Risk of stock out. Justification

Transcription

1 Ministry of Health, Uganda Pharmacy Division STOCK STATUS REPORT AS AT 1ST AUGUST 2011 For actual of dates of data collection, refer to the detail for each commodity Introduction The purpose of this report is to inform Ministry of Health officials especially program managers and all stakeholders of the stock levels in the country in order for appropriate logistics decisions to be made and implemented. This report highlights challenges, bottlenecks and recommends potential solutions to mitigate stock outs and expiries of ARVs & HIV test kits, ACTs, Anti-TB medicines, Reproductive Health items and selected medicines for opportunistic infections. It can be used to: Identify challenges and recommendations to avert supply interruptions Encourage preparation and sharing of supply plans with stakeholders Identify strategies for regularly reviewing supply plans for all the commodities Encourage donors to honor their commitments in terms of quantities of products expected, timeliness of deliveries and flexibility. Summaries of the Central Inventory Level Stock Status Risk of stock out Justification ACTs Stocks available at both NMS & JMS are generally below the recommended minimum central stock levels (NMS+JMS). Partial delivery of the emergency procurement under DFID was recieved at NMS with 20% of the delivery planned to be transferred in Mid-August Deliveries of first half of ACTs under the GF R4 AMFm procurement was received after reopening of NMS following stock counts. DFID Procurement delivered a total of 2.7 million doses of embossed ACTs to NMS with balance of 7.2 million expected in first week of September Part of this consignement will go to JMS. PMI supported supply to the PNFP sector through JMS. Next shipment for AMFm is expected in September There is need to fast-track all deliveries to ensure that the central level does not stock-out. Sulphadoxine/Pyrimethamine stock levels are extremely low. Deliveries are expected at NMS in early August to avert possible stock-out. RDTs from PMI have started arriving into the country with many more facilities now accessing the stocks. Demand continue to rise and there is need to review overall country demand to ensure sustained availability. NMCP plans to carry out a training on use of the RDTs before countrywide roll-out. MEDIUM Stocks of all ACTs are below the minimum recommended for central level warehousing facilities. Furthermore, ongoing procurements are not fully sufficient to meet the total need at central level under steady state. Sulphadoxine-Pyrimethamine 500/25mg Rapid Diagnostic Tests Artemether-Lumefantrine 20/120mg tab (Yellow), 6 pack Artemether-Lumefantrine 20/120mg tab (Blue), 12 pack Artemether-Lumefantrine 20/120mg tab (Brown), 18 pack Artemether-Lumefantrine 20/120mg tab (Green), 24 pack ACTs Min Max SoH Stock ARVs for adults A) - First Line Preferred There are low stock levels of key product: AZT/3TC/NVP. However, AZT/3TC+NVP are being used for patients on this regimen as well. Procurements are ongoing for supplies from Quality Chemicals. If stocks do not come in before end of August, AZT/3TC/NVP will stock-out. JMS has low stock levels of the same product Stock on hand for these commodities are generally below the minimum recommended at central level. It is essential that supplies expected arrive in time and made available for distribution before central level stock out occurs. There are on-going discussion on how to improve availability of these products to the PNFP sector. PEPFAR and CHAI/UNITAID provided temporary support to the PNFPs/PFPs by moving stocks in June 2011 B) - First Line Alternative TDF/3TC is available in-country, available for combination with EFV and NVP. However, stock levels of EFV fell below minimum following delays in anticipated GFTAM procurement. All big PNFP facilities continue to order from NMS. The different stakeholders (NMS, JMS, Pharmacy Division, ACP) are working on mechanisms for access for smaller PNFP and accredited PFP facilities Medium Medium There is an extremely low stock levels of key product: AZT/3TC/NVP. EFV