Ministry of Health, Pharmacy Division STOCK STATUS REPORT AS AT NOVEMBER 1st 2013

Transcription

1 istry of Health, Pharmacy Division STOCK STATUS REPORT AS AT NOVEMBER 1st 2013 Introduction The purpose of this report is to inform the istry of Health 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 It can be used to: Act as an early warning indicator for potential stock outs and possible expiries of EMHS Identify challenges and recommendations to avert supply interruptions Encourage preparation and sharing of joint supply plans with stakeholders Identify strategies for regularly reviewing supply plans for all the commodities Encourage donors to honour their commitments in terms of quantities of products expected, timeliness of deliveries and flexibility Summary of Key Highlights 1. HIV/AIDS Commodities Zidovudine and Nevirapine based adult formulations and TDF/3TC/EFV are well stocked across all warehouses. A circular from ACP is to go out in November 2013, instructing facilities to order TDF/3TC/EFV for all new ART patients. The dissemination of this circular will reduce consumption of, TDF/3TC and EFV adult formulation which has significantly increased at NMS, resulting in lowstock levels for TDF/3TC and EFV. ATV/r has seen increased uptake at all three warehouses, resulting in low stock levels at NMS and JMS. Interwarehouse transfers will be initiated to alleviate the risk of stockout of these formulations at NMS. TDF/3TC/EFV and ATV/r consumption is expected to rise. Interwarehouse transfers will be initiated to alleviate the stock out of NVP 50 tablets at NMS and MAUL. Next UNITAID deliveries to NMS to arrive between Jan to Feb SCMS shipment of NVP Syrup is expected by December JMS is facing low stock levels for AZT paediatric formulations. Interwarehouse stock transfers will be initiated prior to shipments arriving in January Medicines for Opportunistic Infections Fluconazole formulations are wellstocked in country, except for the 50/5ml oral suspension. NMS saw high issues in Aug to Oct 2013, resulting in a stock out situation. An additional request to Pfizer will be scoped and placed as soon as possible. Cotrimoxazole 120 is stocked out at NMS; an emergency procurement request will be initiated. 3. Antimalarials NMS holds 2.1 months of stock of ArtemetherLumefantrine 24' pack. More consignments are expected in country from December 2013 to February 2014 from Quality Chemicals and Global Fund. Additional 1.7M doses of ArtemetherLumefantrine from GF are after approval of the PSM plan. More GF orders will be placed using GF interim funding period between June and December GOU/NMS procurements are expected to fill any commodity gaps before GF funds are disbursed. JMS is well stocked with ACTs. 4. Laboratory There are low stock levels at NMS for key laboratory commodities. Deliveries of CD4 reagents from PEPFAR to NMS continue to come in and most are expected to be delivered by the end of November Procurements of HIV test kits, OI reagents, clinical chemistry and haematology reagents with support from DFID are also expected to start coming in but delivery dates are not confirmed. About 4 months of stock of Determine test kits from GF to NMS are expected at the end of December Anti TB Medicines RHZE, EH and RH (paediatric) are well stocked. RHE and RHZ (paediatric) are at low stock levels. NMS is to procure these formulations in the interim before GF consignments are delivered in April Capreomycin and Cycloserine which were at risk of expiry were loaned to other countries. 6. Reproductive Health Injectable contraceptives (Depoprovera) and oral contraceptives are low on stock at NMS. while the Emergency contraceptives are low on stock at UHMG. Interwarehouse stock transfers shall be initiated to alleviate the respective low stock levels. Urgent procurement of Female condoms, Mama Kits and Misoprostol is recommended to mitigate the stock out situation. 7. Vaccines All vaccines products are low on stock at NMS, with the exception of Hepatitis B. Vaccines pipeline was not accessed for inclusion in this report. No expiry risks to date. 8. Tracer Medicines Tracer medicines are low on stock at a national level. No expiry risk to date.

