Country Highlights

Ethiopia is a large, landlocked country with a population of about 77.4 million, 85 percent of whom live in isolated rural areas. Decades of draught, famine, and conflict have led to large population shifts. As a result, implementing testing and treatment programs, as well as gathering data on infection rates, can be quite difficult.

The Ethiopian government and international partners have nevertheless increased access to treatment from 24,400 in March 2006 to 104,000 as of May 2008. Under the Strategic Plan for Intensifying Multisectoral HIV/AIDS Response, 2004 – 2008, the Ethiopian government is working to better coordinate HIV/AIDS programs.

Working with agencies of the Ministry of Health, SCMS’s key objectives in Ethiopia are to:

• Support quantification, supply planning and procurement of required HIV/AIDS related commodities.
• Develop and implement a commodity tracking system to monitor supplies of HIV/AIDS medicines, test kits, laboratory supplies and medicines for opportunistic infections, and provide data for quantification, supply planning and program management.
• Develop and implement a comprehensive logistics management information system.
• Develop and implement a comprehensive logistics management information system.
• Strengthen logistics management practices and technologies to improve procurement and distribution.
• Improve procurement of essential laboratory supplies and strengthen logistics management systems for laboratory commodities to support comprehensive HIV/AIDS testing and treatment.

Value of commodities delivered as of June 2008: Over $21.5 million

Progress to date:

Forecasting commodity demand helps to ensure product availability and to reduce costs for purchase and delivery. In March 2007, the Ministry of Health and SCMS developed a six- year national forecast for all essential HIV/AIDS commodities that the government is using for resource mobilization, procurement planning and Ethiopia’s Global Fund Round 7 application. Since the completion of the original forecast, an update was conducted in November of 2007, and the next update is scheduled for October of 2008.

In June 2007, SCMS completed a procurement and supply plan for all major HIV/AIDS commodities based on the quantification developed in March. The plan was shared with all major funding partners, and led to the major involvement of UNITAID through the Clinton HIV/AIDS Initiative to assume funding and coordinate the procurement of second-line adult antiretrovirals (ARVs), and first- and second-line pediatric ARVs through December 2008. As of April 2008, SCMS increased the number of quantifications performed by in-country personnel to ten, meeting an important USAID goal for capacity building. In Ethiopia, stakeholders completed the final report of the second national quantification.

By using supply plans like those produced by Ethiopia, SCMS is now saving our clients hundreds of thousands of dollars by carefully selecting commodities that can be shipped by sea freight or over land rather than by air. The resulting cost savings are considerable. Shipments by sea of laboratory commodities have saved more than $140,000 (80 percent) on certain shipments. Greater collaboration within a country can lead to cost savings in procuring medicines and supplies, increase donor confidence and funding, provide greater flexibility in how countries spend funds and, therefore, rapidly increase the number of HIV/AIDS patients receiving treatment. In Ethiopia, SCMS helps increase collaboration by serving as technical secretariat for the National HIV/AIDS Commodity Security Advisory committee.

In Ethiopia, management of laboratory supplies, including those for HIV/AIDS programs, was once outsourced to a private company that purchased and installed laboratory equipment. Having one company manage the entire program provided a level of standardization not seen in other countries, but stock-outs and other supply problems persisted due to several factors, including the lack of a common functional laboratory logistics system. The government of Ethiopia, through the Ethiopia Health and Nutrition Institute (EHNRI) and the Pharmaceutical Fund and Supply Agency (PFSA), is working with SCMS to improve the supply of laboratory reagents and other commodities.

As a first step EHNRI and SCMS partnered to define inventory control and logistics management for laboratory commodities and developed procedures and forms for reporting the logistics data and ordering supplies. Now the two have begun training laboratory technicians and pharmacists at 89 sites countrywide to manage inventory and place orders. SCMS’s Regional Distribution Centers (RDCs) are placed close to PEPFAR countries and warehouse stock to provide ongoing deliveries as well as respond to emergencies. At the request of the Ethiopian Ministry of Health, SCMS procured an urgent order for Stavudine, an ARV, to cover a potential gap while the country transitions to fixed-dose combination ARVs in the Spring of 2008. SCMS delivered the order 18 days after the initial request (ten days ahead of the requested delivery date).