Cameroon

Project Dates: September 2012 – September 2016

Background

A 2009 study by the National AIDS Control Committee (NACC) with support from the US Government, projected more than 50,000 new cases of HIV/AIDS and 560,000 people living with HIV/AIDS in 2010 and an estimated 620,000 cases by 2015 in Cameroon. There was limited access to quality essential medicines, including antiretrovirals (ARVs). Inadequate staffing, poor management of HIV commodities, and limited funding contributed to limited access to treatment for people living with HIV/AIDS.

SIAPS started work in Cameroon in 2012 with funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR). The goal was to ensure availability of HIV commodities at all levels. During the project, USAID provided USD 6 million – over four years. Technical assistance gradually moved from the national level to regional and health facility levels.

Project Highlights

SIAPS addressed various components of the pharmaceutical system. Project activities were implemented in collaboration with government counterparts, international partners, other PEPFAR implementing agencies, and national associations. Interventions provided an immediate response to urgent pharmaceutical problems, developed the policy framework, and built human resource capacity to strengthen the health system.

– Institutional Governance and compliance with donor requirements: To increase the availability of ARVs at the national level, SIAPS supported the NACC to prepare Global Fund documents related to Round 10 extensions by developing the Report on Quantification of Needs for HIV/AIDS Commodities.

– Building capacity and governance: At the regional level and at antiretroviral therapy (ART) sites, technical advisors helped strengthen coordination among HIV program managers and medical stores to improve regional distribution plans for HIV commodities.

– Accuracy, availability, and use of data: SIAPS and other partners printed and disseminated forms, standard operating procedures (SOPs), and guidelines and implemented a training and supervision strategy to ensure the accuracy and timeliness of HIV data and reports.

– Storage and distribution of HIV products: Technical assistance on the procurement and storage of ARVs included the provision of essential equipment (e.g., shelving, inventory cards) and training.

Results

– Medicine storage: SIAPS improved storage conditions and inventory management. In the North West and South West regions, the number of facilities maintaining adequate stock of ARVs increased by 29% and 32% respectively. 

South West regional medical store prior to SIAPS intervention (2013) and after (2014) [click to enlarge]

– Pharmaceutical and patient data Improvements: Prior to 2012, the HIV program in Cameroon lacked a system to capture patient and pharmaceutical information. With support from SIAPS, The availability, quality, and use of data at 129 ART and prevention of mother-to-child transmission (PMTCT) sites improved. By December 2015, 63% of facilities were reporting on time and with complete reports, and 87% had complete patient information.

A pharmacy attendant in a health facility in Littoral updates stock cards. [click to enlarge]

Human resource capacity: Most improvements in human capacity to manage HIV commodities and oversee pharmacy services were attributed to the implementation of a continuous quality improvement methodology and key SOPs. SIAPS facilitated the transfer of leadership for HIV commodity management from the national HIV program to regional HIV coordinators.

– Stock-outs and Availability of Medicines: At SIAPS-supported health facilities, stock-outs of ARVs decreased significantly, from 100% of facilities reporting a stock-out in 2014 to 9% in 2016.

Project Legacy 

SIAPS has played a crucial role in enhancing the coordination and management of pharmaceuticals at the national and facility levels, which has reduced stock-outs in Cameroon. Users throughout the health system have increased access to information to generate reports for decision making. These interventions contributed to a 91% reduction in stock-outs and successful integration of the HIV program into the general pharmaceutical management system.