2 istry of Health, Pharmacy Division STOCK STATUS REPORT AS OF NOVEMBER National 1. HIV/AIDS Commodities a) ARVs Adult Stock Status Nov 1'13) & Total confirmeddeliveries in next three months (Nov to Jan '14) NMS AZT/3TC TDF/3TC TDF/3TC/EFV EFV 600 NVP 200 ATV/r 300/100 LPV/r 200/50 300/150/ / / /300/ AZT/3TC TDF/3TC TDF/3TC/EFV EFV 600 NVP 200 ATV/r 300/100 LPV/r 200/50 300/150/ / / /300/600 JMS MAUL Months stock hsof AZT/3TC TDF/3TC TDF/3TC/EFV EFV 600 NVP 200 ATV/r 300/100 LPV/r 200/50 300/150/ / / /300/600 Months hsof stock AZT/3TC TDF/3TC TDF/3TC/EFV TDF/3TC/EFV EFV 600 NVP 200 ATV/r 300/100 LPV/r 200/50 300/150/ / / /300/ /300 + NVP 200 Please see Months of Stock over 6 Months to view months of stock including deliveries and consumption over time.

3 b) ARVs Paediatric National f AZT/3TC 60/30 ABC/3TC 60/30 EFV 200 NVP 50 LPV/r 100/25 60/30/50 NMS AZT/3TC 60/30 ABC/3TC 60/30 EFV 200 NVP 50 LPV/r 100/25 60/30/50 JMS MAUL onthsof /30/ AZT/3TC 60/30 ABC/3TC 60/30 EFV 200 NVP 50 LPV/r 100/ /30/ AZT/3TC 60/30 ABC/3TC 60/30 EFV 200 NVP 50 LPV/r 100/25 Please see Months of Stock over 6 Months to view months of stock including deliveries and consumption over time.

4 ARVs Adult and Paediatric Risk of stock out in next three months Formulation NMS JMS MAUL Comment Legend Adult Adequate stock More than 3 months of stock 300/150/200 Stock out risk Below 3 Months of Stock AZT/3TC 300/150 Stock out Currently Stocked out TDF/3TC 300/300 NMS: High issues in Aug to October Expiry risk Below 6 months shelf life TDF/3TC/EFV 300/300/600 EFV 600 NMS: High issues in Aug to October NVP 200 ATV/r 300/100 Scale up occurring as preferred PI LPV/r 200/50 Paediatric 60/30/50 AZT/3TC 60/30 ABC/3TC 60/30 EFV 200 NVP 50 Scale up ocurring NVP 100 ml / NVP 240 ml Shipment expected from SCMS by Dec'13 LPV/r 100/25 LPV/r 80/20 /ml Stock Out Risks and Zidovudine and Nevirapine based adult formulations and TDF/3TC/EFV are well stocked across all warehouses. A circular from ACP is to go out in November 2013, instructing facilities to order TDF/3TC/EFV for all new ART patients. The dissemination of this circular will reduce consumption of, TDF/3TC and EFV adult formulation which has significantly increased at NMS, resulting in lowstock levels for TDF/3TC and EFV. ATV/r has seen increased uptake at all three warehouses, resulting in low stock levels at NMS and JMS. Interwarehouse transfers will be initiated to alleviate the risk of stockout of these formulations at NMS. TDF/3TC/EFV and ATV/r consumption is expected to rise. Interwarehouse transfers will be initiated to alleviate the stock out of NVP 50 tablets at NMS and MAUL. Next UNITAID deliveries to NMS to arrive between Jan to Feb SCMS shipment of NVP Syrup is expected by December JMS is facing low stock levels for AZT paediatric formulations. Interwarehouse stock transfers will be initiated prior to shipments arriving in January Expiry Risks and

