World AIDS Day 2020: Developments and updates from PFSCM direct clients: CONAVIHSIDA, Gilead DREAMS, and Janssen New Horizons Collaborative

by | Dec 1, 2020

Apart from PFSCM’s work as an official procurement services agent for the Global Fund to Fight AIDS, Tuberculosis and Malaria, we also serve a wide range of other clients including:

On World AIDS Day 2020, we throw the spotlight on a few of these clients for whom we provide HIV related procurement and distribution services.

 

Celebrating 10 years of diverse services to enhance HIV service delivery in the Dominican Republic 

 

PFSCM has been serving El Consejo Nacional para el VIH y el Sida (CONAVIHSIDA) of the Dominican Republic (DR) for 10 years.

CONAVIHSIDA is a government organization that coordinates the formulation and recommendation of evidence-based guidelines on HIV testing, treatment and patient management.

PFSCM and CONAVIHSIDA renew the scope of work and contract requirements annually, and to date PFSCM has been responsible for procurement, and has also undertaken diverse technical assistance– and in-country logistics projects. Our core activities include the procurement and distribution of HIV health products, mainly antiretrovirals (ARVs).

Since partnering with CONAVIHSIDA, we have delivered more than 939 shipments of HIV commodities valued at more than $91 million to the DR. Through best procurement practices, we have saved CONAVIHSIDA over $10 million in procurement costs over the last decade.

 

Multi-month dispensing 

 

Most recently, PFSCM helped CONAVIHSIDA to plan for and adopt multi-month dispensing (MMD) of ARVs to stable patients who meet strict treatment criteria. With MMD a patient may receive a three or six-month supply of ART.

MMD dispensing has several benefits:

 

Supply Chain 
  • Increased order intervals.
  • Fewer but larger orders that have the potential to improve downstream activities such as storage and inventory throughput.
  • Space reducing packaging options.
  • Fewer shipments reduce the global logistics carbon footprint
Human resources for health 
  • MMD reduces the number of patient visits to a health facility and frees up valuable human resources while decongesting facilities.
  • The reduced patient load, means that health care workers can spend more time on other critical HIV services.
Patient
  • The treatment burden is reduced by fewer clinic visits.
  • Improved ARV adherence and improved retention on ARVs.

 

Diverse technical assistance

 

In 2018, in collaboration with local firm GIS Public Health Consulting Group. PFSCM started doing technical assistance for CONAVIHSIDA.

Our recent forecasting, procurement and product quality assurance technical assistance work included:

  • Quantifying the DR’s 2021 HIV product volumes for efficient and accurate procurement.
  • Developing a plan for the introduction of new ARV formulations. Advising the client about new ARV formulas scheduled to be introduced on the market and advising the addition of new formulas to the Essential Medicines List.
  • Developing and implementing Standard Operating Procedures for the procurement of health products through international agencies and for auditing dispatches and reception of HIV products.
  • Performing a procurement assessment with a focus on tenders, process and policy gaps specific to ARV medicines and related medical supplies in order to ensure the future procurement of quality products for HIV programs.
  • Organizing training workshops to develop specific knowledge needed in the ARV procurement.
  • Performing a quality gap assessment on the downstream ARV supply chain and delivering training to formally introduce a Quality Management Approach.

Further, through our technical assistance projects we have helped the MOH of the DR to improve their downstream distribution to better support the transfer of HIV products to regional health services facilities.

PFSCM assisted in the below activities:

  • Assessed the nine regional health services facilities and their compliance with national and international regulations, including current Good Distribution Practices.
  • Provided guidance on how to improve the inventory management practices in all regional health services facilities.
  • Provided guidance on how to improve the warehouse conditions and practices in HIV diagnostic and treatments facilities located in remote and warm areas.
  • Developed an option analysis for the mobilization of resources to support the improvement of transportation and storage in regional health services facilities.
  • Strengthened the Logistics Management and Information System for decision making at central and regional levels. Enabled data driven decision processes in public health supply chain management.
  • Optimized logistics through a Milk Run system which achieves efficacy by combining products to be transported in a single vehicle.

After concluding the above mentioned activities the MOH dedicated $2.6 million over two years (2020/2021) to upgrade the logistics network, including constructing warehouses and procuring temperature controlled trucks and supporting equipment.

In the meanwhile, PFSCM has also taken over an in-county logistics project for CONAVIHSIDA.

PFSCM usually only took responsibility for the shipments up to delivery at the local airport, but since April 2020, we have been collaborating with a local freight forwarder to move our products directly from the airport to the Central Medical Store (CMS). The MOH then distributes the products from the CMS to the regional health services facilities using the Milk Run system that was established.

