Country Overview

SCMS's innovations and new approaches have significantly improved data flow and reduced duplication—improving reporting rates on ARV logistics from 16 percent to 100 percent. 

As of the end of 2009, 312,000 of an estimated 3 million adults and children in Nigeria living with HIV/AIDS received antiretroviral therapy (ART). The Government of Nigeria has set an ambitious goal to provide antiretroviral (ARV) treatment to 694,000 recipients by the end of 2011. Strengthening the country’s supply chain system for ARVs is essential to making this happen.

Nigeria’s HIV/AIDS supply chains—many of which include separate procurement, warehousing, and distribution systems—are owned and operated by various federal, state, nongovernmental, and faith-based stakeholders with oversight from the Federal Ministry of Health (FMOH) and the National Agency for the Control of AIDS (NACA). To improve visibility and coordination across these disparate supply chains, SCMS is working with the FMOH and PEPFAR-funded agencies and implementing partners to strengthen quantification and procurement planning, logistics data collection and management, inventory control, storage and distribution, and supply chain coordination for HIV/AIDS commodities.

In 2010, SCMS will procure all first line ARV drugs and HIV Test kits for PEPFAR partners in Nigeria, along with a broad array of laboratory equipment and supplies to support PEPFAR efforts and the Government of Nigeria’s goals in addressing the impact of HIV/AIDS in Nigeria.

Key Objectives

• Enhance long-term sustainability of HIV/AIDS commodities
• Design and implement an integrated national monitoring and evaluation system for public and nongovernmental and faith-based partners
• Train logistics staff in quantification
• Modify the existing national HIV/AIDS commodities logistics system
• Improve policies and procedures at the Central Medical Store
• Assess the federal distribution system
• Improve coordination among key stakeholders, such as establishing a supply chain management steering committee and facilitating quarterly stakeholder meetings to address commodity security issues

Activities and Impact

Value of commodities delivered as of December 2009: $86.5 million

Quantification:  A national estimation of annual ARV drug needs was developed for the first time in Nigeria last year combining three program-specific drug quantifications from PEPFAR, the Global Fund, and the Government of Nigeria-supported programs, as well as the regimens provided by the Clinton Foundation under UNITAID funding. The estimation was presented to stakeholders at a consensus building workshop where a common set of clinical and program assumptions were developed for estimating a five-year forecast. The resulting five-year forecast determine that Nigeria required a minimum of $792 million to finance procurement of ARV drugs from 2009 – 2014. This analysis, which presented the cost of a variety of treatment regimen options, was used as part of the Global Fund Round 9 proposal and is an essential resource for budget planning, resource mobilization, and procurement planning in the coming years.

Warehousing and distribution:  As part of its comprehensive package of services to its PEPFAR clients and partners, SCMS follows up regularly by reviewing the utilization of commodities it procures for IPs and clients. During one of these reviews, SCMS observed that the quantity of the IPs was high and available data revealed that projected consumption of these stocks risked expiry of a large volume of the kits. To avoid wastage, SCMS used its network of offices in other countries to identify potential needs and opportunities to redistribute the test kits, while ensuring they will be used before the expiry dates. Subsequently, donations were made to Cameroon and Sierra Leone. With the approval of the US Government office in Nigeria, the remainder was donated through AmeriCares (a disaster relief and humanitarian aid organization) to Ghana, Malawi and Democratic Republic of Congo.

Coordination: SCMS is coordinating procurement and supply management (PSM) activities among the various implementing partners, Government of Nigeria, Global Fund PRs, and the Clinton Foundation through routine meetings of the PSM Backbone, a routine stakeholder meeting where operational details are shared to maximize existing supplies, coordinate procurements and shipments, address stock imbalances, and share information about PSM-related activities. This mechanism has helped avoid wastage by identifying and redistributing short-shelf life commodities, and addressed shortages by brokering loans and reimbursements of ARV drugs among partners.

Information systems: SCMS is developing the Logistics and Health Program Management Information Platform (LHPMIP) for the Government of Nigeria. LHPMIP is an integrated information platform designed to help strengthen the logistics and management of Nigeria’s HIV/AIDS program by the provision of real time data. It is being used to collect in real time, store, retrieve and analyze critical HIV/AIDS information as it relates to HIV/AIDS services delivery. The platform is currently being used in over 160 ART sites to report ART patient data and related HMIS data, with a target of rolling out to over 420 sites by the end of COP 10. In 2010, SCMS is building the LMIS module of LMHPMIP to serve as the national data collection and management system for logistic data and HIV/AIDS supply chain transactions. This work builds on the existing paper and Excel-based LMIS tools currently in use in over 200 Global Fund, Government of Nigeria, and PEPFAR-supported sites.