5 2. Medicines for Opportunistic Infections Stock Status (Nov 1'13) & Total confirmeddeliveries in next three months (Nov to Jan '14) National NMS ock Fluconazole Fluconazole 2/ml I.V. Fluconazole 50/5ml Cotrimoxazole 120 Cotrimoxazole (Diflucan)** Infusion 100ml oral suspension Tab Tab** (Diflucan)** (Diflucan)** Fluconazole Fluconazole 2/ml I.V. Fluconazole 50/5ml Cotrimoxazole 120 Tab Cotrimoxazole (Diflucan)** Infusion 100ml oral suspension Tab** (Diflucan)** (Diflucan)** JMS MAUL Months stock of 6.2 Fluconazole 200(Diflucan)** 6.8 Fluconazole 2/ml I.V. Fluconazole 50/5ml Infusion 100ml oral suspension (Diflucan)** (Diflucan)** Cotrimoxazole 120 Tab Cotrimoxazole 960 Tab** 9.9 Fluconazole 200(Diflucan)** Fluconazole 2/ml I.V. Fluconazole 50/5ml Infusion 100ml oral suspension (Diflucan)** (Diflucan)** Cotrimoxazole 120 Tab Cotrimoxazole 960 Tab** Please see Months of Stock over 6 Monthsto view months of stock including deliveries and consumption over time. Risk of stock out in next three months Legend Formulation NMS JMS MAUL Comments Adequate stock Stock out risk Within 36 months of stock Below 3 Months of Stock Fluconazole 200(Diflucan) Fluconazole 2/ml I.V. Infusion Stock out Expiry risk Stock Out Risks and Expiry Risks and Fluconazole 50/5ml oral Stock out now or expected suspension (Diflucan) Below 6 months shelf life Cotrimoxazole 120 Tab Cotrimoxazole 960 Tab NMS: High issues in Aug to Oct 2013 Fluconazole formulations are wellstocked in country, except for the 50/5ml oral suspension. NMS saw high issues in Aug to Oct 2013, resulting in a stock out situation. An additional request to Pfizer will be scoped and placed as soon as possible. Cotrimoxazole 120 is stocked out at NMS; an emergency procurement request will be initiated. No expiry risk to date.

6 3. Antimalarials Stock Status (Nov 1'13) & Total confirmeddeliveries in next three months (Nov to Jan '14) National NMS JMS ACT 20/120 tab, 24 pack ACT 20/120 tab, 18 pack ACT 20/120 tab, 12 pack ACT 20/120 tab, 6 pack Please see Months of Stock over 6 Months to view months of stock including deliveries and consumption over time.

7 Legend Risk of stock out in next three months Adequate stock Within 36 months of stock Formulation NMS JMS Comments Stock out risk Below 3 Months of Stock ACT 20/120 tab, 24 pack Stock out Stock out now or expected ACT 20/120 tab, 18 pack Expiry risk Below 6 months shelf life ACT 20/120 tab, 12 pack ACT 20/120 tab, 6 pack Artesunate Injection 60/ml Quinine HCl injection, 600/2ml SulphadoxinePyrimethamine 500/25 tab* Stock Out Risks and NMS holds 2.1 months of stock of ArtemetherLumefantrine 24' pack. More consignments are expected in country from December 2013 to February 2014 from Quality Chemicals and Global Fund. Additional 1.7M doses of ArtemetherLumefantrine from GF are after approval of the PSM plan. More GF orders will be placed using GF interim funding period between June and December GOU/NMS procurements are expected to fill any commodity gaps before GF funds are disbursed. JMS is well stocked with ACTs. Expiry Risks and No expiry risk to date.

8 4. Laboratory Stock Status (Nov 1'13) & Total confirmed deliveries in next three months (Nov to Jan '14) National NMS JMS MAUL Determine HIV 1/2 Rapid Test Kit 7.1 StatPak HIV Rapid Test Kit 6.3 Unigold HIV Rapid Test Kit PartecCD4 Easy Alere Pima CD4 Count Kit 100X Catridge Kit FACS Count CD4/CD3/CD8 50 TESTS Please see Months of Stock over 6 Months to view months of stock including deliveries and consumption over time.

