Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011

Details for Mechanism ID: 12097
Country/Region: Ukraine
Year: 2010
Main Partner: Management Sciences for Health
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $150,000

Via the field support mechanism "Strengthening Pharmaceutical Systems" (SPS), Management Sciences for Health (MSH) is providing technical assistance to strengthen pharmaceutical procurement systems to improve Ministry of Health (MOH) capacity in HIV/AIDS medications and commodities, including procurement of methadone for expansion of substitution treatment programs. This technical assistance will build on other support from MSH to be provided in 2010 in procurement and supply management systems. With FY 2010 funds, MSH will assist the MOH in the development and implementation of a national procurement and supply management strategy.

A key constraint to the effective delivery of HIV/AIDS treatment services, including substitution treatment, is poor pharmaceutical and commodity procurement and management. Particularly in the case of HIV/AIDS and TB medications and commodities, this weakness constrains Ukraine's efforts to achieve universal access to comprehensive prevention programs, treatment, care and support by 2010. The commitment of Ukraine to universal access to HIV prevention, treatment and care is a major milestone towards its achievement of Millennium Development Goal (MDG) number five to halt and begin to reverse the spread of HIV and AIDS by 2015.

Ukraine's country proposal for the Sixth Round of grants through the Global Fund to Fight AIDS, TB and Malaria indicated that a key priority for the national health system is to strengthen procurement and supply management of the MOH for HIV-related medications to ensure reliable access to essential drugs and commodities. ART coverage is meeting only a small proportion of actual needs. With projections indicating that by 2013 approximately 100,000 persons will need treatment, reliable supplies of high quality, low cost medicines are essential, and as such the national program must prepare for large scale expansion. Meeting rapidly increasing needs for reliable supplies of ART medications will require improved systems for forecasting, drug registration, tendering, quality assurance and supply management as well as increased transparency in procurement practices.

As opiate drug dependence plays an important role in HIV/AIDS transmission in Ukraine, opiate replacement programs, also known as medication assisted therapy (MAT) programs, must be rapidly scaled up as well and integrated into national HIV/AIDS programs, both as an HIV prevention measure and to support adherence to antiretroviral treatment and medical follow up for opiate dependent drug users. Currently, only a fraction of injecting drug users have access to MAT, which are an operational prerequisite for entry into antiretroviral treatment programs. If efforts to combat HIV/AIDS are to be successful, substitution treatment programs, including programs with methadone, must be expanded to increase injecting drug users' access and adherence to antiretroviral treatment. Moreover, substitution treatment services must be diversified to include substitution treatment programs for young injectors and women.

In the Round 6 Global Fund Grant, the Government of Ukraine committed itself to adopting open and transparent processes for tenders related to drug purchases. In light of the fact that US implementing partners in health have predominant capability in drug procurement and supply management systems, and building on the other work that the USG is doing to strengthen capacity of public and private sector stakeholders in HIV/AIDS, the USG should collaborate closely with WHO and other donors to assist the GOU to address structural and procedural weaknesses in MOH procurement and improve its procurement and supply management functions.

MSH's technical assistance directly contributes the achievement of two of Ukraine's forthcoming Partnership Framework goals and benchmarks. These are: improved quality and cost effectiveness of HIV prevention, care, and treatment services for MARPs; and strengthened national and local ability to achieve Ukraine's National AIDS Program objectives.

MSH contributes to the USG strategy for health systems strengthening in service delivery quality, and national, regional, and local leadership in health care. This is in line with Ukraine's National AIDS Program strategic goals and objectives, which include strengthened procurement and supply management systems aligned to international standards.

Funding for Health Systems Strengthening (OHSS): $150,000

With FY 2009 Partnership Framework funding, MSH will assist the MOH to investigate widespread weaknesses in the procurement and supply management system. During calendar year 2010, activities will include an assessment of the procurement system to look at tendering, management, and monitoring processes, analyze some of the areas of vulnerability for corruption, and develop plans to address vulnerabilities using best international practices. Within this, MSH will look at the gaps and inconsistencies in policy planning to enable proper procurement planning.

In addition, MSH will also provide technical assistance to the MOH to develop and document procurement policy and standards guidelines. This would help create a system of checks and balances, and allow the adoption of auditing procedures and other internal controls. The establishment of appropriate procurement management structures would ensure separation of functions and responsibilities. Other issues include transparency in drug management processes, instituting supplier prequalification and performance monitoring systems to ensure provision of quality products at reasonable cost and in a timely manner, and make price information widely available using a tool such as the MSH/WHO International Price Guide.

With FY 2010, MSH will collaborate with the MOH to use the resulting analyses and recommendations to develop a Procurement and Supply Management Strategy. Additionally, MSH will provide technical assistance to the MOH in the implementation and institutionalization of this strategy, the exact nature of which will be identified within the national strategy. MSH will also support advocacy efforts arising from the resulting recommendations, and provide technical assistance as required to align policies, systems, and procedures to international standards.

MSH will work closely with USG, the Global Fund, other donor organizations, and key stakeholders throughout this process; the enactment of procurement and supply management systems aligned to international standards has far-reaching impact beyond the implementation of PEPFAR-funded HIV/AIDS service delivery.

Cross Cutting Budget Categories and Known Amounts Total: $150,000
Human Resources for Health $150,000