Country Highlights

In Rwanda, the number of patients on treatment has increased from 400 in 2003 to over 40,000 in 2008. Existing health systems and supply chain networks have struggled to keep pace. To meet the need for scale-up, the Government of Rwanda introduced a national coordinated procurement and distribution system for health commodities, in which Centrale d'Achate Medicaments Essentiels du Rwanda (CAMERWA) operates the national medical stores and has sole responsibility for procurement, storage and distribution of ARVs. CAMERWA's primary objective is to create a modernized professional and competitive regional operation by implementing best practices from the commercial sector.

SCMS has forged an important partnership with CAMERWA, to build in-country supply chain capacity and drive down the costs of medicines for the country's HIV/AIDS program.

Our key objectives in Rwanda are to:

• To improve and increase the quantity and quality of the basic information required for forecasting and supply planning of all HIV/AIDS commodities
• To assist CAMERWA to become eligible for grant recipient status, improve product flow, implement effective warehouse management standards and modernize operations
• To strengthen storage and management capacity at the district level and improve distribution systems to districts
• Improve the capacity and capability of provincial warehouses
• Identify and pursue opportunities to procure drug commodities to meet scale up requirements

Value of commodities delivered as of December 2007: Over $4 million

Progress to date:

Because SCMS is able to pool procurements across many countries, purchase generic pharmaceuticals whenever possible, and establish long-term contracts with suppliers, SCMS and CAMERWA were able to agree on prices with suppliers to save the Rwanda program about 23 percent compared with previous orders for the same commodities. The cost savings are enough to potentially treat an additional 3,000 adults for one year. Last year, CAMERWA conducted a comprehensive restructuring of all warehouse management operations. SCMS provided technical assistance in warehouse best practices, redrafted standard operating procedures and reviewed the existing warehouse management software, introducing bar coding and stock management system. CAMERWA recently introduced the T-CARD system, an interim solution to manage stocks and aid in inventory management until a computerized warehouse solution is implemented. This makes stock replenishment and pick and pack faster and more effective.

Thanks to these changes, CAMERWA has reduced the receipt process of drugs into the warehouse from 15 to 5 days, improving inventory control and stock reporting. Dispensing time was reduced by half, lowering overtime costs. New shelving for the warehouse increased storage capacity by 64 percent, improving layout and product mapping. Accuracy of monthly reporting on stock levels and inventory is improving, alerting partners to potential stockouts before they occur. Monitoring and supervision of dispensing ARVs is more effective and customers are receiving ARVs in a timely manner.

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