Detailed Mechanism Funding and Narrative

Years of mechanism: 2011 2012 2013 2014 2015 2016

Details for Mechanism ID: 13226
Country/Region: Uganda
Year: 2012
Main Partner: Medical Access Uganda Limited
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: HHS/CDC
Total Funding: $45,178,403

Medical Access Uganda Ltd (MAUL) is a local and indigenous not for profit organization engaged in drug supply and logistics management systems for HIV and other chronic illnesses drugs for national and donor funded projects. The overall goal of the Health Logistics Project under MAUL is to support the centralized procurement, warehousing and distribution of HIV/AIDS-related commodities including ARVs, Cotrimoxazole, laboratory equipment, reagents and accessories plus HIV test kits for CDC funded HIV programs in private sector and only do procurements for the public sector programs; and to strengthen the capacity of institutions to manage HIV/AIDS logistics. MAUL will collaborate with CDC, implementing partners (IP), MOH and National Drug Authority (NDA) to select health commodities and suppliers that meet National Treatment guidelines, the national formulary and PEPFAR guidelines.The specific objectives are: procurement of health commodities from approved suppliers in accordance with approved procurement plan and budget, establish safe and effective product storage systems, maintain good warehousing and stock management systems at all sites under this program, process orders from health facilities and distribute the products in line with an agreed delivery schedule, utilizing a reliable and cost effective distribution system.SPARS is a supply chain strengthening program for districts so they collect accurate, reliable and timely logistics data from all health facilities and to ensure that the Health Logistics Management Project is implemented effectively and efficiently in a way that fosters integration with other components of the health system.

Funding for Care: Adult Care and Support (HBHC): $2,122,300

In FY 2013, PEPFAR will focus on supporting the Government of Uganda (GOU) to further expand access to HIV care and support services with the goal to achieve universal access of 80% in care by 2015. T o achieve this goal, all the procurements for Cotrimoxazole and laboratory reagents will be centralized at Medical Access Uganda Limited (MAUL) in an effort to increase access to Cotrimoxazole and CD4 testing among pre-ART clients for ART initiation. This is in line with the national CD4 access expansion plan which has been a major bottleneck to treatment scale up. Using the FY 2013 funding, MAUL will procure, warehouse and distribute HIV commodities including Cotrimoxazole and laboratory reagents and accessories for the 93,354 adult clients in care in private not for profit facilities supported/run by CDC partners. For the 82,111 adult clients in care in public health facilities supported by CDC partners, MAUL will procure these commodities on request by Ministry of Health to buffer the public facilities when there are impending stock outs. These 175,465 adult clients in care will contribute to the overall PEPFAR target of 812,989 HIV positive individual accessing care and support services in FY 2013.MAUL in collaboration with other CDC implementing partners supporting the 53 districts will oversee the supply chain management activities for the HIV/AIDs care commodities plus capacity building of facility and district staff to accurately and timely reports, forecast, quantify and order for these commodities to mitigate stock outs and expiry.The program will be aligned to the National Strategic Plan for HIV/AIDS (2011/12-2014/15) to support and strengthen the national supply chain systems; and work within district health plans. MAUL will work under the guidance of MoH/ACP and the Pharmacy Department for trainings, mentorship and supportive supervision.

Funding for Care: TB/HIV (HVTB): $312,775

Through the National TB program, PEPFAR will support the National Aids Control Program to diagnose and treat TB cases among HIV positive patients. With funds in the mechanism, MAUL in collaboration with the National TB program, will procure the Xpert MTB/RIF cartridges from approved suppliers to supplement those procured by other TB partners for the program. These cartridges will be delivered to National TB and Leprosy Program for onward distribution to the testing sites. In collaboration with the National TB Program, MAUL will oversee the supply chain management activities to mitigate stock outs and expiry.

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

In FY 2013, PEPFAR will focus on supporting the GOU to further expand pediatric HIV care and OVC with the goal to achieve universal access to care by 2015. To achieve this goal, all the procurements for cotrimoxazole and laboratory reagents will be centralized at Medical Access Uganda Limited (MAUL) in an effort to increase access to cotrimoxazole and CD4 assessment among children in HIV/AIDS Care. Using FY 2013 funding under PDTX, MAUL will procure, warehouse and distribute HIV commodities including cotrimoxazole and laboratory reagents and accessories for the 3,249 children in care in private not for profit facilities supported/run by CDC partners. For the 2,857 children in care in public health facilities supported by CDC partners, MAUL will procure these commodities on request by Ministry of Health to buffer the public facilities when there are impending stock outs. This will contribute to the overall PEPFAR target of 812,989 HIV positive individuals in care and support services of which 74,555 will be children.MAUL in collaboration with other CDC implementing partners supporting the 53 districts will oversee the supply chain management activities for the HIV/AIDs care commodities plus capacity building of facility and district staff to accurately and timely reports, forecast, quantify and order for these commodities to mitigate stock outs and expiry.The program will be aligned to the National Strategic Plan for HIV/AID (2011/12-2014/15) to support and strengthen the national supply chain systems and work within district health plans. MAUL will work under the guidance of MoH AIDS Control Program and the pharmacy Department in trainings, mentorship and support supervision.

