In June 2005, President George W. Bush launched the President’s Malaria Initiative (PMI). He pledged the U.S. Government to increase malaria funding by more than $1.2 billion over five years to reduce deaths from malaria by 50 percent in 15 African countries. President Bush also challenged other donor countries, private foundations, and corporations to help reduce the suffering and death caused by this disease. With the increased resources of PMI, the U.S. Government now has the ability to meet ambitious treatment and prevention coverage targets by providing, expanding access to, and ensuring the appropriate use of, key malaria commodities.
The USAID | DELIVER PROJECT, Task Order Malaria (TO3) was awarded on April 6, 2007; it is funded by the U.S. Agency for International Development (USAID) under contract number GPO-I-03-06-00007-00. Implemented by John Snow Inc. (JSI) and ten principal partners, TO3 supports the USAID/ PMI strategy to reduce the impact of malaria in Africa using a three-pronged strategy: procuring, managing, and delivering high-quality, safe, and effective malaria commodities; providing on-the-ground logistics capacity, technical assistance, and pharmaceutical management expertise; and ensuring technical leadership to strengthen the global supply, demand, and financing of high-quality malaria commodities. These activities are part of TO3’s three overarching objectives:
Objective 1: Improve and expand USAID’s provision of malaria commodities to programs in order to increase the availability of safe, effective prevention measures and treatment.
Objective 2: Strengthen in-country supply systems and capacity for management of malaria commodities by improving logistics capacity and pharmaceutical management.
Objective 3: Improve global availability of malaria commodities through activities that promote a more stable global supply and more efficient distribution.
Contact Information for Task Order 3:
USAID | DELIVER PROJECT John Snow, Inc. 1616 Fort Myer Drive , 11th Floor Arlington , VA 22209 USA Phone: 703-528-7474 Fax: 703-528-7480 Email: askdeliver@jsi.com Internet: deliver.jsi.com
To learn more about the President’s Malaria Initiative (PMI), visit: http://www.pmi.gov/.
TO3 procures and delivers long-lasting insecticide-treated bed nets (LLINs), rapid diagnostic tests (RDTs), anti-malarial pharmaceuticals, and other commodities (for example, lab equipment) to the 15 PMI focus countries, as well as to Nigeria and other countries, as requested by USAID.
TO3 also provides logistical expertise to ensure that the commodities procured for PMI programs reach the end user. A well-functioning supply chain ensures that all components of the logistics cycle —product selection, forecasting and quantification, procurement, distribution (including storage, transportation, and inventory control), logistics management information, quality monitoring, and client service —work effectively and efficiently. By successfully managing this supply chain, TO3 helps increase malaria commodity security, which ensures that people are able to obtain and use quality malaria commodities when they are needed.
There are a number of special logistics considerations for malaria commodities as they move through the system. For example —
Climate considerations: RDTs and antimalarial pharmaceuticals: artemisinin-based combination therapy (ACT) medicines are temperature sensitive and easily absorb moisture. They should be stored at temperatures not exceeding 30 0 C, and must be protected from moisture. Exposure to excessive heat and moisture degrades the drugs and makes them less effective. This presents real challenges in the African countries where these commodities are needed.
Shelf life and expiry: ACTs, RDTs, and other pharmaceutical products have a relatively short shelf life of 24 months.
Size and volume of commodities: LLINs present special challenges. One LLIN shipment of 790,000 bed nets requires as much room as 30 40-foot shipping containers, straining the storage capacity of most central medical stores and regional and local warehouses.
Procurement Process
After USAID and John Snow, Inc., signed the TO3 contract in April 2007, one of the team’s first activities was to establish a list of products requested by PMI programs and potential suppliers for the products. For RDTs and LLINs, the objective was to pre-qualify manufacturers that met stringent technical and business requirements. Expressions of Interest for these two categories of commodities were published and the results reviewed. As a result of this process, six RDT manufacturers and six LLIN manufacturers were identified for the initial round of procurements. The Expression of Interest procedure will be repeated periodically to give other manufacturers an opportunity to submit their dossiers.
Objective 1 : Improve and expand USAID’s provision of malaria commodities to programs. Activities include —
Tender and administer contracts with suppliers and internationally recognized wholesalers.
Define criteria to prequalify commodities and sources of supply for procurement with respect to dimensions that include quality, efficacy, safety, performance, reliability, and sensitivity.
Create and maintain a quality assurance (QA) program to ensure that commodities meet contractual product specifications.
Provide procurement management and commodity ordering support to all USAID-funded malaria programs; and provide support for commodity procurement, ordering, reporting, and management through the management information system (MIS).
Provide freight forwarding, insurance, custom clearance, and consignment that promote efficient and secure delivery of malaria commodities.
Coordinate procurements and deliveries with other international donors.
Provide commodity-specific information to USAID for inclusion in the annual PMI report and other congressional requests for information.