at risk of stocking out. There is need to work on overall supply plan AZT 300mg DDI 400mg DDI 250mg ABC 300mg LPVr 200/50mg EFV 600mg TDF/3TC 300mg/300mg NVP 200mg AZT/3TC 300/150mg AZT/3TC/NVP 300/150/200mg Min Max 8.0 SoH C) - Second Line UNITAID donation through CHAI is expected to meet all the country requirements. The stock levels for adult second line ARVs are within the recommended max-min range for central level. However, much of the stock is placed at NMS, with little at JMS. Low There are adequate stocks AZT 50mg/ml D4T 1mg/ml NVP 50mg/ml Min Max ARVs for Children The stock level for almost all pediatric ARVs have improved since June 2011 but are generally still below the recommended level for central level. most UNITAID deliveries arrived as scheduled. Stavudine-based formulations are still being expected from the pipeline. EFV-200mg and d4t/3tc 6/30 are at risk of expiry. CHAI and UNICEF need to review UNITAID pipeline of products being phased out There is also need to assess whether there is now sufficient information on adoption of pediatric FDCs and whether utilization has now stabilized. UNITAID donation through CHAI was extended to end of procurement will be done for the products for use well into Medium Stocks are being distributed well between JMS and NMS. Need to ensure timely delivery of planned shipments to prevent future stock-outs LPVr 100/25mg LPVr 80/20mg 0.2 3TC 50mg/ml D4T/3TC/NVP 12/60/100mg D4T/3TC 12/60mg 0.6 AZT/3TC/NVP 60/30/50mg AZT/3TC 60/30mg D4T/3TC/NVP 6/30/50mg D4T/3TC 6/30mg SoH EFV 200mg EFV 50mg 2.0 ABC/3TC 60/30mg 3.5 ABC 20mg/ml Questions or clarifications? to pharmacy@health.go.ug or mokumu@sure.ug This report was made with Technical Assistance from the USAID/SURE Program

2 Ministry of Health, Uganda Pharmacy Division PMTCT items HIV Test Kits Uganda is currently having Option A for PMTCT while plans for switch to Option B are on-going. Selected PNFP facilities and IPs have already started using Option B. As such, the demand for these commodities continue to fluctuate. The delayed PMTCT supplies from UNITAID started arriving since May s meant for JMS are being delivered directly. There is need to critically monitor the pipeline to ensure no stock-out occurs The change of PMTCT guidelines should be managed with full knowledge of the stock limitations at the moment. Future participation in the Boehringer Ingelheim program for NVP donations should also be evaluated. MEDIUM Several PMTCT supplies stock levels are fluctuating. There is need to monitor closely HIV Test Kits (Unigold) HIV Test Kits (Stat-Pak) Min Max SoH HIV Test kits The stock levels are general health but no pipeline information exist. These kits have continued to have highly fluctuating stock positions based on seasonality of demands and expectations. JMS in particular has had very low stocks of test kits and is out of stock of Unigold and Determine. Test kits are now being procured using funding from CDC and additional shipments expected from GF Round 7 Phase 2 with others through UNITAID. There is need to effectively schedule deliveries of shipments from the different sources The procurements from both UNITAID and NMS should now be scheduled for deliveries from November 2011 so as to ensure sustained availability. MoH Pharmacy Division will work on effective scheduling of the different deliveries. Low The stock situation has stabilized following arrival of stocks in April and May However, this situation might be hampered by increase in demand HIV Test Kits (Determine- Abbot) + Buffer Stock Anti-TB Medicines - Stock Min Max SoH Anti TB Medicines RH (Adult) tablet 30.3 These medicines are procured exclusively with donor funding. Stock levels have stabilized due to deliveries of GF emergency orders. However, the pipeline remains poor despite availability of funding from GF Round 6 Phase 2 and Round 10 Phase 1. RHZE & EH are low in stock, however resupplies expected under GF R6 emergency procurement have arrived in the country. RHE is relatively well stocked. EH and RHEZ are going to stock out The other anti-tb medicines are overstocked in the system, with