UNICEF- Update on key activities and - PowerPoint Presentation

Slide1

UNICEF- Update on key activities and

plansIPC, 5th-6th June. 2014Slide2

Procurement in support of programmes- 2013

Supplies and services for 134 countries and areasTotal procured$2,839Emergency$127Supplies to 33 countries and areasProcurement Services$1,363

Supplies to 99 countriesSlide3

Supplier and destination countriesSlide4

Medicines: 2014 Activities

Procurement strategies to address increasing demand for priority medicines: ORS/Zinc, amoxicillin DT, gentamicin, CHX, dexamethasone inj, IFA…Support work of UNCLSC and Pneumonia and Diarrhoea WG: Amoxi DT ERP, availability of medicines and diagnostics, collaboration to increase sources, country implementation including activities resulting from GF/UNICEF MoU.Optimization of kits: iCCM (DRC), Diarrhoea kit, PEP KitPartnerships to ensure availability of pediatric ARVs: IATT Formulary development Pediatric ARV WG Pediatric ARV Procurement Working GroupControlled temperature

shipmentsImprove internal process and supplier relations to provide optimal service Slide5

The market dashboardInspired from UNITAID Market dynamics Dashboard

The Dashboard monitors the market dynamics of more than 50 essential commodities for women and children. It provides a qualitative assessment of the determinants of a healthymarket, including:• Availability• Affordability• Competition• Quality• Acceptability• Delivery• Funding securityhttp://www.unicef.org/supply/index_70578.htmlPublished twice a year, aim is to encourage internal and collaborative thinking on ways to address gaps and achieve a more balanced marketSlide6

ORS/Zinc co-pack: 3 LTAs established, first procurement of over 200K packs

Chlohexidine 4% for umbilical cord care: collaboration through UNCLSC to increase number of manufacturers and qualify gel formulations.Amoxicillin DT: increase in demand and initiation of substitution of suspension Introduction of optimal productsSlide7

Kit delivery

Majority are health kitsSlide8

Supply of commodities to manage sexual assault of

children and women in the context of emergenciesChallengesForecasting the need Kit design not addressing diversity of situations where it is used (target, skills and care services)Repacking of kits at Country Office level to meet needsSplit up kit contents to distribute to smaller health facilitiesSplit up blisters/packs to dispense to patientsSpecific needs of children usually not taken care of, e.g. paediatric dosagesLack of specific GuidancePEP Children

PEP Adults

Wound Care

Psychosocial Support

Associated Conditions

+ Guidance

D

ocuments

Proposed

Response (for discussion with partners)

Easy identification of the necessary items for management of sexual assault

More flexibility in procurement of PEP for children

Holistic response, Clear guidance

Guidelines to be reviewed 2014 (WHO)Slide9

Consolidate regimens used

Consolidate formulations usedEnsure pediatric ART guidelines are up to dateIdentify regimens and products that can be phased out of formulary (eg. d4T, ddI)Review current procurement list for redundancies Explore areas for transition to optimal products such as FDC’s and phase out suboptimal or redundant formulations

Partnerships to ensure availability of optimal treatment for HIV in children

Consolidate formulations used

Coordinate

pediatric ARV procurement amongst

partners

Align

both supply and demand to more efficient products.

Interagency Task Team (IATT)/ Pediatric ARV Working Group

Pediatric

ARV Procurement Working

Group/ Buyer ConsortiumSlide10

Health Technology Centre Essential supplies for Health Programmes

Medical equipment and consumables, diagnostics tests and

clinical laboratory

equipment

Long Lasting Insecticide treated bed nets ( LLIN’s),

Insecticides and Rapid Tests

Malaria

Prevention

and Diagnostics

Medical Devices and Laboratory

Cold

Chain

Cold chain equipment, refrigerators, waste disposal, injection safety devices

Maternal and New born Health Issues

INNOVATION

FOCUS

Injection

safety

devices,

waste

disposal

.

Immunisation DevicesSlide11

Health Technology: 2014 Activities

Optimization strategies defined for Health Technologies Supply Chains,.i.e. Performance indicators, Forecasting, Shipments optimization and Total Landed Cost optionsQuality policies prepared, harmonization with key partners (IVD, High Risk Medical Devices, mapping high-risk products that could be those correspond to class IIB and III of European MDD and develop its risk mitigation protocol).Innovation – ARIDA project ( pneumonia diagnostics ), in collaboration with WHO, Malaria Consortium, BMGFPartnerships LLIN procurement – GF, UNDP, DfiD, PMI,Partnerships POC technology – UNITAID, CHAI, 7 countriesSlide12

Ensure a cold chain for all TTSPP ….  Scale up of old vaccines …….

