limited to strengthen the national health commodities supply chain system through information sharing, joint forecasting and quantification of the national commodity needs. The program will also coordinate with MoH, USG and PEPFAR implementing partners who will support the accreditation of about 883 additional health facilities, and work to build the capacity of health facility staff to accurately and timely report, quantify and order commodities.

Funding has been allocated to build internal capacity for warehousing and distribution, as well as, monitoring and evaluation of the supply chain in the public health facilities. All these activities will mitigate stock outs of HIV commodities that have affected the scale up and quality of care and treatment services.

This program is aligned to the National Strategic Plan for HIV/AIDS (2011/12-2014/15); supports and strengthens the national M&E systems; and works to support district health plans.

Quantification for all the laboratory supplies will be conducted in collaboration with the Central Public Health Laboratory (CPHL). This will ensure that whatever is procured is in line with the national needs. NMS has the mandate to procure, warehouse and distribute health commodities for the public sector in thee country and handles donated health supplies and commodities. NMS is involved in Global Fund commodity programming and is a critical partner in efforts to harmonize procurement and distribution of health supplies and commodities in liaison with the Global Fund, and other partners in Uganda.NMS will provide technical assistance to district level supply chain management stakeholders providing mentorship and coaching to improve the efficient requisition, acquisition, storage and distribution of commodities. National Medical Stores will support MoH, CPHL and district authorities to coordinate and implement training in supply chain management system for districts in Uganda. This will equip health care personnel, particularly laboratory staff, with the required skills for accurate ordering and tracking consumption of commodities, which in turn will lead to optimal forecasting and quantification at national level, and eventually to reduction of stock out of lab reagents and supplies.

The plan in the revised COP is to continue to stream line procurement of laboratory commodities through centralization and maximizing efficiencies. It is expected that the National Medical Stores will support warehousing and distribution of these commodities in view of NMSs unique capabilities, capacity and experience in this area. It is anticipated that a system will be developed with all stakeholders by which NMS will provide the needed logistics including the last mile system for distribution of laboratory reagents to all end user health facilities supported by PEPFAR in both public and private not-for profit facilities.

The National Medical Stores (NMS) is mandated to procure, warehouse and distribute health commodities and supplies for all public health facilities in Uganda. In FY 2013, PEPFAR will support the Government of Uganda (GOU) to further expand access to HIV Testing and Counseling (HTC) services with the goal to achieve universal access by 2015. Over the next 12 months, the national and PEPFAR targets for provision of HTC is to reach over three million individuals with HTC including all pregnant women and their babies and partners, clients seeking Voluntary Medical Male Circumcision (VMMC) services, and the most at risk populations. Working on the well-established ware houses and the last mile distribution system, NMS will warehouse and distribute HIV commodities including HIV test kits, cotrimoxazole, ARV drugs, laboratory reagents and accessories procured by PEPFAR procurement mechanisms as a contribution to the achievement of these targets.

Essential laboratory tests for the delivery of HIV prevention, care and treatment services include testing for HIV, CD4, hemoglobin assessment and viral load estimation for suspected treatment failure amongst adults on treatment. Increasing access to HTC among women, adults and children in line with MoH guidelines is a priority. PEPFAR collaborating with MoH/Central Public Health Laboratory (CPHL), Global fund and other stakeholders will work to improve coverage for HTC in 12 months. Laboratory reagents and HIV test kits for the set targets have been fully funded, and NMS will warehouse and distribute to health facilities in the public sector.

As a national distribution entity, NMS will work with the MoH/Pharmacy division and AIDS Control Program, Joint Medical Stores, Supply Chain Management Systems, SURE and Medical Access Uganda Limited to strengthen the national health commodities supply chain system through information sharing, joint forecasting and quantification of the national commodity needs. The program will also coordinate with MoH, USG and PEPFAR implementing partners who will support the accreditation of about 883 additional health facilities, and work to build the capacity of health facility staff to accurately and timely report, quantify and order commodities.

Funding has been allocated to build internal capacity for warehousing and distribution, as well as, monitoring and evaluation of the supply chain in the public health facilities. All these activities will mitigate stock outs of HIV commodities that have affected the scale up and quality of care and treatment services.

This program is aligned to the National Strategic Plan for HIV/AIDS (2011/12-2014/15); supports and strengthens the national M&E systems; and work to support district health plans.

The National Medical Stores (NMS) is mandated to procure, warehouse and distribute health commodities and supplies for all public health facilities in Uganda. In FY 2013, PEPFAR will support the Government of Uganda (GOU) to further expand access to adult HIV care, support and treatment services with the goal to achieve universal access by 2015. Over the next 12 months, the national and PEPFAR targets for provision of HIV positive adults with clinical care services and maintenance on ART is at least 739,820 and 426,324 adults respectively. Working on the well-established ware houses and the last mile distribution system, NMS will warehouse and distribute HIV commodities including cotrimoxazole, ARV drugs, laboratory reagents and accessories procured by PEPFAR procurement mechanisms as a contribution to the achievement of these targets.

Essential laboratory tests for the delivery of HIV prevention, care and treatment services include testing for HIV, CD4, hemoglobin assessment and viral load estimation for suspected treatment failure amongst adults on treatment. Current estimates show that only 60% of individuals in pre-ART care are able to access CD4 testing, this has been a major challenge to treatment scale up nationally. In addition, CD4 access for ART client monitoring is also less than optimal. Increasing access to CD4 assessment among pre-ART and ART clients in line with MoH guidelines is a priority. PEPFAR working with MOH/ Central Public Health Laboratories and other stakeholders will work to improve CD4 coverage the current 60% to 100% over the next 12 months. Laboratory reagents for CD4 testing and other tests required for HIV care and treatment services for the set targets have been fully funded, and NMS will warehouse and distribute to health facilities in the public sector.