9 Risk of stock out in next three months Formulation NMS JMS MAUL Comments Legend Adequate stock Stock out risk Stock out Expiry risk Malaria Rapid diagnostic kits Within 36 months of stock Determine HIV 1/2 Rapid Test Kit Below 3 Months of Stock StatPak HIV Rapid Test Kit Stock out now or expected Unigold HIV Rapid Test Kit Below 6 months shelf life PartecCD4 Easy Count Kit Alere Pima CD4 100X Catridge Kit FACS Count CD4/CD3/CD8 50 TESTS FACS Caliber Multitest CD4/CD3/CD8 50 TESTS HUMACOUNT DILUENT NIHON KOHDEN MEK DILUENT Coulter Diluent Sysmex Cell Pack HUMAN GOT (ASAT) LIQUICOLOR COBAS c 311 ALT Stock Out Risks and There are low stock levels at NMS for key laboratory commodities. Deliveries of CD4 reagents from PEPFAR to NMS continue to come in and most are expected to be delivered by the end of November Procurements of HIV test kits, OI reagents, clinical chemistry and haematology reagents with support from DFID are also expected to start coming in but delivery dates are not confirmed. About 4 months of stock Determine test kits from GF to NMS are expected at the end of December Expiry Risks and No expiry risk to date.

10 5. Anti TB Medicines Stock Status (Nov 1'13) & Total confirmeddeliveries in next three months (Nov to Jan '14) National/NMS RHZE tablet 75/150/275/400/ EH twoweek blister strip 400/150 RH (Pediatric) tablet RHE (150/75/275 ) RHZ (Pediatric) tablet 60/30/75 Please see Months of Stock over 6 Monthsto view months of stock including deliveries and consumption over time. Legend Adequate stock Stock out risk Stock out Expiry risk Within 36 months of stock Below 3 Months of Stock Stock out now or expected Below 6 months shelf life Risk of stock out in next three months Formulation NMS Comments RHZE tablet 75/150/275/400/ EH twoweek blister strip RH (Pediatric) tablet RHE (150/75/275 ) RHZ (Pediatric) tablet 60/30/75 Streptomycin vial 1g Capreomycin 1G Vials Cycloserine 250 Tablets Ethionamide 250 Tablets Kanamycin 1G Vials Levofloxacin 250 Tablets Moxifloxacin 400 Tablets Paser 4 GM Sachets Stock Out Risks and Expiry Risks and RHZE, EH and RH (paediatric) are well stocked. RHE and RHZ (paediatric) are at low stock levels. NMS is to procure these formulations in the interim before GF consignments are delivered in April Capreomycin and Cycloserine which were at risk of expiry were loaned to other countries.

11 6. Reproductive Health Stock Status (Nov 1'13) & Total confirmeddeliveries in next three months (Nov to Jan '14) Public/NMS Private 9.5 Monthsof stock Months Please see Months of Stock over 6 Months to view months of stock including deliveries and consumption over time.

12 Legend Adequate stock Stock out risk Stock out Expiry risk Within 36 months of stock Below 3 Months of Stock Stock out now or expected Below 6 months shelf life Formulation DepoProvera (Medroxyprogesterone Acetate 150/ml INJ) Implants (Implanon& Jadelle) IUD Copper Containing Device TCU380A Combined Oral Contraceptives (Microgynon) Progestinonly oral contraceptives Male Condom Risk of stock out in next three months NMS Private Comments Manual Vacuum Aspiration (MVA) Double Valve Mama Kit Female Condom Levonorgestrel 750 mcg Tab (Emerg. Contraceptive) Misoprostol 200mcg Tabs Stock Out Risks and Expiry Risks and Injectable contraceptives (Depoprovera) and oral contraceptives are low on stock at NMS. while the Emergency contraceptives are low on stock at UHMG. Interwarehouse stock transfers shall be initiated to alleviate the respective low stock levels. Urgent procurement of Female condoms, Mama Kits and Misoprostol is necessary to mitigate the stock out situation. No expiry risk to date.

