Background
In the 2013 global tuberculosis (TB) report, WHO indicated that, of the 8.6 million new cases of TB reported worldwide, a quarter of them (and the resulting 1.3 million deaths) occurred in African countries.[1] Africa has the highest rates of cases and deaths relative to the population. The majority of East, Central, and Southern Africa (ECSA) countries are among the 22 countries that have the highest TB burden; most have reported cases of extensively drug-resistant TB. ECSA-Health Community (HC) member states have inefficient supply chain systems and inadequate access to high-quality pharmaceuticals. These countries lack enabling medicine policy, a robust regulatory environment, and strategic pharmaceutical management information.[2]
The USAID-funded SIAPS Program conducted an assessment to strengthen management of regional TB-commodity data.
Project Highlights
A rapid situational analysis of TB-commodity data management was conducted in five member states: Malawi, Swaziland, Tanzania, Uganda, and Zambia. The assessments highlighted TB supply-chain management practices and readiness of TB logistics management information systems to provide the information necessary for routine monitoring of key supply chain indicators.
Results
Information about funding of TB medicines could not be obtained for Swaziland and Tanzania; clear information on the basis and rationale of funding allocation and budgeting for TB medicines for the different countries assessed was not available. Other assessment findings include the following:
- Countries are at different levels of maturity in establishing pharmaceutical management systems with clearly defined structure, processes, and functions.
- All countries have procurement and supply management plans for TB commodities in place.
- Although policies and guidelines to support medicine management are available in all countries, only Malawi, Swaziland, and Uganda have guidelines and policies specific to TB medicine management.
- Malawi, Tanzania, and Zambia use the Global Drug Facility online monitoring system to track commodities in the pipeline.
- There were cases of either over- or under-quantifying, especially for pediatric and second-line drugs.
- Only two countries have a three-year documented budget forecast for procuring TB commodities.
- Supplier performance monitoring is not done in any of the countries assessed.
- All countries have a three-tier logistics system: central, regional, and district or facility. The central medical stores and national TB programs monitor procurement, storage, distribution, and stock levels. Four countries reported that they have set the required minimum and maximum stock levels and have defined ordering schedules and schedules for stock taking.
Project Legacy
SIAPS disseminated findings from the TB data and commodity management analysis during the ECSA TB experts’ forum in August 2014. The following courses of action were recommended:
- Establish a platform for TB commodities and information management for ECSA member states
- Strengthen human resources capacity on TB commodity management within ECSA-HC
- Strengthen TB lab commodity and data management among ECSA member states
Resources
[1] World Health Organization, Global Tuberculosis Report 2013 (Geneva: WHO, 2013), http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf
[2] ECSA-HC, “Technical Report of the Ninth Meeting of the Regional Pharmaceutical Forum,” Nairobi, Kenya, May 5–6, 2014, www.ecsahc.org/download/?file=rpf_report_nine.pdf
