Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2015

Details for Mechanism ID: 7549
Country/Region: Zimbabwe
Year: 2013
Main Partner: Partnership for Supply Chain Management
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: USAID
Total Funding: $33,565,913

In Zimbabwe, the SCMS Project is implemented by JSI Research & Training Institute Inc, one of the 16 project partners. SCMS procures first line ARV drugs for approximately 80,000 adult patients, PMTCT ARV, HIV Rapid Test Kits, CD4 POC reagents and Male Circumcision kits and commodities. SCMS strengthens MOHCW, NatPharm and ZNFPC capacity in supply chain management through technical assistance and operations support which includes the design and implementation of distribution and LMIS systems; provision of staff to the MOHCW; provision of delivery and monitoring vehicles, fuel and maintenance; training in forecasting and quantification; an ARV stock audit system; support for warehousing improvements, and support for donor coordination. Additionally, the project strengthens MOHCW technical ART capacity by providing two key staff to the national ART program. VEHICLES

a. Inventory (purchased/leased):

- Purchased/leased under this mechanism

from the start of the mechanism through COP FY2011 = 20

- New requests in COP FY 2012 = 0

- Total planned/purchased/leased vehicles for the life

of this mechanism = 20

Funding for Laboratory Infrastructure (HLAB): $700,000

Funds will support treatment scale-up

Funding for Strategic Information (HVSI): $200,000

In FY 2012, SCMS will continue to support the maintenance and adjustment when necessary of the Logistics Management Information System (LMIS), ZISHAC (Zimbabwe Information System for HIVAIDS Commodities) used by the LSU to capture ART patient data and MC procedures and ARV, Fluconazole and Male Circumcision commodities consumption, stock on hand and losses and adjustment data, all used for informed quantification, storage and distribution decision-making.

The project will also continue to support the cell phones rolled out to the most remote ART sites to facilitate timely patient and logistics data transmission and, based on the successful outcomes of the pilot implemented during the previous year, SCMS will continue to support a ARV dispensing software at selected high volume sites.

SCMS will also continue supporting TopUp and AutoDRV, the LMIS and data capturing tools integrated in the NatPharm Navision Warehouse Management System and used to operate the Delivery Team Topping Up (DTTU) distribution system for HIV and Syphilis RTK, PMTCT, CD4 POC commodities and EID bundles. In addition SCMS will continue to support monthly stock audits by an independent audit firm of USG and other donor funded ARVs that were initiated in 2009 to controls receipt, storage and distribution of ARVs by the Harare and Bulawayo warehouses to the treatment sites.

Funding for Health Systems Strengthening (OHSS): $5,000,000

In FY 2012, SCMS will provide ongoing technical assistance and resource support to the Logistics sub-unit (LSU) which is serving as the health commodities management unit for the whole MOHCW and operates from Harare and Bulawayo. The 15 current staff positions of the LSU are funded through SCMS, as is the SCM Advisor based at the MOHCW Directorate of Pharmacy Services.

The LSU manages the MOHCW supply chains for the national AIDS and TB Program (ART, VCT, PMTCT, OI and MC) as well as the supply chains for Essential Medicines, TB and Malaria commodities. The LSU chairs the Procurement and Logistics Sub-committee of the ART Partners Forum, a central body for donor and partner collaboration and communication. SCMS, through the LSU, will continue to provide the following:

Product Selection: review national treatment guidelines, offer logistics considerations of choosing products, and work to minimize pack size proliferation

Quantification/Forecasting /Supply Planning: lead and manage quarterly updates of quantifications for HIV/AIDS, TB and Malaria commodities and other Essential Medicines.

Procurement: prepare procurement plans for all USG funded products; assist other partners in the development of procurement plans; highlight supply gaps and mobilize resources to fill these gaps

Warehousing: work with and support NatPharm to address any existing or potential storage challenges.

Distribution: support NatPharm with national bi-monthly distribution of ARV drugs and Male Circumcision Commodities providing 3 delivery trucks, fuel and maintenance, drivers, and per diem. SCMS will also continue to assist the MOHCW in implementing DTTU (Delivery Team Topping Up, an informed push distribution system for HIV diagnostics and PMTCT commodities.)

Capacity Building: provide technical and operational support to MOHCW and system-specific training on logistics for HIV/AIDS commodities SDPs as necessitated by addition of new sites and personnel attrition, as well as trainings to personnel in associated delivery systems like ZNFPCs DTTU. In addition, the project supports Supply Chain Management Pre-Service Training for Pharmacists, Pharmacy Technician and Nurses at local training institutes.