13 7. Vaccines Stock Status (Nov 1'13) & Total confirmeddeliveries in next three months (Nov to Jan '14) National/NMS Measles Vaccine 10 Bacillus Calmette Human papilloma dose vial Guerin (BCG),20 Virus (HPV),1 dose dose vial vial Hepatitis B, 10 dose vial DPTHEPB+HIB) 1 dose vial Diphtheria, Pertusis 3.1 Tetanus toxoid vaccine (TT) 20 dose vial 2.7 Polio oral trivalent Polio Oral Bivalent (TopV) 20 dose, vial(bopv) 20 dose vial Please see Months of Stock over 6 Months to view months of stock including deliveries and consumption over time. Legend Formulation NMS Adequate stock Stock out risk Stock out Expiry risk Within 36 months of stock Below 3 Months of Stock Stock out now or expected Below 6 months shelf life Measles Vaccine 10 dose vial Bacillus CalmetteGuerin (BCG),20 dose vial Human papilloma Virus (HPV),1 dose vial Hepatitis B, 10 dose vial DPTHEPB+HIB) 1 dose vial Diphtheria, Pertusis Tetanus toxoid vaccine (TT) 20 dose vial Polio oral trivalent (TopV) 20 dose, vial Polio Oral Bivalent (BOPV) 20 dose vial Risk of stock out in next three months Comments Stock Out Risks and Expiry Risks and All vaccines products are low on stock at NMS, with the exception of Hepatitis B. Vaccines pipeline was not accessed for inclusion in this report. No expiry risks to date.

14 National 8. Tracer Medicines Stock Status (Nov 1'13) & Total confirmeddeliveries in next three months (Nov to Jan '14) DepoProvera ArtemetherLumefantrine (Medroxyprogesterone Acetate 20/120 tab (Green), 24 pack* 150/ml INJ)* Cotrimoxazole 480 Oral Rehydration Salts for 1 Litre Measles Vaccine Please see Months of Stock over 6 Months to view months of stock including deliveries and consumption over time. Legend Formulation Nat'l Adequate stock Within 36 months of stock DepoProvera Stock out risk Below 3 Months of Stock ArtemetherLumefantrine Stock out Stock out now or expected Cotrimoxazole 480 Expiry risk Below 6 months shelf life Oral Rehydration Salts for 1 Litre Measles Vaccine Risk of stock out in next three months Comments Stock Out Risks and Expiry Risks and Tracer medicines are low on stock at a national level. No expiry risk to date.

15 istry of Health, Pharmacy Division STOCK STATUS REPORT AS AT 1 NOVEMBER 2013 National and Warehouse Six Month Analysis of Consumption Trends and Deliveries Introduction Below are the six month consumption trends together with deliveries for ARVs & HIV test kits, ACTs, AntiTB medicines, Reproductive Health items, selected Laboratory commodities and selected medicines for opportunistic infections to assist in mitigating stock outs and reducing expiries. Stock levels are forecasted using estimated average monthly consumption and include expected confirmed pipeline (Drugs yet to be delivered in the next six months) HIV/AIDS Commodities ARVs Adult and Paediatric National and by Warehouse Months of Stock on Hand by Formulation including deliveries (with a confirmed delivery date) for the next six months. Note: on hand for each month reflect remaining months of stock (MOS) at the end of each month after any deliveries arrive and average monthly distribution is made. New patient and regimen scale up are included in the AMCs used. Only deliveries with a delivery date are included. National: Includes deliveries and expected consumption over 6 month period Nov Dec Jan Feb Mar Apr Adult 300/150/ , NMS: Includes deliveries and expected consumption over 6 month period Months of Stock Nov 1 AMC Nov Dec Jan Feb Mar Apr Adult 300/150/ , AZT/3TC 300/150 98, AZT/3TC 300/150 55, TDF/3TC 300/ , TDF/3TC 300/300 86, TDF/3TC/EFV TDF/3TC/EFV 300/300/ , /300/600 82, TDF/3TC 300/300 + NVP , EFV , EFV , NVP , NVP , ATV/r 300/100 3, ATV/r 300/100 6, LPV/r 200/50 5, LPV/r 200/50 15, Paediatric Paediatric 31, /30/50 42, AZT/3TC 60/30 8, AZT/3TC 60/30 13, ABC/3TC 60/30 3, ABC/3TC 60/30 6, EFV 200 3, EFV 200 5, NVP 50 3, NVP 50 5, NVP 100 ml 7, NVP 100 ml 10, LPV/r 100/25 2, LPV/r 100/25 4, LPV/r 80/20 /ml LPV/r 80/20 /ml 1, *AMCs increase over time in accordance with scale up targets *AMCs increase over time in accordance with scale up targets

