UNAIDS HIV Drug Access Initiative: Providing Wider Access to HIV-related Drugs in Developing Countries, Pilot Phase

* Ensure continuous procurement and supply of drugs and avoid any
shortage in stocks.
* Assist the centres in their stock management to ensure continuous supply
of drugs to patients.
The following lessons can be drawn from the experience of the Initiative:
* The issue of channelling subsidies is currently less relevant, as the more
favourable political outlook on differential pricing has led most companies
to reduce their prices directly.
* When the country has medical stores that are operational in the public
sector, the added value of the NPC with respect to ensuring continuous
procurement and supply of drugs to the centres becomes less evident.
* A key element remains the flexibility of the medical stores to purchase
directly in emergency situations in which the volume of drugs required has
been underestimated. The medical stores should also have the flexibility
to issue tenders and have room to adjust drug volumes during the course
of the year. This is essential since the needs estimates established for one
year may vary, especially in situations in which drug consumption is
growing.
* The NPC plays a vital role in improving and maintaining adequate stock
management of drugs, including placing orders, maintaining adequate
financial facilities, and keeping sufficient but not excessive stocks of all
Sdrugs. It is clear that stock management of ARVs is more complicated
than that of average drug supplies, since clients take different
combinations and may switch in the middle of treatment. Stock
movements of ARV drugs are therefore interdependent, reducing the
accuracy of needs estimates.
Computerized Stock Management
The computerized stock management system has been designed specifically
for the Drug Access Initiative by UNAIDS. This unique system combines
clinical and anonymous data of individual patients with data on drug stocks,
turnover and accounts. The combination is extremely useful for the centres
since it allows a tracking record of the patients which can operate at the
pharmacy as well as at the physician's level, optimizing patient monitoring
and follow-up.
The stock management software has been improved following feedback from
people in the field, resulting in a flexible system that can be adapted to any
country context and any language.

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