IV. Key Challenges GEORGIA - PowerPoint Presentation

1. IV. Key Challenges GEORGIAVaccine Procurement WorkshopTbilisi, April, 2019III. Vaccine Procurement in PracticeII. Vaccine Procurement OrganogramMoHUNICEF SDMoFcontractorsUNICEF COUNICEF procurement State Procurement AgencyfinancingplanningNational Public Health InstituteCustomsLocal procurement I. What and HowVaccinePresentationManufacturer / Price per dose (USD)Procurement MechanismHepB10 doseLG LIFE SCIENCES LTD (Korea) / 1.75UNICEF mechanismBCG20 doseBB-NCIPD (Bulgaria) / 2.1UNICEF mechanismHexavalent Single doseSanofi Pasteur (France) 19.75Local procurement ROTASingle doseGSK (Belgium) / 2.17UNICEF mechanismPCV2 dosesGSK (Belgium) / 6.1UNICEF mechanismMMR2 dosesGSK (Belgium) / 8.94UNICEF mechanismDPT10 dosesSERUM INSTITUTE OF INDIA (India) / 1.89UNICEF mechanismbOPV20 dosesGSK (Belgium) / 2.7UNICEF mechanismDT10 dosesBB-NCIPD/ 1.8 (Bulgaria)UNICEF mechanismTD10 dosesBB-NCIPD (Bulgaria) / 1.3UNICEF mechanismRegulatory frameworkLaw of Georgia on Public Procurement, 2006Approves General provisions including Unified Electronic System of Public Procurement Allows multiyear purchasingLaw of Georgia on Drugs and Pharmaceutical activities, 2009Approves registration rulesAllows for importers to register their products based on two types of “recognition”: prior recognition by an accepted international partner or national recognition and national recognitionThe Budget Law of Georgia (annual)Approves annual state health program budgetNational Immunization Program as part of the State Health Programs, Gov Resolution (annual) Approves vaccines, target groups, the NIP budget Recent Vaccine introductionsRotavirus vaccine – 2013; Pneumococcal vaccine -2014; Hexavalent vaccine – 2015; HPV – 2018 (demo project) 2020 (introduction is planned)Vaccine budget and sources of financingVaccine and supplies budget 22,4 mln Gel (8,8 mln USD), on vaccines alone 15 lmn Gel (5.9 mln USD), or 113 USD per live born.Source – The state budget; HPV - Gavi Sources of information on vaccine market and pricesThe database V3P http://www.who.int/immunization/programmes_systems/procurement/v3p/platform/module1/en/) The database of NRA (http://pharmacy.moh.gov.ge/Default.aspx);The database of state procurement (http://procurement.gov.ge/); Data on the inventory of vaccines and suppliesShortages and over-stocks. No shortage since 2013V. Way ForwardWhat main challenges may arise over the next 3 years?Following Gavi support, it is important to maintain financial stability, introduce two new vaccines (HPV-2020, DaPT-2020) and secure funds in the budget for the communication and supervision. Ensure registration of vaccines purchased by UNICEF mechanismSkills, tools and support needed to improve vaccine procurement efficiency and introduction of new vaccines Establishment of Purchasing Efficiency Monitoring Mechanism, Introduction of current trends of the Global Market, Sharing Countries ExperienceIf available, please insert a chart on the quantities of vaccine procured in 2015-2018 by vaccine type, prices (if possible). Indicate stock outs and delays in introduction due to unavailability.Explaining factorsThe country's small sizeAbsence of commercial interestGlobal deficiency of vaccines productionVaccine high price in the global market.Mitigating MechanismsInternational purchase mechanisms and donor supportPossibility of joint procurement, including joint purchases with neighboring countriesIncrease strategic stock.Possible Solutions UNICEF Unified Procurement Mechanism Increase quant. through multi-year purchases Legislation that provides opportunities to ensure transparency and free competitive environment, through intern. procurement electronic systemUse of the mechanism for the abolition of registration of the vaccines registered in the countries with a high level of control and also prequalified by the WHO.ChallengesSmall volumes of purchasesSmall number of registered vaccines (50%)Deficiency of some vaccines in the global market; (e.g. MMR Jeryl Lynn strain; Hexavalent vaccine). Challenges with multi-country (joint) purchasing due to non synchronized legislation with other countries.03 04 05 06 07 08 09 10 11 12 01 02 03 04 05 06 07 08 09 10 11 1220182019PlanningBudget negotiation with MoHBudget approvalBudgetingMarket survey; TenderingBids evaluation, SelectionQuality controlContracting Payment Delivery, Monitoring UNICEF request development3-year projections for MTEFLocal ProcurementUNICEF requests sent UNICEF Invoices; delivery plan Delivery and Customs clearanceDelivery to central storeWaivers Payments to UNICEFDeliveryCustoms clearance 1-2 dDelivery to central store Distribution to subnational stores, Monitoring Quality CheckQuantification with technical specifications Cost EstimationsUNICEF ProcurementVaccine Procurement cycle