Country Overview

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

With an estimated 140 million residents, Nigeria is Africa’s most populous country. About 3.6 million Nigerians are believed to be HIV-infected, but only
about  247,000 are currently receiving antiretroviral (ARV) treatment at the end of December 2008. This fell short of the government of Nigeria’s ambitious goal to provide ARV treatment to 350,000 recipients by the end of 2008. The target set for end of 2009 is to have 540,000 persons on treatment. Strengthening the country’s supply chain for ARVs is essential to making this happen.

SCMS supports the Federal Ministry of Health (FMOH) and the National Agency for the Control of AIDS (NACA) in their oversight of the many parts of Nigeria’s HIV/AIDS supply chain--multiple supply chains owned and operated by various federal, state, nongovernmental and faith-based stakeholders. To improve visibility across these many entities, the FMOH recently created a Logistics Unit for collecting and distributing supply chain data. SCMS supports the Logistics Unit by ensuring that systems provide accurate data, identifying how the data can be used to improve logistics and planning, and finding ways to integrate or coordinate the disparate supply chain systems. We also support two newly created FMOH institutions, the Logistics Technical Working Group and Logistics Steering Committee, which are enhancing the capacity of the government to manage its health supply chains.

Key Objectives

• Design and implement an integrated national monitoring and evaluation system for public and nongovernmental and faith-based partners
• Train Logistics Unit staff in quantification
• Modify the existing National HIV and 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 2008: 24.5 million

Quantification: In years past, PEPFAR implementing partners (IPs) developed individual drug quantifications for their treatment programs using different methods with different assumptions and data. In July and August 2008, SCMS worked with IPs to compile the first PEPFAR-wide aggregated quantification for ARV drugs in Nigeria. In a series of highly participatory meetings, each IP quantification was peer-reviewed by SCMS and other IP colleagues, methodologies tested, assumptions examined, and the breadth of regimens and commodities compared. The PEPFAR quantification has been combined with Global Fund and Government of Nigeria ARV drug quantifications to develop the first-ever national ARV drug need estimate for 2009. A five-year (2010 – 2014) national ARV drug requirements forecast which takes into consideration the planned phase out of UNITAIDS funding for adult second line regimens in 2010 and pediatrics regimens in 2011 has also been developed.

Logistics: SCMS worked with a new PEPFAR implementing partner, the Nigerian Indigenous Capacity Building Project (NICaB), in designing a logistics system that harmonizes with the existing logistics system for national HIV/AIDS. commodities.

Warehousing and distribution: In spring 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 received uninterrupted treatment. SCMS also facilitated an additional shipment of ARVs from Cote d’Ivoire to Nigeria.

In June 2008, we conducted a National HIV/AIDS Program process mapping and a needs assessment of the Central Medical Stores (CMS) and commodity distribution system. The study identified significant weaknesses in process and capacity to effectively manage and distribute HIV/AIDS commodities—and provided concrete recommendations for system strengthening and capacity building.

information system: SCMS is coordinating information sharing with various implementing partners through a common management information platform that supports facility level and partner reporting. Innovations and new approaches recommended by SCMS have significantly improved data flow and reduced duplication—improving reporting rates on ARV logistics from 16 percent to 100 percent.