16 JMS: Includes deliveries and expected consumption over 6 month period MAUL: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 Nov 1 Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 Months of Stock AMC Adult Adult 300/150/200 34, /150/200 51, AZT/3TC 300/150 15, AZT/3TC 300/150 27, TDF/3TC 300/300 24, TDF/3TC 300/300 42, TDF/3TC/EFV TDF/3TC/EFV 300/300/600 13, /300/600 24, EFV , TDF/3TC 300/300 + NVP , NVP , EFV , ATV/r 300/ NVP , LPV/r 200/50 3, ATV/r 300/100 2, Paediatric LPV/r 200/50 6, , Paediatric AZT/3TC 60/30 1, /30/50 9, ABC/3TC 60/ AZT/3TC 60/30 4, EFV ABC/3TC 60/30 2, NVP EFV 200 1, NVP 100 ml 1, NVP 50 1, LPV/r 100/ NVP 100 ml LPV/r 80/20 /ml LPV/r 100/25 1, *AMCs increase over time in accordance with scale up targets LPV/r 80/20 /ml *AMCs increase over time in accordance with scale up targets Stock Out Risks and Zidovudine and Nevirapine based adult formulations and TDF/3TC/EFV are well stocked across all warehouses. A circular from ACP is to go out in November 2013, instructing facilities to order TDF/3TC/EFV for all new ART patients. The dissemination of this circular will reduce consumption of, TDF/3TC and EFV adult formulation which has significantly increased at NMS, resulting in lowstock levels for TDF/3TC and EFV. ATV/r has seen increased uptake at all three warehouses, resulting in low stock levels at NMS and JMS. Interwarehouse transfers will be initiated to alleviate the risk of stockout of these formulations at NMS. TDF/3TC/EFV and ATV/r consumption is expected to rise. Interwarehouse transfers will be initiated to alleviate the stock out of NVP 50 tablets at NMS and MAUL. Next UNITAID deliveries to NMS to arrive between Jan to Feb SCMS shipment of NVP Syrup is expected by December JMS is facing low stock levels for AZT paediatric formulations. Interwarehouse stock transfers will be initiated prior to shipments arriving in January Expiry Risks and 0

17 Medicines for Opportunistic Infection National: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr Fluconazole 200(Diflucan)** 7, Fluconazole 2/ml I.V. Infusion 100ml (Diflucan)** Fluconazole 50/5ml oral suspension (Diflucan)** Cotrimoxazole 120 Tab 5, Cotrimoxazole 960 Tab** 28, NMS: Includes deliveries and expected consumption over 6 month period Months of Stock Nov 1 Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 AMC Fluconazole 200(Diflucan)** 4, Fluconazole 2/ml I.V. Infusion 100ml (Diflucan)** Fluconazole 50/5ml oral suspension (Diflucan)** Cotrimoxazole 120 Tab 2, Cotrimoxazole 960 Tab** 17, JMS: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr Fluconazole 200(Diflucan)** 1, Fluconazole 2/ml I.V. Infusion 100ml (Diflucan)** Fluconazole 50/5ml oral suspension (Diflucan)** Cotrimoxazole 120 Tab 2, Cotrimoxazole 960 Tab** 2, Cotrimoxazole 960 Cotrimoxazole 960 MAUL: Includes deliveries and expected consumption over 6 month period Months of Stock Nov 1 Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 AMC Fluconazole 200(Diflucan)** 1, Fluconazole 2/ml I.V. Infusion 100ml (Diflucan)** Fluconazole 50/5ml oral suspension (Diflucan)** Cotrimoxazole 120 Tab Cotrimoxazole 960 Tab** 9, Stock Out Risks and Fluconazole formulations are wellstocked in country, except for the 50/5ml oral suspension. NMS saw high issues in Aug to Oct 2013, resulting in a stock out situation. An additional request to Pfizer will be scoped and placed as soon as possible. Cotrimoxazole 120 is stocked out at NMS; an emergency procurement request will be initiated. Expiry Risks and No expiry risk to date.