most of the supplies at central store level or district level. There is a high risk of expiry for most of them if the consumption trends remain the same. The NTLP needs to review utilization trends and come up with a plan immediately to avert risk of expiry of these. Given the long lead times for procurement of ant-tb medicines (at least 8 months through GDF), there is need to consider procurements through NMS to avert risks of stock-out. In addition, there is need to revisit the utilization of RHE, RHZ and Pyrazinamide that are at risk of expiry The signing of R6 Phase 2 grant is expected soon. No grant signing has yet been done although the PSM plans have been submitted. If the grant is not signed off, the country is at risk of stock outs. HIGH Mixed in-country stocks situation. However, there is a greater impending risk of both stock outs if pipelines are not monitored. The signing of GF Round 6 Phase 2 needs to be quickened to prevent stockouts by Feb 2012 Pyrazinamide tablet 400 mg Isoniazid 300mg tablet Streptomycin vial 1g RHZ (Pediatric) tablet 60/30/75 mg RHE (75/150/275 mg) EH two-week blister strip 400/150 mg RHZE tablet 75/150/275/400/ mg Stock RH Commodities These items are funded by USAID, UNFPA, MoH (GoU and World Bank funding) and Global Fund Round 7 (for the male and female condoms). The Contraceptive Supply Plan for the country has been developed and different partners are committing to selected products. There are low stock levels of male condoms and implants, with very little in the pipeline. There is a high risk that these will stock out. There are also low levels of the progestin-only and combined oral pills at the centre. However, the SURE kit assessment report indicated that these are piling up at HC3 and HC2. MoH needs to mobilize these products from over-stocked facilities. Emergency contraceptive pill and Misooprostol are over stocked, and run a risk of expiry if consumption trends remain the same. Review of alternative distribution channels through which these commodities are made available to clients is ongoing. Medium The Contraceptive Supply Plan for the country has been developed and different partners are committing to selected products. Male condoms and implants are at risk of stocking out Emergency Contraceptive Female Condoms Manual Vacuum Aspiration (MVA) Male Condoms Progestin-only pills 1.6 RH Commodities 6.0 SoH Min Max A 5 year quantification exercise for contraceptives led to increase in funding. There is need to now take a critical look at demand creation to ensure better uptake of RH commodities. Other Medicines for Opportunistic infections The Fluconazole tablets donated by Pfizer are available at NMS and a little at JMS. The pediatric suspensions are out of stock at both facilities. However, distribution and reporting remain a challenge that needs to be addressed in the short run for Uganda to benefit from this donation. Procurement of Cotrimoxazole 960mg for prophylaxis in HIV patients has been initiated after approval of funding by CDC. Additional supply is expected through GFATM HIV Round 7 phase 1 disbursement. Deliveries were expected upon reopening of both JMS and NMS after stock taking Medium Products are available at central level Combined Oral Pills IUDs Implants Depo-Provera Stock Data Sources Data on stocks was collected from National Medical Stores, Joint Medical Stores and National TB & Leprosy Programme Questions or clarifications? to pharmacy@health.go.ug or mokumu@sure.ug This report was made with Technical Assistance from the USAID/SURE Program