Funding for Laboratory Infrastructure (HLAB): $1,259,989

PEPFAR will support the National Aids Control program through Central Public Health Laboratory (CPHL) to offer accessible laboratory services to all HIV patients in care and on ART treatment using the national hub system. To achieve this, MAUL using FY 2013 funds in collaboration with CPHL and CDC will procure laboratory equipment, supplies and commodities for CD4, Clinical chemistry and Hematology testing for the hub sites within the CDC supported districts. The funding in MAUL will facilitate the delivery, installation and user training of the equipment at the hub site. MAUL will procure start up kits for all the equipment for at least six months and service contracts for at least 12 months. MAUL will support access to laboratory services and effective resource utilization by minimizing stock outs and expiries of reagents through a harmonized and centralized procurement plan.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $3,224,417

With support from PEPFAR, Voluntary Medical Male Circumcision (VMMC) is being offered in Uganda as part of a comprehensive HIV prevention package with a target to circumcise 750,000 eligible men in FY 2013. To achieve this, MAUL with the funds for FY 2013 will support the program with the procurement, warehousing and distribution of HIV test kits plus consumables for VMMC for the target of 320,019 eligible men to be circumcised by CDC implementing partners around the country.All the reusable and disposable kits for conventional circumcision will be procured centrally from headquarters and when the non-surgical devices become available they will also be procured for the country program centrally. MAULs role will be to warehouse and distribute the circumcision kits to the CDC implementing partners that are carrying out circumcision.MAUL in collaboration with other CDC implementing partners supporting the circumcision program will oversee the supply chain management activities for the SMC commodities plus capacity building of facility and district staff to accurately and timely reports, forecast, quantify and order for these commodities to mitigate stock outs and expiry.

Funding for Testing: HIV Testing and Counseling (HVCT): $824,074

For CDC implementing partners to meet the FY 2013 care and treatment targets within the CDC supported districts, they will have to scale up Provider Initiated Testing and Counseling (PITC) in all Health Center IIIs and above plus customizing HIV Testing and Counseling (HTC) for the key populations to the target of 955,315 individuals both women and men to be tested in FY 2013. To achieve this target, all HTC kits and accessories procurement will be centralized at MAUL. This will help resolve the problem of recurrent stock out of Rapid HIV test kits and also improve efficiency, standards, and remove procurement related burden from the CDC supported HTC service providers. With the FY2013 funding, MAUL will procure HIV test kits and accessories for testing 133,745 individuals in the CDC supported private not for profit facilities (PNFPs).On request by Ministry of Health, MAUL will procure HIV test kits and accessories for the public facilities when there are impending stock outs.MAUL in collaboration with other CDC implementing partners supporting the 53 districts will oversee the supply chain management activities for the HTC commodities plus capacity building of facility and district staff to accurately and timely reports, forecast, quantify and order for these commodities to mitigate stock outs and expiry.

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

In FY 2013 PEPFAR will support the government of Uganda PMTCT national program in rolling out Option B+ throughout the country with HIV test kits for Counseling and Testing of pregnant women within the ANC and ARV drugs for prophylaxis for all HIV positive pregnant women.

To achieve this, MAUL using the PMTCT acceleration funds in FY2013 through a centralized system will procure HIV test kits and accessories for the testing of 74,116 pregnant women in the CDC supported private not for profit facilities (PNFPs). On request by Ministry of Health, MAUL will procure HIV test kits and accessories for the public facilities when there are impending stock outs.

They will receive 8% of the Option B+ ARV drugs procured by SCMS (PEPFAR procurement agent) for the national program to warehouse and distribute to the PNFP facilities supported by CDC that will be accredited by MOH to offer PMTCT services.MAUL in collaboration with other CDC implementing partners supporting the 53 districts will oversee the supply chain management activities for the PMTCT (HIV test kits and ARV drugs) commodities plus capacity building of facility and district staff to accurately and timely reports, forecast, quantify and order for these commodities to mitigate stock outs and expiry.

