Country Overview
Ethiopia's large population of citizens living in isolated rural areas has brought significant challenges to HIV/AIDS testing and treatment programs. Despite the obstacles, the country has made significant strides despite these obstacles.
SCMS is one of several international partners working with the Government of Ethiopia to increase access to HIV/AIDS testing and treatment. We have operated in Ethiopia since November 2006 with the primary mandate of expanding logistics services to PEPFAR-supported programs and strengthening supply chain activities for the national HIV/AIDS program in Ethiopia overall. To meet the challenges and realities of the national program, we have effectively staffed up.
We work with Pharmaceutical Fund and Supply Agency (PFSA), a primary partner within the Ministry of Health (MOH) responsible for storing and distributing all health commodities to public facilities, by supporting the implementation of Pharmaceutical Logistics Master Plan.
Key Objectives
- Move from a “doing” role to a “coaching/mentoring" role in HIV/AIDS and national supply chain management with activities directed toward PFSA. The approach intends to leverage tools and systems tested for HIV/AIDS commodities and industry best practices in supply chain management (such as warehouse operations, fleet and distribution management, inventory control, and order processing).
- Strongly focus on ensuring that PFSA has the systems needed to handle state-of-the-art quantification/forecasting, efficient procurement, direct distribution of all essential health commodities, and management information systems (MIS) for all aspects of the supply chain.
- Phase out support for a parallel laboratory logistics system, and ensure that this system begins to be incorporated into the national supply chain.
- Strengthen the PFSA distribution system to ensure integration of other medicines and supplies for tuberculosis (TB), malaria, family planning and any other appropriate public health commodities, toward “one public health supply chain.”
- Strengthen the public sector capacity for overseeing health facility inventory management and data quality.
- Conduct procurements to ensure availability of an on-going supply of needed medicines and other commodities to complement procurements by the Global Fund Project, Clinton HIV/AIDS Initiative (CHAI), World Bank and others.
Activities and Impact
Antiretroviral therapy (ART) program: SCMS has supported the ART scale-up by graduating the ART supply chain from an informed “push” system to a “pull” system, implementing demand-driven logistics to minimize understocking or overstocking of commodities. The pull system was rolled out to all existing and newly initiated sites within a two-and-a-half month period, and training was provided to more than 1,000 pharmaceutical and facility store personnel. In the past three years, no single report of an ARV stockout has been recorded—a testament to successful logistics performance. SCMS is also supporting the Ministry of Health, PFSA in quantifying antiretroviral (ARV) drugs to be procured by the Global Fund.
Supply chain capacity building: SCMS has designed and implemented supply chain systems for ARVs and laboratory reagents and other commodities in Ethiopia, enabling a dramatic reduction in emergency orders at the facility level—with commensurate gains in distribution efficiency. We procured equipment for the PFSA which will be used to deliver drugs and commodities to hospitals and health centers, ensuring an uninterrupted supply of HIV/AIDS, malaria, tuberculosis, reproductive health, and other essential program commodities.
We also procured racking, shelving and other material handling equipment which will greatly increase operational capacity at warehouses and PFSA efficiency across the country. We have leased additional warehouse spaces for PFSA to address the scale-up needs of HIV/AIDS and other health programs, including locations in Addis Ababa, Adama, Bahir Dar, Hawassa, Mekelle and Nekemte. SCMS is working with PFSA to strengthen its management information systems and develop human resource capacity. This support includes seconding highly qualified, trained pharmacists and other professionals specialized in management information systems (MIS) and information technology.
Partner coordination: SCMS has coordinated with key partners, the Government of Ethiopia, donors and implementers for commodity security throughout the supply chain continuum—from forecasting and quantification to procurement, financing, and delivery. As the designated Secretariat for the National HIV/AIDS Commodities Supply Chain Management Advisory Committee, SCMS is raising awareness of the important role of sustainable and robust supply chain management systems in responding to the HIV/AIDS program.
We have worked closely with the MOH, HIV/AIDS Prevention and Control Office, and CHAI in supply chain planning and monitoring to avert stockouts and critical shortages by responding with emergency orders of first- and second-line ARVs. We have also facilitated the quantification of over 300 program commodities through national quantification exercises, enabling resource mobilization, procurement, and distribution planning.