As a national distribution entity, NMS will work with the MoH/Pharmacy division and AIDS Control Program, Joint Medical Stores, Supply Chain Management Systems, SURE and Medical Access Uganda Limited to strengthen the national health commodities supply chain system through information sharing, joint forecasting and quantification of the national commodity needs. The program will also coordinate with MoH, USG and PEPFAR implementing partners who will support the accreditation of about 883 additional health facilities, and work to build the capacity of health facility staff to accurately and timely report, quantify and order commodities.

Funding has been allocated to build internal capacity for warehousing and distribution, as well as monitoring and evaluation of the supply chain in the public health facilities. All these activities will mitigate stock outs of HIV commodities that have affected the scale up and quality of care and treatment services.

This program is aligned to the National Strategic Plan for HIV/AIDS (2011/12-2014/15); supports and strengthens the national M&E systems; and works to support district health plans.

The National Medical Stores (NMS) is mandated to procure, warehouse and distribute health commodities and supplies for all public health facilities in Uganda. In FY 2013, PEPFAR will support the Government of Uganda (GOU) to further expand access to adult HIV care, support and treatment services with the goal to achieve universal access by 2015. Over the next 12 months, the national and PEPFAR targets for provision of HIV positive adults with clinical care services and maintenance on ART is at least 739,820 and 426,324 adults respectively. Working on the well-established ware houses and the last mile distribution system, NMS will warehouse and distribute HIV commodities including cotrimoxazole, ARV drugs, laboratory reagents and accessories procured by PEPFAR procurement mechanisms as a contribution to the achievement of these targets.

Essential laboratory tests for the delivery of HIV prevention, care and treatment services include testing for HIV, CD4, hemoglobin assessment and viral load estimation for suspected treatment failure amongst adults on treatment. Current estimates show that only 60% of individuals in pre-ART care are able to access CD4 testing, this has been a major challenge to treatment scale up nationally. In addition, CD4 access for ART client monitoring is also less the optimal. Increasing access to CD4 assessment among pre-ART and ART clients in line with MoH guidelines is a priority. PEPFAR working with MoH/ Central Public Health Laboratories and other stakeholders will work to improve CD4 coverage the current 60% to 100% over the next 12 months. Laboratory reagents for CD4 testing and other tests required for HIV care and treatment services for the set targets have been fully funded, and NMS will warehouse and distribute to health facilities in the public sector.

As a national distribution entity, NMS will work with the MoH/Pharmacy division and AIDS Control Program, Joint Medical Stores, Supply Chain Management Systems, SURE and Medical Access Uganda Limited to strengthen the national health commodities supply chain system through information sharing, joint forecasting and quantification of the national commodity needs. The program will also coordinate with MOH, USG and PEPFAR implementing partners who will support the accreditation of about 883 additional health facilities, and work to build the capacity of health facility staff to accurately and timely report, quantify and order commodities.

Funding has been allocated to build internal capacity for warehousing and distribution, as well as, monitoring and evaluation of the supply chain in the public health facilities. All these activities will mitigate stock outs of HIV commodities that have affected the scale up and quality of care and treatment services.

This program is aligned to the National Strategic Plan for HIV/AIDS (2011/12-2014/15); supports and strengthens the national M&E systems; and works to support district health plans.

The National Medical Stores (NMS) is mandated to procure, warehouse and distribute health commodities and supplies for all public health facilities in Uganda. I n FY 2013, PEPFAR will support the Government of Uganda (GOU) to further expand access to pediatric HIV care, support and treatment services with the goal to achieve universal access by 2015. Over the next 12 months, the national and PEPFAR targets for provision of HIV positive children with clinical care services and maintenance on treatment is at least 73,169 and 63,704 children respectively. NMS will warehouse and distribute HIV commodities including cotrimoxazole, ARV drugs, laboratory reagents and accessories procured by PEPFAR procurement mechanisms to all health facilities providing HIV care and treatment services in the public sector as a contribution to the achievement of these targets. NMS will warehouse and distribute to health facilities in the public sector.

Essential laboratory tests for the delivery of pediatric HIV prevention, care and treatment services include testing for HIV, CD4, hemoglobin assessment, screening for HIV in exposed infants by polymerized chain reaction (DNA PCR) technology and viral load estimation for suspected treatment failure amongst clients on treatment. Although the national Early Infant Diagnosis (EID) program has made gains in delivery of quality and timely services, in contrast only 60% of individuals in pre-ART care are currently accessing CD4 testing which is a major challenge to treatment scale up nationally. CD4 access for ART client monitoring is also below the recommended MOH guidelines. As a priority, PEPFAR will work with MoH/Central Public Health Laboratory and other stakeholders to improve CD4 access from the current 60% to 100% over the next 12 months. Funded for laboratory reagents for CD4 testing and other tests required for HIV care and treatment services to meet the targets are available.

NMS will work with the MoH/Pharmacy division and AIDS Control Program, Joint Medical Stores, Supply Chain Management Systems, SURE and Medical Access Uganda Limited to strengthen the national health commodities supply chain system through information sharing, joint forecasting and quantification of the national commodity needs. NMS will also coordinate with MOH, USG and PEPFAR implementing partners who will support the accreditation of about 883 additional health facilities, and work to build the capacity of health facility staff to accurately and timely report, quantify and order commodities.

Internal capacity of the program for warehousing and distribution will be built, and monitoring and evaluation of the supply chain in the public health facilities strengthened. All these activities will minimize stock outs of HIV commodities that have affected the scale up and quality of care and treatment services.

This program is aligned to the National Strategic Plan for HIV/AIDS (2011/12-2014/15); supports and strengthens the national M&E systems; and works to support district health plans.