Scale up of new vaccines …… Scale up of new versions such as IPV …. Healthy market for innovative cold chain equipment Supply Chain integration – Oxytocin, Insulin Cold chains for lab samples, blood banks, test kits …Immunization devices available for allOptimizing immunization shipments/cost per device delivered Untangling the web of quality requirements Waste management for immunization, diagnostic testing ?Aligning with WHO PQS for injection safety devices procurement and providing feedback on evaluation protocols and technical specificationsContribute to the updating of WHO guideline of injection safety.

2014 ActivitiesSlide13

UNICEF-CHAI Project: Accelerate Access to Innovative Point of Care (

PoC) HIV Diagnostics: CD4, Early Infant Diagnosis, and Viral LoadFunded by UNITAID Targets: 7 focus countries Zimbabwe, Tanzania, Kenya, Ethiopia, Uganda, Mozambique, MalawiProgrammatic and Supply coverage:CD4 testing, which is used for staging and monitoring HIV patients prior to initiation onto antiretroviral therapy (ART).Early Infant Diagnosis (EID) testing for infants less than 18 months of age (this technology can be performed on viral load platforms as well).Viral Load (VL) testing, which is mainly used for monitoring HIV patients following initiation to ARTUNICEF Quality Policy for procurement of IVDs consulted with WHO, CDC, MSF and fully harmonized with Global Fund.Phase 1 Nov 2012-December June 2014 US$ 20million

Phase 2a Project proposal approved and MOU currently under negotiations

Period July 2014

–Dec 2015 US$ 35million

Phase2b

Project

ending 2018 funding remains subject to UNITAID board approvalSlide14

Source:

UNIICEF Supply DivisionImmunization Supplies

Vaccines

BCG , DTP, TT/Td/DT, Measles containing, OPV,

HepB

, YF, DTP-

HepB

, DTP-

HepB

/

Hib

, DTP/

Hib

,

Hib

, MR, Meningitis, MMR, PCV, RV IPV

, HPV etc

.

Safe Injection equipment

Cold Chain Equipment

Vaccines Supplies: US$

1, 285 million

2.79

billion doses

2,185

shipments

2013

Countries UNICEF procures on behalf of

Full schedule

Partial schedule

UNICEF has a key role in vaccine procurement, procuring immunization supplies on behalf of

around 100 countries

annually

Source UNICEF Supply DivisionSlide15

Vaccines: 2014 Activities*

Support to countries / on-going operations: Coordination internally and support to countries for high number of new vaccine introductions (79 new vaccine introductions (13 IPV) in GAVI supported countries in 2014; 123 (59 IPV) in 2015) , and continuing programmes; specific innovative projects follow up: VAR, Visual Vaccines; KPIsContinued/increased support to MICs and GAVI graduating countries

through procurement practitioners forum to support countries moving to self-procurement, review VII and other financing mechanisms, engagement with partners and countries, MIC tender for new vaccines

Polio eradication

– IPV tender concluded in Q1 2014 and operationalized during the year; OPV supply and demand planning for vaccines and funding; strategy for type 2 withdrawal

Timely completion of tender activities

and additional awards

(JE,

Mening

,

penta

,

HPV, PCV,

Rota

); develop consolidated strategy for achieving price goals

Provide

more

useful and accessible information

for countries, manufacturers and partners (

eg

,

update website, pricing

data, procurement contexts, market updates)

Continue to strengthen

supplier relationships

, including at least 1 visit to each of the top 10 suppliers and visit to

China

Follow-up with DRC and Nigeria on

supply chain optimization

projects

Coordination with

partners

, including GAVI, BMGF, WHO, GPEI,

etc

*Key activities, not all inclusiveSlide16

Virus detection & interruption

Last wild polio case

Certification

RI strengthening & OPV withdrawal

Containment & certification

Introduce IPV

Wild virus

interruption

Outbreak response

(esp.

cVDPVs

)