3 ACTs and Malaria Test Kits (Max MOS: 6, Min MOS: 4 for central level) * Average is estimated using NMS issues data ** Average of RDTs is only indicative based on scale-up targets. AMC = Average ; NMS = National Medical Stores; JMS = Joint Medical Stores; MOS = Stock Note: Some ACTs were delivered by Ajanta, but have not yet been captured in the NMS stock report. It was not possible to verify these quantities. Inventory NMS at 31st July 2011 Inventory JMS at 31st July 2011 Total Inventory (Central Level) Estimated Average Estimated Months of Stock (Central Level) Stock on Delivery Date Artemether-Lumefantrine 20/120mg tab (Green), 24 pack* Artemether-Lumefantrine 20/120mg tab (Brown), 18 pack* Artemether-Lumefantrine 20/120mg tab (Blue), 12 pack* 30 Strips 73,375 26, ,075 43, , Sep-2011 AMC: Est. from NMS+JMS Issues data. The 6x4 pack size is what is predominantly available in the system to public facilities; AMC has therefore been adjusted. The quantity on order is from Quality Chemicals and USAID/PMI. Quality Chemicals deliveries for 24 pack continues to come as part of the framework contract. PMI continues to support PNFP sector through JMS. DFID supplies have started coming in with 4.8 million doses of mixed pack sizes delivered in July Further deliveries expected in first week of September There 30 Strips 26,553 6,870 33,423 8, , Sep-2011 appears to be some rationing of the supplies of ACTs. The stock of all ACTs are below the recommended minimum level for central level (NMS+JMS). 30 Strips 23,231 7,788 31,019 12, , Sep-2011 Current stocks at JMS are predominantly (over 96%) from the PMI supported procurements with the balance being stocks from previous Global Fund transfers from NMS. Based on existing framework contracts at NMS (for Public Sector) and planned procurements by PMI (for PNFP sector), there is low risk of stock outs. 4 Artemether-Lumefantrine 20/120mg tab (Yellow), 6 pack* 30 Strips 93,309 13, ,082 22, , Sep Rapid Diagnostic Tests** Test 14,573-14, ,000 1,275, Average of RDTs is only indicative based on scale-up targets. Quantities on order by USAID through Presidential Malaria Initiative (PMI). Procurement is also anticipated using GoU funding by NMS, but quantities have not yet been determined. 6 Sulphadoxine-Pyrimethamine 500/25mg tab* 1000 tab , , Aug-11 Stock levels went down in July Stocks have been called from the existing NMS framework contract Questions or clarifications? to mokumu@sure.ug or pharmacy@health.go.ug

4 HIV/AIDS Commodities Stock Status as of 31 July 2011 ARVS, Fluconazole, HIV test kits (Max MOS: 6, Min MOS :4 for central level) * Average is estimated using health facility reports ** Average is estimated using NMS and JMS issues data *** Average is estimated using scale-up plan AMC = Average ; NMS = National Medical Stores; JMS = Joint Medical Stores Inventory NMS at 31st July 2011 Inventory JMS at 31st July 2011 Total Inventory (Central Level) Estimated Average Estimated Months of Stock (Total System) Stock on Delivery Date A Adult Formulations Lamivudine 150mg + Zidovudine 300mg + Nevirapine 200mg*** 60 30,849 6,413 37,262 56, , Quality Chemicals order for 14,577 packs were delivered in June GF R7 procurement for 341,993 packs were expected in last week of July NMS to confirm delivery of the consignment. Lamivudine150mg + Zidovudine 300 Mg Tab** , ,026 65, , Quality Chemicals order for 83,873 packs were delivered in early June GF R7 procurement for 110,469 packs expected by July 2011 were delivered. Letters of credit were opened in March 2011 Nevirapine 200mg Tab** , ,691 20, , GF R7 procurement for 53,851 packs were delivered July Letters of credit were opened in March 2011 giving a supplier lead time of five months TDF/3TC 300/300mg Tabs** ,542 32, ,343 14, , Supplies expected from UNITAID/CHAI. Efavirenz 600mg Tab** , ,840 35, , GF R7 procurement for 168,503 packs expected by July 2011 was delayed. Letters of credit were opened in March JMS stock level is extremely low. Lopinavir 200mg+Ritonavir 50mg Tab (LPV/r)** ,480 1,430 17,910 3, Supplies expected from UNITAID/CHAI. Abacavir Sulfate Tablets 300mg** Supplies expected from UNITAID/CHAI. Didanosine 250mg Tab** Supplies expected from UNITAID/CHAI. Didanosine 400mg Tab** 30 4, , Supplies expected from UNITAID/CHAI. Stocks will be transferred in third week of August 2011 by CHAI from NMS to JMS to take care of insufficiencies. Zidovudine 300mg Tab** ,306 29, ,196 15, GF procurements arrived in July Questions or clarifications? to pharmacy@health.go.ug or mokumu@sure.ug

