Country Highlights

As of June 2008, out of the estimated 3.2 million adults and children in Nigeria living with HIV/AIDS, 270,000 were receiving antiretroviral therapy (ART), up from just 67,000 in 2006. The government of Nigeria has set an ambitious goal to provide antiretroviral (ARV) treatment to 350,000 recipients by the end of 2008. Strengthening the country’s supply chain system for ARVs is essential to making this happen.

Nigeria’s HIV/AIDS supply chain is made up of multiple supply chains—many of which include separate procurement, warehousing, and distribution systems—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 across these disparate supply chains, the FMOH recently created a Logistics Unit to collect and distribute supply chain data. However, to succeed, the Logistics Unit must be supported by systems that provide accurate data; understand how the data can be used to improve logistics and planning; and identify ways to integrate or coordinate the disparate supply chain systems. In this context, SCMS has identified information sharing, capacity building, and procurement and distribution as key focus areas.

In the short term, planned activities are largely tactical, including:

• Designing and implementing an integrated national monitoring and evaluation system for public and nongovernmental/faith-based partners
• Training Logistics Unit staff on quantification
• Modify the existing National HIV and AIDS Commodities logistics system
• Working to improve policies and procedures at the Central Medical Store
• Assessing the Federal distribution system.

Other, more strategic activities focus on improving coordination among key stakeholders, such as establishing a Supply Chain Management Steering Committee and facilitating quarterly stakeholder meetings to address commodity security issues.

Value of commodities delivered as of March 2008: Over $7 million

Since April 2006, SCMS has procured $2.3 million in antiretrovirals (ARVs), $3.2 million in HIV test kits and more than $900,000 in other commodities for our clients in Nigeria, including the US Centers for Disease Control and Prevention, the US Department of Defense, University of Maryland and Harvard University. In June, SCMS conducted a National HIV/AIDS Program process mapping and a needs assessment of the Central Medical Stores (CMS) and commodity distribution system, which identified significant weaknesses in both process and capacity to effectively manage and distribute HIV/AIDS commodities. The findings resulted in concrete recommendations for system strengthening and capacity building.

In October 2007, SCMS and various implementing partners, including the National Agency for the Control of AIDS (NACA), signed a memorandum of understanding to coordinate information sharing using a common management information platform that supports facility level and partner reporting. SCMS conducted an assessment of the information sharing system currently used by the Federal Ministry of Health and found that technology solutions could significantly improve data flow and reduce the considerable duplication that exists within the system. Based on the assessment, SCMS made a series of recommendations that, once implemented, helped improve reporting rates on ARV logistics from 16 percent in July 2007 to 100 percent by December.

In the spring of 2008, SCMS was one of several PEPFAR implementing partners who came to the aid of Harvard University after a fire destroyed the warehouse that supplied its HIV/AIDS treatment programs in Nigeria. We made three shipments of ARVs from our regional distribution centers in Ghana and South Africa, helping ensure that patients depending on Harvard’s program receive uninterrupted treatment. SCMS also facilitated an additional shipment of ARVs from Cote d’Ivoire to Nigeria.

As of June 2008, SCMS has developed supply plans for all PEPFAR Implementing Partners (IPs). SCMS also now stores and distributes HIV test kits for IPs and has begun procuring commodities from the local market for some clients.

The Federal Ministry of Health has also approved the establishment of the Logistics Technical Working Group and Logistics Steering Committee. Long promoted by SCMS, these new institutions will enhance the capacity of the government to manage their health supply chains.