Country Highlights

Zimbabwe is experiencing a severe economic downturn characterized by hyperinflation. In spite of these challenges, the Government of Zimbabwe is making progress reducing infection rates and in scaling up treatment for people living with HIV/AIDS. In 2001, HIV infection rates were estimated about 33 percent for people aged 15-49. Since then the rate has dropped to about 15.6 percent.

SCMS provides first-line antiretroviral medicines (ARVs) for 40,000 of the 103,000 adult patients estimated to be on treatment in Zimbabwe and provides HIV test kits to perform more than 500,000 tests per year.

In addition, SCMS's key objectives in Zimbabwe are to:

• Improve information sharing and leverage capabilities of partners
• Build capacity in quantification and supply planning among Ministry of Health partners
• Develop and operate an improved National HIV and AIDS Commodities logistics system
• Enhance current central warehousing and distribution capabilities

Value of commodities delivered as of mid-September 2008: Over $ 7million

Progress to date:

In such an unstable economic environment, coordination among key stakeholders is key to the success of treatment programs. SCMS provides support to the Ministry of Health and Child Welfare (MOHCW) in several ways.

SCMS helps support the Procurement and Logistics Subcommittee of the National Anti-retroviral Treatment Partnership Forum, a program of the MOHCW to coordinate the efforts of government agencies with donor and partner organizations like the Clinton Foundation, DFID, Elizabeth Glaser Pediatric AIDS Foundation (EGPAF),the European Union, the Global Fund, Médecins Sans Frontières (MSF) and UNICEF. Effective quantification for adult and pediatric ARVs, HIV rapid test kits, Fluconazole, Cotrimoxazole for opportunistic infections (OI) and TB drugs—including 24-month forecasts, 12-month supply plans and quarterly review of both—reduces the incidence of stockouts, lowers the price of purchased commodities and helps donors coordinate funding.

Since November 2007, the MOHCW AIDS & TB Logistics Sub-unit (LSU) leads and manages quarterly updates to forecasts and supply plans for ARVs, HIV test kits, OI drugs and TB drugs, with limited SCMS guidance, demonstrating the growth in technical capacity of the MOHCW staff. The quantification results are presented to partners during monthly meetings of the Procurement and Logistics Subcommittee (PLS).

In spite of the prevailing challenging economic environment, SCMS continued to maintain and operate a fleet of 3 ARV delivery trucks. These vehicles deliver ARVs to 150 initiating and follow-up sites in all provinces and 55 out of the 62 districts in Zimbabwe, helping to avoid stock-outs and treatment interruptions.

Zimbabwe is reducing stockouts of key HIV/AIDS commodities through an innovative program first developed for family planning programs in Zimbabwe. In partnership with SCMS and USAID | DELIVER PROJECT, the Ministry of Health and Child Welfare (MOHCW)/AIDS & TB Logistics Sub-Unit (LSU), the Zimbabwe National Family Planning Council (ZNFPC), and Crown Agents/DFID piloted in two provinces a project to add HIV rapid test kits and Nevirapine for prevention of mother-to-child transmission (PMTCT) to an existing distribution system that delivers condoms and contraceptives to health facilities. Under the Delivery Team Topping Up (DTTU) distribution system, delivery team leaders carry commonly used commodities in large trucks—or “moving warehouses”—to health facilities, checking remaining supplies and leaving behind what is needed to replenish stocks. According to an evaluation in January 2008, in one province stockout rates fell by 19 percent for rapid test kits and by 37 percent for Nevirapine. In light of the excellent results, this innovative program was rolled out nationwide and, since August 2008, covers approximately 700 health facilities which offer PMTCT and HIV/AIDS testing. SCMS has supported this roll out by purchasing an additional 5 DTTU delivery trucks to supplement the original fleet of 5 DTTU delivery trucks provided by the USAID | DELIVER Project.

SCMS also seconds two Zimbabwean medical doctors to the MOHCW AIDS & TB Programme, one of whom serves as National ART Coordinator and one who serves as Assistant National ART Coordinator. SCMS supports these staff in assessing sites for readiness to offer ART services, in training ART site staff in OI/ART, and in decentralization of stable ART patients for follow up care at health facilities nearer to their homes.