18 3. Antimalarials National: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr ACT 20/120 tab, 24 pack 56, ACT 20/120 tab, 18 pack 11, ACT 20/120 tab, 12 pack 10, ACT 20/120 tab, 6 pack 22, Artesunate Injection 60/ml 62, Dihydroartemisin 40+Piperaquine 320 2, Quinine HCl injection, 600/2ml 1, Sulphadoxine Pyrimethamine 500/25 tab* 1, NMS: Includes deliveries and expected consumption over 6 month period Months of Stock Nov 1 Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 AMC ACT 20/120 tab, 24 pack 52, ACT 20/120 tab, 18 pack 8, ACT 20/120 tab, 12 pack 8, ACT 20/120 tab, 6 pack 19, Artesunate Injection 60/ml 62, Dihydroartemisin 40+Piperaquine 320 2, Quinine HCl injection, 600/2ml 1, Sulphadoxine Pyrimethamine 500/25 tab* 1, JMS: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr ACT 20/120 tab, 24 pack 4, ACT 20/120 tab, 18 pack 2, ACT 20/120 tab, 12 pack 2, ACT 20/120 tab, 6 pack 2, Stock Out Risks and Expiry Risks and NMS holds 2.1 months of stock of ArtemetherLumefantrine 24' pack. More consignments are expected in country from December 2013 to February 2014 from Quality Chemicals and Global Fund. Additional 1.7M doses of ArtemetherLumefantrine from GF are after approval of the PSM plan. More GF orders will be placed using GF interim funding period between June and December GOU/NMS procurements are expected to fill any commodity gaps before GF funds are disbursed. JMS is well stocked with ACTs. No expiry risk to date.

19 4. Laboratory National: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr Malaria Rapid diagnostic kits 76, Determine HIV 1/2 Rapid Test Kit 11, StatPak HIV Rapid Test Kit 5, Unigold HIV Rapid Test Kit 2, PartecCD4 Easy Count Kit Alere Pima CD4 100X Catridge Kit FACS Count CD4/CD3/CD8 50 TESTS 1, NMS: Includes deliveries and expected consumption over 6 month period Months of Stock Nov 1 Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 AMC Malaria Rapid diagnostic kits 68, Determine HIV 1/2 Rapid Test Kit 7, StatPak HIV Rapid Test Kit 3, Unigold HIV Rapid Test Kit 1, PartecCD4 Easy Count Kit Alere Pima CD4 100X Catridge Kit FACS Count CD4/CD3/CD8 50 TESTS FACS Caliber Multitest CD4/CD3/CD8 50 TESTS 1, FACS Caliber Multitest CD4/CD3/CD8 50 TESTS HUMACOUNT DILUENT HUMACOUNT DILUENT NIHON KOHDEN MEK NIHON KOHDEN MEK DILUENT DILUENT Coulter Diluent Coulter Diluent Sysmex Cell Pack Sysmex Cell Pack HUMAN GOT (ASAT) LIQUICOLOR HUMAN GOT (ASAT) LIQUICOLOR COBAS c 311 ALT COBAS c 311 ALT

20 JMS: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr Malaria Rapid diagnostic kits 7, Determine HIV 1/2 Rapid Test Kit 1, StatPak HIV Rapid Test Kit Unigold HIV Rapid Test Kit PartecCD4 Easy Count Kit MAUL: Includes deliveries and expected consumption over 6 month period Months of Stock Nov 1 Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 AMC Determine HIV 1/2 Rapid Test Kit 16, StatPak HIV Rapid Test Kit 9, Unigold HIV Rapid Test Kit 4, Alere Pima CD4 100X Catridge Kit FACS Count CD4/CD3/CD8 50 TESTS Alere Pima CD4 100X Catridge Kit FACS Caliber Multitest CD4/CD3/CD8 50 TESTS FACS Count CD4/CD3/CD8 50 TESTS HUMACOUNT DILUENT NIHON KOHDEN MEK DILUENT Coulter Diluent Sysmex Cell Pack HUMAN GOT (ASAT) LIQUICOLOR COBAS c 311 ALT Stock Out Risks and There are low stock levels at NMS for key laboratory commodities. Deliveries of CD4 reagents from PEPFAR to NMS continue to come in and most are expected to be delivered by the end of November Procurements of HIV test kits, OI reagents, clinical chemistry and haematology reagents with support from DFID are also expected to start coming in but delivery dates are not confirmed. About 4 months of stock Determine test kits from GF to NMS are expected at the end of December Expiry Risks and No expiry risk to date.