5 HIV/AIDS Commodities Stock Status as of 31 July 2011 Inventory NMS at 31st July 2011 Inventory JMS at 31st July 2011 Total Inventory (Central Level) Estimated Average Estimated Months of Stock (Total System) Stock on Delivery Date B Pediatric Formulations Abacavir Sulfate Oral Solution 240ml 20mg/ml** 240ml 1, , Supplies expected from UNITAID/CHAI Abacavir/Lamivudine 60/30mg tab** 60 1,343 2,000 3, Supplies expected from UNITAID/CHAI Didanosine 200mg EC Caps** Product being phased out Efavirenz 50mg Cap** 30 2, ,365 1, Supplies expected from UNITAID/CHAI Efavirenz 200mg Cap** 90 36,630 8,237 44, Supplies expected from UNITAID/CHAI Lamivudine 30mg + Stavudine 6mg** 60 1, , Product being phased out Lamivudine 30mg+Stavudine 6mg+Nevirapine 50mg** 60 6,750 2,791 9,541 3, Product being phased out Lamivudine 30mg+Zidovudine 60mg Tablets** ,725 1, Lamivudine 30mg+Zidovudine 60mg+Nevirapine 50mg** About 16,000 packs of this product meant for NMS is expected from UNITAID/CHAI in third week of August ,413 6,591 1, Supplies expected from UNITAID/CHAI Lamivudine 60mg + Stavudine 12mg** Lamivudine 60mg+Stavudine 12mg+Nevirapine 100mg** 60 4,293 1,282 5,575 1, Lamivudine Oral Solution 50mg/ml** Bottle 1, , ed supplies expected from UNITAID/CHAI. Products are being phased out based on recommendations of the pediatric ART sub-committee ed supplies expected from UNITAID/CHAI. Product being phased out in favor of FDC preparations Lopinavir 80mg +Ritonavir 20mg** 5X60ml Supplies expected from UNITAID/CHAI Lopinavir+Ritonavir 100mg/25mg** Supplies expected from UNITAID/CHAI Nevirapine 50mg/5ml Susp** 240ml ,951 13,113 7, ed supplies expected from UNITAID/CHAI. is expected to be much higher with roll our of Option A PMTCT guidelines. Efavirenz 100mg Supplies expected from UNITAID/CHAI Stavudine 1mg/ml Soln, 200ml pack** 200ml 2, , Product being phased out in favor of FDC preparations Stavudine 20mg Cap** 60 0 Supplies expected from UNITAID/CHAI Zidovudine 50mg/5ml Oral Soln. 240ml** Bottle 1,976 1,976 2, Product being phased out in favor of FDC preparations Zidovudine100mg Cap** ,000 Questions or clarifications? to pharmacy@health.go.ug or mokumu@sure.ug

6 HIV/AIDS Commodities Stock Status as of 31 July 2011 Inventory NMS at 31st July 2011 Inventory JMS at 31st July 2011 Total Inventory (Central Level) Estimated Average Estimated Months of Stock (Total System) Stock on Delivery Date C ARVs for PMTCT Nevirapine 200mg Tab** PMTCT Kit** Kit Commodities to be reviewed in line with new PMTCT Guidelines Zidovudine Oral Soln** Bottle 981 D HIV test kits HIV Test Kits (Determine-Abbot) + Buffer** 100 Tests 42,551 42,551 5, No information available on pipeline. Stock levels continues to fluctuate HIV Test Kits (Stat-Pak)** 30 Tests 19,749 2,286 22,035 2, No information available on pipeline. Stock levels continues to fluctuate HIV Test Kits (Unigold)** 20 Tests 2,230 2, No information available on pipeline. Stock levels continues to fluctuate E Other Medicines for Opportunistic infections Fluconazole (Diflucan)** 28 17, ,547 4, No information on pipeline available. Low stock level Fluconazole 2mg/ml I.V. Infusion 100ml (Diflucan)** 100ml Product stocked out since April 2011 Fluconazole 50mg/5ml oral suspension (Diflucan)** 35ml 1, , No information on pipeline available. Low stock level Cotrimoxazole 960mg Tab** ,529 3,750 97,279 16, Available stock is at NMS. Product stock level now stable. There is need to place orders Questions or clarifications? to pharmacy@health.go.ug or mokumu@sure.ug

7 TB Stock Status August Anti TB Medicines (Max MOS: 12, Min MOS: 6 for central level ) Central Stores * Average is estimated using consumption data from the facilities. Reporting rate for May/June 2011 cycle was 53% AMC = Average ; NTLP = National TB & Leprosy Program Inventory at NTLP (as at August 05, 2011) Inventory at District Level (as at June 31, 2011) Est. stocks at Facility level (as at end of June, 2011) Estimated Average Estimated Stock (Total system) Quantity on Stock on Delivery Date 1 RHZE tablet 75/150/275/400/ mg Blisters 99,072 30,856 62,588 24, No product confirmed in the pipeline. Grants signing for Round 6 Phase 2 are in advanced stages. The stock levels at central level have fallen low. Total country pipeline stock is at 6.7 months providing