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 (ARV) therapy. The Government of Nigeria has set an ambitious goal to scale-up the total number of patients receiving ARV treatment. 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, 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.

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

Quantification: 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 were combind to develop the first national estimation of annual ARV drug needs for Nigeria. The estimation was presented to stakeholders at a consensus-building workshop where a common set of clinical and program assumptions was developed for estimating a five-year forecast. The resulting forecast determined that Nigeria required a minimum of $792 million to finance procurement of ARV drugs from 2009 to 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 use of commodities it procures for implementing partners and clients. In one of these reviews, we observed that the quantity of test kits was high and available data revealed that projected consumption of these stocks risked expiry of a large kit volume. To avoid waste, we leveraged our network of offices in other countries to identify potential needs and opportunities for redistributing 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 remaining kits were 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 principal recipients, and the Clinton Foundation through a routine stakeholder meeting. There 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 waste by identifying and redistributing short-shelf life commodities, and has 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 providing real-time data. It is being used to collect in real-time, store, retrieve and analyze critical HIV/AIDS information relating to HIV/AIDS services delivery. 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.