 

 

PFSCM continues collaboration with the New Horizons Collaborative to supply 2nd and 3rd line pediatric HIV medicines

 

In 2020, PFSCM’s contract with Janssen Pharmaceutical Companies of Johnson & Johnson’s New Horizons Collaborative has been extended, and we will continue to provide Janssen with diverse services as the group prepares for the launch of the second phase of the project.

PFSCM has been serving the New Horizons Collaborative since 2016. We undertake forecasting, procurement, and coordination activities to ensure donated pediatric HIV medicines such as Prezista® and Intelence® reach recipient countries on time and in full.

In collaboration with other New Horizons Collaborative service providers, we have also undertaken technical assistance projects that entail training and the development of forecasting tools.

Additionally, we have supported the Healthcare Systems Strengthening Activities of the New Horizons Collaborative by partaking in various technical-, country implementation- and onboarding workshops. Most recently, PFSCM and its parent company JSI presented a joint training in Kenya on quantifying 3rd line pediatric ARVs using JSI’s forecasting and the validation tool.

In 2020, PFSCM has delivered $20.4 million worth of donated pediatric HIV products to South Africa from where it was distributed further to other countries. By September 2020, we have already placed orders for $58.9 million worth of products to be delivered in Q4 2020 and 2021.The countries have also already started submitting their forecasted figures for next year. In total, since 2016, we have delivered $38.0 worth of donated products on behalf of the New Horizons Collaborative.

The New Horizons Collaborative serves eight countries: Cameroon, Eswatini (Swaziland), Kenya, Lesotho, Nigeria, Rwanda, Uganda, Zambia and Zimbabwe. So far this year, PFSCM has delivered goods to seven out of the eight participating countries, with an order for Cameroon is still underway.

 

PFSCM contract extended for DREAMS PrEP procurement services in South Africa and Zambia 

 

In 2020, PFSCM’s contract with GILEAD was extended for procurement and distribution services of donated pre-exposure prophylaxis (PrEP) products for PEPFAR’s Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) partnership.

PFSCM has been serving GILEAD since 2016. We undertake sourcing, price negotiations, product quality testing, and we analyze stock and consumption rates at in-county service points while also coordinating the delivery of products in collaboration with implementing partners.

 

Donated PrEP products for the DREAMS partnership were initially supplied to eight African countries including Botswana, Kenya, Malawi, Namibia, South Africa, Swaziland, Zambia and Zimbabwe. In recent years, country-specific treatment-, guideline-, and policy changes have altered the donation landscape; and currently PFSCM only supplies South Africa and Zambia with Emtricitabine/Tenofovir Disoproxil Fumarate 200/300mg (FTC/TDF).

South Africa

South Africa has excelled with its prevention program ordering medicines for implementing partners in five DREAMS districts. This year the country added an additional 19 DREAMS districts and increased its PrEP service points from 49 to over 140.

PFSCM delivers products to Cape Town, Johannesburg, Pietermaritzburg and Durban, from there the implementing partners and other associated service providers move the products further downstream to the various service points.

 

In 2021, the project plans to serve more than 13,000 adolescent girls and young women (AGYW) in South Africa.

Find the South Africa DREAMS Fact Sheet here.

 

Zambia 

In 2020, the country team set up a target of 2,663 AGYW to be covered with the PrEP treatment. It was more than a two-fold increase compared with the target of 1,150 patients in 2018/2019. In 2021, the plan is to further increase the coverage to reach about 5,659 AGYW.

PFSCM’s parent company JSI Research & Training Institute (JSI) implements the USAID DISCOVER-Health Project (DISCOVER) which supports the Ministry of Health (MOH) to improve access to and utilization of quality HIV services in Zambia.

DISCOVER was among the first MOH partners to roll out PrEP after the May 2018 scale-up approval and is currently providing oral PrEP services to AGYW in DREAMS districts, using products donated for DREAMS by Gilead Sciences.

Learn more about JSI’s role and find resources here.

Learn more about JSI and the DREAMS Innovation Challenge here.

Find the Zambia DREAMS Fact Sheet here.

 

GILEAD DREAMS impact figures

Over the last five years*, PFSCM has organized the procurement and delivery of FTC/TDF valued at $2 million to eight countries (Botswana, Kenya, Malawi, Namibia, South Africa, Swaziland, Zambia and Zimbabwe).

Assuming the consumption rate of one pack of 30 tablets per month for a patient on PrEP, the procured quantity of 894,282 packs is sufficient to cover 74,524 yearly treatments. The majority of the product (about 73.6%) was procured for the project in South Africa – 657,937 packs.

*2016 to Q3 2020