Funding for Treatment: ARV Drugs (HTXD): $33,150,182

In FY 2013, PEPFAR will focus on supporting ACP to achieve the National Strategic Plan 2011/12-2014/15 objective of increasing access to ART from 57% to 80% by 2015. To achieve this objective, all the procurements of ARVs for CDC implementing partners will be centralized at Medical Access Uganda Limited (MAUL) in an effort to improve coordination, accountability and leverage of resources. Using the FY 2013 funding, MAUL will procure, warehouse and distribute ARVs for 122,695 patients currently on ART plus 39,961 new patients to be started on ART in private not for profit health facilities supported or run by CDC implementing partners. The patients will be from all CDC-funded care and treatment implementing partners including TASO, UPMB, UEC, Baylor PIDC, IDI, MUSPH, MJAP, Reach out Mbuya and Mildmay. MAUL will procure ARVs on request by Ministry of Health to buffer the public facilities when there are impending stock outs.MAUL has been and will continue to participate in the National quantification exercise with MOH, USAID, CDC, GF and other donors. All FY 2013 activities will be done in a manner that fosters integration of processes into the health system and sharing of information between all the implementing partners and the government for sustainability, as well as, ensuring that stronger health systems are built through human capital development.The program will align with all national processes and guidelines that have been established for the implementation of care and treatment of HIV patients. The ARV procurement plan developed by MAUL for CDC implementing partners will be harmonized with the national quantification and procurement plan developed by the AIDS Control Program through the QPPU under the pharmacy department.In collaboration with CDC treatment advisors, MAUL will support the CDC care and treatment implementing partners to rationalize regimens and avoid requests for non-conforming products. As a measure of keeping with the national quality policy system, products on the National Drug Authority (NDA) register will be procured at all times and an effort to get approval will be sought for those items that are not on the list but are required.MAUL in collaboration with other CDC implementing partners supporting the 53 districts will oversee the supply chain management activities for ARV drugs plus capacity building of facility and district staff to accurately and timely reports, forecast, quantify and order for these drugs to mitigate stock outs and expiry.

Funding for Treatment: Adult Treatment (HTXS): $4,036,280

In FY 2013, PEPFAR will focus on supporting ACP to achieve the National Strategic Plan 2011/12-2014/15 objective of increasing access to ART from 57% to 80% by 2015. To achieve this objective, all the procurements for cotrimoxazole and laboratory reagents will be centralized at Medical Access Uganda Limited (MAUL) in an effort to increase access to cotrimoxazole and CD4 testing among ART clients as per MoH guidelines. Using FY 2013 funding, MAUL will procure, warehouse and distribute HIV commodities including cotrimoxazole and laboratory reagents and accessories for the 146,682 adult clients on ART inclusive of 4,632 pregnant women on PMTCT option B+ in private not for profit facilities supported/run by CDC implementing partners. For the 161,943 adult clients on ART inclusive of 41,690 pregnant women on PMTCT option B+ in public health facilities supported by CDC partners, MAUL will procure these commodities on request by Ministry of Health to buffer the public facilities when there are impending stock outs. This will contribute to overall national and PEPFAR target of 190,804 new clients and 490,028 individuals current on treatment. This target is not a ceiling, allowing for higher achievements with continued program efficiencies and lowering ARV drug prices on the market.MAUL in collaboration with other CDC implementing partners supporting the 53 districts will oversee the supply chain management activities for the ART services commodities plus capacity building of facility and district staff to accurately and timely reports, forecast, quantify and order for these commodities to mitigate stock outs and expiry.The program will be aligned to the National Strategic Plan for HIV/AID (2011/12 2014/15), support and strengthen the national supply chain systems and work within district health plans. MAUL will work under the guidance of MoH AIDS Control Program and the Pharmacy Department in trainings, mentorship and support supervision.

Funding for Treatment: Pediatric Treatment (PDTX): $248,386

In line with the National Strategic Plan 2011/12-2014/15, PEPFAR will support MoH/ACP to achieve the objective of increasing access to ART from 57% to 80% by 2015. To achieve this objective, all the procurements for cotrimoxazole and laboratory reagents will be centralized at Medical Access Uganda Limited (MAUL) in an effort to increase access to cotrimoxazole and CD4 assessment among pediatric ART patients as per MOH guidelines. Using FY 2013 funding (these are only partial funds to meet the targets, and additional funds for commodity procurement are available in the UPMB, UEC and CAF mechanisms), MAUL will procure, warehouse and distribute HIV commodities including cotrimoxazole and laboratory reagents and accessories for the 20,606 children on ART in private not for profit facilities supported/run by CDC partners. For the 17,444 children on ART in public health facilities supported by CDC partners, MAUL will procure these commodities on request by Ministry of Health to buffer the public facilities when there are impending stock outs. This will contribute to overall national and PEPFAR target of 39,799 new and 64,072 children current on treatment.MAUL in collaboration with other CDC implementing partners supporting the 53 districts will oversee the supply chain management activities for the ART services commodities plus capacity building of facility and district staff to accurately and timely reports, forecast, quantify and order for these commodities to mitigate stock outs and expiry.The program will be aligned to the National Strategic Plan for HIV/AID (2011/12-2014/15), support and strengthen the national supply chain systems and work within district health plans. MAUL will work under the guidance of MoH/ACP and the pharmacy Department in trainings, mentorship and supportive supervision.

Key Issues Identified in Mechanism
Increasing gender equity in HIV/AIDS activities and services