Country Overview

The country has adopted a compelling, long-term vision to have no new AIDS infections by 2016.

The government of Botswana has declared HIV/AIDS a national emergency. Committed to an aggressive, comprehensive and expansive multisectoral response to curb the impact of the disease, the country has adopted a compelling, long-term vision to have no new HIV infections by 2016. One of the first countries in Africa to establish a national HIV/AIDS treatment program, Botswana has achieved a six-fold coverage in antiretroviral (ART) coverage, from 15 percent in 2003 to 90 percent in 2008. SCMS supports the government's effort through technical assistance to the central medical stores (CMS), the Drug Regulatory Unit (DRU), Prevention of Mother to Child Transmission (PMTCT) Unit, National ARV Programme (MASA) M&E Unit and Laboratory Services to strengthen the supply chain system for antiretroviral (ARV) medications, infant formula and HIV test kits and laboratory commodities.

Key Objectives

• Build capacity in HIV/AIDS treatment and laboratory infrastructure: We provide technical assistance and support to the Ministry of Health and other agencies.
• Facilitate effective procurement and distribution: We establish mechanisms for timely procurement and supply planning of laboratory supplies, reagents and equipment.
• Improve information sharing: We promote strategic information management to ensure required tracking of ARVs and other HIV-related commodities.

Activities and Impact

Value of commodities delivered as of December 2008: $3.3 million

Procurement: Until recently, Botswana had purchased mainly branded, high-cost ARVs for HIV/AIDS patients who receive free health care from the government. SCMS is partnering with the DRU to streamline the drug regulatory process within the Ministry of Health and provide safe, effective, more affordable generic alternatives. With a streamlined drug registration process, Botswana’s DRU is eliminating backlogs and speeding generic ARV approval, which will present a wider range of options accessible to demand planning. SCMS supported the ARV team at the CMS in producing a five-year ARV quantification and forecast using quantimed. SCMS also helped Botswana produce its first national laboratory commodity quantification, a 12-month quantification of laboratory reagents and supplies to provide the basis for planning national laboratory commodity requirements.

A national team of 29 members has been trained in laboratory quantification. Forecasting and quantification are guiding the Ministry of Health in planning future resources needs and purchases—helping to reduce the prices paid for commodities. Supply planning for HIV related laboratory commodities in collaboration with other development partners has promoted continuous availability of commodities including HIV test kits, which used to stock out frequently.

 Laboratory logistics: A major challenge facing Botswana’s HIV/AIDS treatment programs is delayed and missing test results and specimens. This has resulted in delays in initiating treatment for people testing positive for HIV and in monitoring patients already on treatment. SCMS facilitated establishment of a national committee that has responsibility of routine monitoring of specimen and results management, including developing standard operating procedure for use at all lab service delivery points. Botswana is working to standardize and harmonize test techniques, test menus and equipment, streamlining a list of more than 850 commodities to just over 250 essential items required to meet the country’s testing needs. The shorter list simplifies and speeds procurement of testing commodities. In addition, a national laboratory commodity specification database has been developed to guide planning for national requirements and requisitioning of appropriate commodities by service delivery points.

 Logistics Management Information System (LMIS): We are supporting the development of an LMIS in Botswana that will monitor national pipelines of ARVs, test kits, laboratory supplies and other HIV/AIDS-related commodities.