Funding for Biomedical Prevention: Voluntary Medical Male Circumcision (CIRC): $4,735,000

SCMS will procure MC male circumcision kits and related commodities and equipment for approximately 61,000 procedures, based on a average commodities cost of $27.01 per procedure, including the Forceps Guided Disposable Kit at $15.50 based on a weighted average. This will support the MOHCW strategy for safe medical male circumcision scale up to promote comprehensive HIV prevention in Zimbabwe 2010-2015 aims at contributing to the reduction of HIV incidence by scaling up male circumcision (MC) to reach 80% of 15-29 year old HIV negative adolescents and men by 2015. MOHCW is planning to perform a total of 236,000 procedures in 2013 and has not identified other partners to support the procurement of MC commodities for the public civilian sector at the time of writing.

SCMS will continue to provide technical and operational support to assist the Ministry of Health & Child Welfare to operate the ordering and distribution system for Male Circumcision (MC) kits and related commodities for the supply of static and outreach sites.

Funding for Testing: HIV Testing and Counseling (HVCT): $200,000

SCMS will continue in FY 2012 to procure up to approximately $ 200,000 of HIV rapid tests to contribute to the achievement of the MOHCW targets (2,061,935 adults and children to be tested in CY 2013, including 1,581,935 person tested in public health facilities and 480,000 person tested in PSI supported New Start Centers) and will assist the MOHCW in accurately quantifying HIV rapid test kit requirements. Distribution for the rapid tests is part of SCMSs OHSS activities (see below).

Funding for Biomedical Prevention: Prevention of Mother to Child Transmission (MTCT): $1,327,740

In FY 2012, approximately $540,000 will be used for the procurement of point of care (POC) rapid CD4 testing machines and reagents or other products as necessary to increase the numbers of pregnant women initiated to ART.

MOHCW will continue to implement the revised PMTCT strategy initiated in 2010 to progressively increase the proportion of pregnant women who received more efficacious regimens (MER) based on WHO recommended option A (Mothers on AZT from 14 weeks and breastfeeding infants on daily Nevirapine during breastfeeding period). It is expected that 43,909 pregnant mothers will need PMTCT during Sept 2012- Aug 2013; 29,858 (68%) will receive the AZT based PMTCT More Efficacious Regimen; 878 (2%) will receive single dose Nevirapine and 13,172 (30%) will be provided ART for their own health. About 5,708 (13%) of HIV exposed babies will take Nevirapine Solution for 18 months. SCMS will use approximately $220,000 from COP 12 to procure medicines for about 1,500 mother/ infants. Other potential donors include GF and GOZ/NAC and MOHCW will continue resource mobilization.

Funding for Treatment: ARV Drugs (HTXD): $19,684,038

In FY 2012, SCMS will provide first-line ARVs for 80,000 adult patients treated in public sector health facilities. SCMS-supplied ARVs will contribute to meeting the MOHCW target (496,197 adult ART patients by the end of 2013 according to the Zimbabwe National AIDS Strategic Plan 2011-2015) and which is also supported by the Government of Zimbabwe, Global Fund, the DFID-led Expanded Support Programme, UNITAID/CHAI, and other donors such as Axios/Abbot.

To support these patients in accordance with the revised MOHCW Guidelines for ARV Therapy in Zimbabwe based on the WHO recommendation to switch patients away from Stavudine containing regimens, and based on the MOH strategy to put all new patients on Tenofovir-containing regimens and switch respectively 20%, 50% and 100% of the existing patients from Stavudine to Tenofovir containing regimens in 2011, 2012, and 2013, SCMS will procure the following medicines: Tenofovir/Lamivudine 300mg/300mg + Nevirapine 200mg for patients on the new standard first line regimen, Tenofovir/Lamivudine 300mg/300mg and Efavirenz 600mg for first line patients with tuberculosis; LamivudineZidovudine/Nevirapine 150/300/200mg and LamivudineZidovudine 150/300mg and Efavirenz 600mg as alternative first line patients with tuberculosis. These drugs will be FDA-approved/tentatively-approved generics, whenever possible and logical

Funding for Treatment: Adult Treatment (HTXS): $740,000

In FY 2012, SCMS will continue to second two medical officer positions to MOHCW AIDS & TB Programme: the National ART Coordinator and one Assistant National ART Coordinator. SCMS will continue supporting the funding of site readiness assessments and site supervision aimed at enhancing the MOHCW's ART scale-up activities, the national quality of care initiative, and decentralization of ARV treatment.

Funding for Treatment: Pediatric Treatment (PDTX): $979,135

The USG team had proposed to expand support for treatment of an additional 45,000 adult and 25,000 pediatric patients through procurement of medicines, health worker training, quality of care investments, and strengthening laboratory supply chain management should additional resources be availed. SCMS will procure EID bundles, CD4 POC machine cartridges, and consumables.

Cross Cutting Budget Categories and Known Amounts Total: $2,433,922
Human Resources for Health $2,433,922
Key Issues Identified in Mechanism
enumerations.Malaria (PMI)
Child Survival Activities
Tuberculosis
Family Planning