a high risk of stock out for this high consumption product. There is an urgent need to place an order for this product preferably from the proposed supply from NMS owing to long lead time of GDF. High risk of stock-out 2 EH two-week blister strip 400/150 mg Blisters 82,176 26,269 59,971 26, Total country pipeline has fallen below 8 months with the bulk being at central level. Grant signing for Global Fund Round 6 Phase 2 has delayed the procurement process. There is immediate need to place order for this product so as to avert possible stock out in January Consider possibility of an emergency order through NMS since the GDF lead time is over 7 months. High risk of stock-out 3 Isoniazid 300mg tablet Blisters 41,376 6,947 9, Pyrazinamide tablet 400 mg Blisters 3,288 8,223 2, RH (Adult) tablet Blisters 32,832 17,046 6,914 1, RHE (75/150/275 mg) Blisters - 10,957 18,107 2, Available stock at central level expires in March 2013 (about 19 months remaining shelf life). Much of this stock is still at the central level. NTLP should develop a utilization plan for this product to avoid wastage due to expiry. Currently only selected HIV programs are utilising this product for prophylaxis. There is very high risk of expiry of this product These item was not included among list of products to be procured under GFATM grant. However, consumption remains relatively low. Product has an expiry date of February 2012 (Remaining shelf life of about 8 months) with most of the product being at either central or district level. High risk of expiry The quantity of RHZ to be procured under GF was reduced to encourage consumption of these stocks. However, consumption remains relatively low. Remaining shelf life is about 10 months (expiry May 2012) making over 20 months of stock at risk of expiry. Very High risk of expiry Central level has stocked out following distribution to facilities level. most stocks are at district and facility level with remaining shelf life of about 10 months (Expiry in May 2012). s should have been placed at least two months ago. Stocked out 7 RHZ (Pediatric) tablet 60/30/75 mg Blisters 39,744 3,527 5,901 2, Remaining shelf life is about 27 months (Expiry in Dec 2013) posing low risk of expiry. The product is relatively overstocked, with much of the stock at central and district stores level. There is need to consider access to IPs involved in pediatric HIV/AIDS care 8 Streptomycin vial 1g Vial 150,000 24,578 21,045 18, Remaining shelf life is about 26 months (Expiry in May 2013). A procurement request for 600,000 vials was placed to NMS but order not yet confirmed. With current consumption trend, there is need to adjust the order quantity and as well watch for expiry. NMS needs to confirm this order as lead time might be so long. The product is currently having global scarcity of the active principal leading to increase in price Questions or clarifications? to pharmacy@health.go.ug

8 Reproductive Health Items (Max MOS: 12, Min MOS :6 for central level ) Note * Average is estimated using adjustments to the Contraceptive Procurement Table (CPT) 2011 ** Average is estimated using NMS issues data AMC = Average ; NMS = National Medical Stores Inventory NMS at 31st July 2011 Estimated Average Estimated Stock (Central Level) Stock on Delivery Date 1 Depo-Provera* Vial 599, , , Aug Implants (Implanon & Jadelle)* Piece 9,874 6, , The actual consumption of Depo-provera is 78% compared to the projected consumption from the CPT. 5.5 supply will be shipped into the country in Second week of August 2011 from Vote 116 funding. This product will only be coming in from MoH/World Bank funding. Low risk of stock out The actual consumption of implants is low (29%) compared to the projected consumption. Except for the impending delivery of 43,854 implants by UNFPA, Supply of this commodity has been reserved for NMS with funding from the GoU/WB project. There is need to explore alternative distribution strategies to improve overall intake of the commodities. 