Expected Results of Objective 1 Activities:
Create a procurement system that can deliver up to $300 million or more, per year, of quality-assured, competitively priced products, where and when they are needed.
Ensure quality through a risk-based approach to quality assurance throughout the custody chain.
Develop an MIS to support procurement that collects information on orders, shipments, and funding, and shares it with stakeholders.
Coordinate and collaborate with partners, wherever possible, to minimize duplication of effort; and build or transfer capacity to programs to sustain the effectiveness of procurement in the long term.
The following map illustrates the initial procurements that TO3 made in the first six months of operation (the second half of calendar year 2007):
Objective 2: Strengthen in-country supply systems and capacity for effective management of malaria commodities. Activities include —
Strengthen pharmaceutical management systems and supply chains and coordinate the logistics required throughout the supply chain, with a specific focus on the delivery of commodities from port of entry to point of use.
Ensure quality assurance within the supply chain.
Coordinate, implement, and manage logistics for large-scale long-lasting insecticide-treated bed nets (LLINs) distribution campaigns, retreatment campaigns, and routine distribution.
Support the management of diagnostic equipment, including laboratory supplies and rapid diagnostics tests.
Coordinate, implement, and roll out artemisinin-based combination therapy (ACT) and diagnostics.
Analyze, introduce, and oversee commodities in the private sector supply chain.
Strengthen pharmacovigilance and post-market surveillance.
Strengthen waste management systems.
Expected Results of Objective 2 Activities in Countries Where TO3 Has a Presence:
Implement a core, minimum package of activities to expand access to quality-assured products in PMI-supported countries, including forecasting and procurement planning support and freight and logistics services to consignees.
Depending on the country’s needs and existing partners’ presence, activities, and strengths, provide components for a comprehensive package of activities for system strengthening, capacity building, and quality assurance.
Identify collaborators in each country, whether or not the project has a presence there, to enhance product availability at service delivery points, leverage partner investments and strengths in implementation, and build in-country capacity for supply chain management ( SCM).
Implement best practices where feasible, such as computerized systems for logistics information management and frequent deliveries, which will reduce the strain on storage.
The following map illustrates countries where T03 has provided, or plans to provide, technical assistance to help strengthen supply systems.
Objective 3: Improve global supply and long-term availability of malaria commodities. Activities include —
Establish cost-effective implementation mechanisms for forecasting, procurement, logistics, and management of commodities.
Support global leadership on key commodity supply chain management issues.
Coordinate with other international donors and procurement agencies.
Work with malaria control programs in Africa on policy issues regarding the adoption, financing, and implementation of malaria commodities, particularly LLINs, ACTs, and RDTs.
Coordinate work with other USAID contractors and cooperative agencies.
Strengthen prequalification process for malaria commodities by working with domestic and international standards and partners, as appropriate.
Periodically analyze supply and pricing issues.
Support the development of new technologies and products.
Expected Results of Objective 3 Activities:
Participate in an internationally accepted forum or working group with broad representation to identify and address supply issues, such as the development of accurate demand forecasts and financing issues.
Identify and support international mechanisms at country and global levels to facilitate the procurement and delivery of malaria commodities.
Create opportunities for PMI-supported countries to share better practices and lessons learned in scaling up malaria prevention treatment programs.
Work closely with the Roll Back Malaria Partnership, the WHO Global Malaria Program, UNICEF, the Global Fund (GFATM), the World Bank, and new product development partnerships.
Facilitate or participate in sub-regional meetings to share lessons learned and best practices, leverage partner inputs, and enhance procurement and country supply chain performance.
Timely and efficient procurement, management, delivery, and consignment of malaria commodities, subject to funding availability. (ongoing)
Timely mobilization and response to USAID requests for technical assistance related to Objective 2 and Objective 3, based on USAID concurrence and available funding. (ongoing)
Availability of the first release of the ORION MIS system within 60 days of award. (completed)
USAID procurement mechanisms in place within 60 days of award. (completed)
Availability of quality assurance standard operating procedures (SOP) for pre- and post-shipment inspection and testing of RDTs, LLINS, and pharmaceutical drugs. (completed September 2007)
Availability of ORION release 2.0. (launched November 2007)
Availability of ORION release 2.1. (launched February 2008)
Availability of ORION release 3.0. (launched April 15, 2008)
Task Order 3 Reports
The project uses a planning and monitoring system to report to USAID on program progress that focuses on the performance work statement, annual performance work plans and accompanying budgets, semi-annual performance reports, commodity management reports, and specific technical reports. In addition to these reports, the project will also submit a final contract completion report.
TO3 manages procurement of malaria commodities for all 15 PMI focus countries, as well as for Nigeria. In addition, the project provides both short-term and long-term technical assistance for supply chain strengthening in more than half the PMI focus and non-focus countries.