21 Anti TB Medicines National: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar TB Commodity RHZE tablet Apr /150/275/400/ EH twoweek blister strip 400/ RH (Pediatric) tablet RHE (150/75/275 ) 1, RHZ (Pediatric) tablet 60/30/75 1, Stock Out Risks and Expiry Risks and RHZE, EH and RH (paediatric) are well stocked. RHE and RHZ (paediatric) are at low stock levels. NMS is to procure these formulations in the interim before GF consignments are delivered in April Capreomycin and Cycloserine which were at risk of expiry were loaned to other countries. 0

22 Reproductive Health NMS: Includes deliveries and expected consumption over 6 month period Private: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 Nov 1 Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 Months of Stock AMC DepoProvera (Medroxyprogesterone Acetate 150/ml INJ) 358, DepoProvera (Medroxyprogesterone Acetate 150/ml INJ) 83, Implants (Implanon& Jadelle) 2, Implants (Implanon& Jadelle) 16, IUD Copper IUD Copper Containing Device Containing Device TCU380A TCU380A 6, Combined Oral Combined Oral Contraceptives Contraceptives (Microgynon) 10, (Microgynon) 13, Progestinonly oral contraceptives Progestinonly oral contraceptives (Microlut)[Norgestrel (Microlut)[Norgestrel 0.075] 3, ] 3, Male Condom (52MM with and without Logo) 2,180, Male Condom (52MM with and without Logo) 12,534, Manual Vacuum Manual Vacuum Aspiration (MVA) Aspiration (MVA) Double Valve Double Valve Mama Kit 49, Female Condom Female Condom Levonorgestrel 750 mcg Tab (Emergency Contraceptive) 1, Levonorgestrel 750 mcg Misoprostol 200mcg Tab (Emergency Tabs Contraceptive) 5, Misoprostol 200mcg Tabs Stock Out Risks and Expiry Risks and Injectable contraceptives (Depoprovera) and oral contraceptives are low on stock at NMS. while the Emergency contraceptives are low on stock at UHMG. Interwarehouse stock transfers shall be initiated to alleviate the respective low stock levels. Urgent procurement of Female condoms, Mama Kits and Misoprostol is necessary to mitigate the stock out situation. No expiry risk to date.

23 Vaccines National: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr Measles Vaccine 10 dose vial 22, Bacillus Calmette Guerin (BCG),20 dose vial 29, Human papilloma Virus (HPV),1 dose vial 19, Hepatitis B, 10 dose vial DPTHEPB+HIB) 1 dose vial Diphtheria, Pertusis 365, Tetanus toxoid vaccine (TT) 20 dose vial 33, Polio oral trivalent (TopV) 20 dose, vial 92, Polio Oral Bivalent (BOPV) 20 dose vial Stock Out Risks and Expiry Risks and All vaccines products are low on stock at NMS, with the exception of Hepatitis B. Vaccines pipeline was not accessed for inclusion in this report. No expiry risks to date. Tracer Medicines National: Includes deliveries and expected consumption over 6 month period Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr DepoProvera (Medroxyprogesteron e Acetate 150/ml INJ) 441, Artemether Lumefantrine 20/120 tab (Green), 24 pack 56, Cotrimoxazole , Oral Rehydration Salts for 1 Litre 11, Measles Vaccine 22, Stock Out Risks and Tracer medicines are low on stock at a national level.