3 IUD - Copper Containing Device TCU380A** Piece 88,614 1, The actual consumption of IUD Copper T is 66.7% compared to the projected consumption from the CPT. Supply of this commodity has been reserved for UNFPA and they will be asked to supply when there is need. The funds for this product will be re-allocated to cater for contraceptives needs of other products. There is also need to strengthen alternative channels for accessing this product. No risk of stock-out Combined Oral Contraceptives (Microgynon)** Progestin-only oral contraceptives (Microlut)** Male Condom (52MM with and without Logo)* Cycles 2,072,121 35, , Cycle 21,000 3, , Aug-2011 Piece 8,010,500 4,878, ,000, Aug-2011 The actual consumption of Microgynom is low (29%) compared to the projected consumption. The country has over five years of stock available at central level. At current consumption rate and with expiry date of Aug/2014, approximately four years worth of stock will expire. All pending supply of 648,276 cycles by USAID in the pipeline have been cancelled and planned resources will be allocated to alternative contraceptives on the list. There is need to consider supply of the products through alternative systems including PFP sector to avert possible expiry. USAID has been allocated the supply of this commodity as per the joint national supply plan. Qualitative data from support supervision to health facilities indicate trends of accumulation of these products within the health facilities. High risk of expiry if alternative supply is not urgently considered. The actual consumption of Microlut is reasonable (87.2%) compared to the projected consumption. The pending supply of 26,226 from UNFPA is expected in August Some field reports indicate that this commodity is pilling in some health facilities. Further efforts should be made to improve uptake. No risk of stock out National Need not yet well ascertained. Current estimate of monthly needs stands at 12.5m. The actual consumption of male condoms is still low at 40% of the projected consumption from the current CPT. Approximately 8.8m condoms are ready for distribution at the URCS warehouse m condoms are under quarantine within country and are anticipated to be cleared for distribution by NDA within two weeks. Another 22.72m has been ordered by UNFPA is expected to be shipped in the country in August Manual Vacuum Aspiration (MVA) Double Valve** Kit belongs to NMS & 250 belongs to Third Party. National Need not yet ascertained. NMS committed funds from the GoU RH commodities for this product. Total funding to procure 837 MVA kits has been ring fenced. NMS to prepare a full supply plan for this commodity. 8 Female Condom** ,800,000 Aug-2011 Stocked out at NMS but available through UHMG for private sector channel. A request has been made to UNFPA to supply 1.8m female condoms in August Levonorgestrel 750 mcg Tab (Emergency Contraceptive)** Pack 704,790 16, Very low uptake. Excluded from National quantification until demand in public sector improves and all the supply pipeline placed on hold. There is a high demand for ECP in the private sector. The MoH is considering alternative distribution channel for this product 10 Misoprostol 200mcg Tabs** 1 Tablet 2,726,660 72, Very low uptake. Procurement pipeline under Vote 116 has been cancelled and funds to be reallocated to cater for other RH commodities under same Vote. Considerations for alternative distribution being considered Questions or clarifications? to pharmacy@health.go.ug

9 Questions or clarifications? to

10 Ministry of Health Tracer Medicines (Max MOS: 6 Min MOS: 4 for central level) Note * Average is estimated using NMS issues data AMC = Average ; NMS = National Medical Stores Inventory NMS at 31st July 2011 Estimated Average Estimated Months of Stock (Central Level) Stock on Delivery Date 1 Depo-Provera* Vial See comments under reprodructive health commodities 2 Artemether-Lumefantrine 20/120mg tab (Green), 24 pack* 30 Strips See comments under malaria commodities 3 Sulphadoxine-Pyrimethamine 500/25mg tab* 1000 tab See comments under malaria commodities 4 Cotrimoxazole 480mg 1000 tab 1,308 9, Oral Rehydration Salts for 1 Litre 25 62,959 18, Measles Vaccine Vial Questions or clarifications? to ejemera@sure.ug