RI strengthening &

OPV2 pre-requisites

OPV2

withdrawal

Legacy Planning

Finalize long-term containment plans

Complete containment

& certification globally

Consultation & strategic plan

Initiate implementation of legacy plan

Last OPV2 use

Endgame Major

Objectives

2013 2014 2015 2016 2017 2018

Source: WHOSlide17

WHA endorsement in 2013 of Endgame Strategy require IPV introductions in 123 countries globally within 20 monthsSlide18

Sufficient supply secured to meet projected demand through UNICEF at affordable prices, but planning needed

20 countries requiring supply in 2014, with 7 planned introductionsA total of 75 countries to introduce in this period, and two continuing countries20 LMIC/MIC countries to continue or introduce sourcing through UNICEFFlexibility required with regards to product preferences, number of shipments per year, delivery of buffer stocks, month of introduction, registration requirementsSlide19

UNICEF support to the tOPV/bOPV

switchGlobal synchronized switch from tOPV to bOPV requires careful planning at global and country levelEngagement with partners, countries, and industry to ensure smooth transition and no shortages of any productProtocols and strategies under development for operationalization of a switchSlide20

Vaccines stock monitoring and projection tool…

ViVa (Visibility for Vaccines)

…Enabling

identification and communication of upcoming potential constraints linked to supply

through

graphs.

From May to August 2014:

Pilot phase with EPI in DRC, Niger and Senegal.

Next:

Feedback interest survey and decision on continuity and scaling-up.Slide21

Supporting Middle Income Countries to Access New Vaccines

For additional information on UNICEF’s MIC New Vaccine Procurement Initiative see http://www.unicef.org/supply/index_67101.html

UNICEF Vaccine Procurement Practitioners Forum (Q4 2014)

EURO Inter-country Vaccine Procurement Workshop 2013

Transition planning for GAVI graduating countries

Vaccine Procurement System Assessments

Coordination of MIC support with global/regional partner activities:

Global MIC Task Force

Vaccine Product, Price and Procurement (V3P) Project

EMRO Pooled Vaccine Procurement (PVP) initiative

GAVI support for access to appropriate pricing for graduates & other LMICs

Sharing of knowledge

of (

i

) the vaccine market, (ii) Vaccine Security and underlying elements of forecasting, funding and appropriate contracting, (iii) vaccine procurement.

Issue

market analyses

.

Publish

Reference Prices

to serve as a benchmark for self-procuring MICs.

Aggregate MIC

demand forecasts

for new vaccines to provide better visibility to industry.

Pool

MICs’ vaccine procurement to improve demand predictability, reduce transaction costs and improve pricing.

MIC Pooled Procurement

Information Access

Capacity Building

Technical Assistance

Strategic PartnershipsSlide22

Some countries where we are already working with the govt to strengthen the supply chain and develop capacity

DRC

Immunization and Essential Medicines

Nigeria

Immunization

Sierra Leone

All Health Commodities

Kenya

Essential medicines

Zambia

Essential Medicines

Afghanistan

Immunization

Madagascar

Essential

Medicines

Myanmar

All Health Commodities

Eritrea

Education

Ethiopia

Essential Medicines

Niger

Essential Medicines and Nutrition

Tanzania

Essential Medicines

Cote d’Ivoire

Bednets

Malawi

All Health Commodities

Mozambique

All Health CommoditiesSlide23

2014 Activities

Support to development and implementation of national supply chain strategies Global networking and collaboration (GAVI, Global Fund, RBM etc.)Communication strategy and advocacy tools to raise awareness internally and externallyResearch to increase understanding of national supply chain models and promising practices Guidelines for capacity development with a supply chain toolkit for COs and partners (including a SC health check and performance monitoring tools) Roster of consultants for technical assistanceSupport development of the supply community technical skills framework and professional development planDevelop the Global Learning Centre Strategy including the initial curriculum (starting with vaccines, bednets and nutrition) South to south exchangesSlide24

What does success look like in 2017?

Increased use of national supply chains, from determination of need through to delivery to the last mile, across all programmes and including monitoringIncreased number of countries actively implementing national supply chain strategies, led by governmentStrong networks created with increased collaboration, sharing and co-ordination in capacity development and supply chain systems strengthening initiatives at global, regional and country levelAt least 20 government supply chains strengthened and optimized for targeted products