Global Fund Update
IPC meeting, 11 December 2012
1st MDAG Meeting Geneva 27-28 June 2012
Outline
Global Fund Secretariat
Procurement
Collaboration
Grant Management divisionGrant
ManagementMark Edington
High Impact Africa 1
Michael Byrne
High Impact Africa 2
Linden Morrison
High Impact Asia
Urban Weber
Africa andMiddle East
Lelio Marmora
AELAC
Maria Kirova
Technical hubs
(procurement,
legal, monitoring &
program finance)
LFA, Quality,
Risk, CCM,
Operational Policy
and Renewals
Grant Mgt. Support
Oren Ginzburg
6 Country Teams 7 Country Teams 7 Country TeamsSouthern &
Eastern AfricaCynthia Mwase
Western AfricaTina Draser
Central AfricaRonald Tran Ba
Huy
MENAJoseph Serutoke
South and East Asia
Luca Occhini
LACSilvio Martinelli
EEU / CANicolas Cantau
3 Regions70 countries
4 Regions48 countries
20 countries comprising
70% of global disease burden
23 PSM Specialists
Embedded in the regional teams
• Provide recommendations for approval of the PSM plan (or Procurement Plan) and identify solutions towards effective grant implementation.
• Provide technical guidance on PHPM issues and how to ensure compliance with the Global Fund PSM Policies.
• Develop recommendations to strengthen systems and capacity in the Pharmaceutical Sector.
PSM Hub
• Operational Policies • Technical support• Partnership• Managing consistency in processes • Member of the Operational Risk Management
Committee
4
3. HPM & Health Services Delivery
Risks
3.1 Treatment disruptions
3.2 Substandardquality of PHP2
3.3 Poor selection and use of PHP2 or quality
of health services
Better Grant Management project
• Risk based Management supported by a ORM Committee
• Review of the Pharmaceutical Country Profile implementation
– Strengthened partnership
– Streamlined the tool (part 2)
– Reengineering processes
– Improved procurement planning tool
• Health product procurement Information system– IT tool for PSM plan management, monitoring of procurement activities, and
automating VPP process – with end activities linked to PQR√ improve management and oversight of the status of health product procurement and supply at the grant level
(active Monitoring)
√ Providing data to forecast demand
√ Market intelligence
� Initial modules during 2013
1st MDAG Meeting Geneva 27-28 June 2012
Outline
Global Fund Secretariat
Procurement
Quality Assurance
Procurement strategy
• Strengthen Secretariat’s Capacity for strategic market shaping
“optimize price, quality, design, & sustainable supply”• 3 additional staff to complement PSS/VPP team
• Recruitment of Senior Procurement Officer
• Full staff complement and necessary structure completed by Q1 2013
• Fully implement voluntary pooled procurement (VPP) • Improve and reform VPP Mechanism
• Facilitating Payment options, including allowing for VPP disbursements based on a “cost-estimate” instead of individual invoices
• Real time indicative/reference prices from VPP• Build previous internal price information sharing
• Publish quarterly� externally: indicative prices/ranges
� internally: more in-depth analysis/trend information
• Initially: ARVs, ACTs, LLINs, HIV rapid tests, Malaria rapid tests
Strategic Interventions
1st & 2nd
line ARVs
New 1st
line ARVs
Paed. ARVs
Initial focus
Procurement of key products with grant funds
• From 2009, more than US$ 2.122 billion1 of ARVs, long-lasting insecticidal nets, antimalarial and anti-TB medicines were delivered to Principal Recipients and reported to the PQR.
1 As reported to the PQR on 02 April 2012
Product Category Total Product Cost (USD)
Bednet $863,800,266
Anti-Retroviral $816,509,939
Anti-Malaria Medicine $145,187,211
Diagnostic test $135,067,022
Anti-TB Medicine $124,169,159
Condom $37,407,498
Grand Total $2,122,141,095
41%
38%
7%
6%
6%
2%
Total Product Cost (USD)
Bednet
Anti-Retroviral
Anti-Malaria Medicine
Diagnostic test
Anti-TB Medicine
Condom
Global Fund-financed medicines procurement reported in PQR: Purchase orders 2010-2012 to date (in million US$)
Source: PQR data as at 10 September 2012
Procurement since January 2010 as per Global Fund QA Policy
A: WHO-prequalified
(including “A and B”)
B: SRA-autho-rized*
Source: PQR data as at 10 Sep 2012
Second-line TB: USD 69 million
First-line TB incl.streptomycin:US$ 53 million
Outline
Global Fund Secretariat
Procurement
Quality Assurance
Partnerships in Quality Assurance
• Collaboration with WHO PQ – Expert advice
– QA Policy implementation: ERP management
• WHO Disease Programs: HIV, Malaria, TB, WHOPES
• Collaboration/information sharing with other donors and procurement agencies
• Regular communication with manufacturers
• Monitoring QA activities and publication of results
Quality monitoring at country level
Quality
Ass
ura
nce b
efo
re a
rriv
al of pro
ducts
in c
ountr
y
� Procurement:
Product selection according to Global Fund QA Policy
Pre-shipment quality control testing for ERP-reviewed products (organized by Global Fund Secretariat as per QA Policy)
� Receipt in country, storage, distribution
� Quality control in countries:
Step 1: Selection of quality control laboratory
Step2: Designing a sampling and testing programme
Step 3: Sampling
Step 4: Transport of samples to the laboratory
Step 5: Quality control testing results and reports
Step 6: Records and documentation
� Monitoring storage and distribution sites
� Safe disposal of pharmaceutical products
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1. Clinical Criteria 2. Quality Criteria 3. Monitoring Quality
Collaboration
• Collaboration at country and global level:
– CPP initiative focus on financing flow/situation
– ACT task force
– ACT Global Demand Forecast
– RBM PSM working group
• National collaboration and coordination:
– Joint PSM planning, (pharmaceutical country profile)
– National forecasting and quantification committee
– Development of procurement plan
– Harmonize and Streamline supply chain tools, reporting system and data collection
• Risk assessment and risk mitigation measures
• Joint action plan for strengthening country systems