SCMS program expands procurement volumes and assumes the additional role of distributing rapid HIV test kits.
Kenya has a severe, generalized HIV epidemic among its 38 million people, with an adult prevalence rate today of about 10 percent. In March 2003, President Mwai Kibaki mandated the National AIDS Control Council (NACC) to coordinate and manage a multi-sectoral approach to the national HIV/AIDS program, providing policy direction and mobilizing resources. In late 2004, the Government of Kenya issued guidelines for HIV testing in clinical sites.
The US Government supports the work of NACC and directly funds the Ministry of Health’s National AIDS and Sexually Transmitted Infection (STI) Control Program (NASCOP). The Government of Kenya has announced ambitious plans to scale up treatment, setting a target of 338,000 patients by 2010. Currently, the country has about 230,000 patients on treatment, served by an estimated 650 care and treatment sites.
SCMS opened its Kenya field office in July 2008. We are working with the Government of Kenya and in-country partners to maintain a system for ensuring that PEPFAR-supported government sites receive continuous supplies of laboratory commodities. This solution includes creating a site reporting system, a centralized data collection point, and a centralized warehousing/distribution system.
- Procurement and distribution: Procure and distribute rapid test kits and laboratory supplies to meet scale-up requirements.
- Information sharing: Improve the reporting of information from within provinces and into national reporting systems.
- Capacity building: Identify and build processes to coordinate and share lab supply information while improving forecasting and procurement.
Activities and Impact
Procurement: Procurement activities in Kenya continue to expand rapidly. SCMS has procured 170 pieces of hematology and clinical chemistry laboratory equipment to support the country’s HIV testing and monitoring activities, along with equipment to improve and accelerate pediatric HIV diagnosis. In an effort to prevent stockouts, we continue to procure and distribute CD4, hematology and chemistry reagents. With the goal of enhancing hospital safety, we have procured and distributed commodities for use in safe injection and waste disposal.
Blood safety: SCMS is collaborating with the American Association of Blood Banks, a PEPFAR technical partner, to procure a wide variety of equipment and supplies for the Kenya National Blood Transfusion Service (NBTS) as it automates its manual processes. NBTS has six regional centers and four satellite centers throughout the country. In 2009, SCMS procured equipment that has greatly improved the efficiency of screening and grouping blood in Kenya. NBTS spans three divisions including laboratory, donor, and information and community with over 30 employees involved in day-to-day operations. Equipment procured for NBTS will enhance quality control and enable a move toward centralized testing. Along with meeting equipment needs, SCMS has also procured blood-related laboratory commodities such as Elisa reagents and blood bags.
Regional distribution center (RDC): Kenya is home to an SCMS RDC—one of three facilities in sub-Saharan Africa (along with South Africa) serving customers with essential HIV/AIDS medicines and supplies. These facilities, which are temperature-controlled and secure, follow commercial best practices to ensure security and quality of products as well as timely delivery. SCMS is able to hold inventories closer to where clients are located, providing more frequent deliveries of smaller quantities, reducing prices and contributing to improvements in all services for clients in East African focus countries. The RDC is also uniquely positioned to provide freight and logistics services to our Kenya procurement activities, including customs clearance and distribution of cold-chain products directly to testing sites.
HIV test kits and laboratory reagents distribution: In response to the growing demand to provide a secure, reliable and uninterrupted supply of HIV laboratory-related commodities, the US Government charged SCMS with establishing a new distribution model that includes warehousing and storage components, flow of commodities and information, and direct distribution to all service delivery points. Since May 2009, SCMS has distributed test kits on a quarterly basis to over 4,000 sites, including government, faith-based and community-based SDPs. These sites provide various HIV interventions, such as voluntary counseling and testing, prevention of mother-to-child transmission, voluntary male circumcision, and home-based counseling and testing. To date, SCMS has distributed kits to test over six million people in these program areas. Also, we distribute CD4 reagents and tests, chemistry, hematology, and other laboratory commodities to over 100 facilities. We are procuring service and maintenance contracts for all equipment in the PEPFAR-supported facilities to follow expiration of one-year warranty agreements.
National testing campaign: Since 2008, SCMS has supported the Government of Kenya in conducting national HIV testing campaigns, which are normally held during October and November to precede the World AIDS Day commemoration on December 1. In 2008, SCMS set a national precedent by providing over two million rapid test kits. This achievement led to our playing a central role as an organizing committee member for the 2009 campaign. In this role, we worked closely with the provincial AIDS and STI control officers and district AIDS and STI control officers to provide the necessary logistics to distribute 1.5 million HIV testing kits nationally. We contributed to the campaign's success by ensuring that over 4,000 SDPs received the correct quantities of kits on time.
National support: SCMS staff are active members of various technical working groups within NACC and NASCOP. This involvement has increased our visibility and has contributed to our being recognized as a critical player in the role of logistics in HIV/AIDS programming.