Supplies and Logistics

A record number of HIV-positive people receiving antiretroviral therapy in Malawi

© UNICEF/2005/Giacomo Pirozzi
UNICEF in Malawi is supporting the government to procure and distribute the rapid HIV/AIDS test kits which are simple and easy to use.

COPENHAGEN, March 2007: A record 85,000 HIV-positive people are receiving antiretroviral therapy (ART) in Malawi, through a joint effort by the Government of Malawi, UNICEF, donors and other partners.

“In Malawi the procurement, storage and distribution of medicines is a major challenge. This is why we call on UNICEF Procurement Services, as UNICEF is experienced in procurement and distribution and has quality systems in place”, explained Washington Kaimvi, the Director of Finance and Administration from the Malawi National AIDS Commission, during a visit of a delegation from Malawi to UNICEF Supply Division in Copenhagen.

The role of UNICEF Procurement Services in supporting the Government of Malawi in its fight against AIDS has been threefold:
• procuring quality antiretroviral medicines (ARVs) and test kits at the best price (for a value of $9.2 million in 2006);
• ensuring the in-country distribution; and
• throughout the process transferring knowledge and experience to its government counterparts.

“We went from having 3,000 people on ART in 2003 to 85,000 people at the end of 2006. This rapid scaling-up is due to UNICEF, who has been able to procure regular and emergency antiretroviral medicines. We believe we got the best prices, and delivery was always timely”, Kaimvi said.

Dr. Kelita Kamoto, who is the Head of the HIV-Unit in the Malawi Minister of Health underlined that,”another major challenge in Malawi is the capacity – capacity of people, infrastructure and systems”. Staff from the Central Medical Store came to Supply Division in 2006 to learn about the principles of procurement, storage and distribution of medicines. UNICEF also organised a study tour of four countries in Southern Africa for Malawi staff so that they can learn about their systems and improve their own systems in Malawi.

The National AIDS Commission also plans to learn more about procurement and in-country logistics from UNICEF, as Procurement Services has been coordinating the in-country distribution to 140 sites in collaboration with a private company. This is a major contribution to the success of the ART programme in Malawi as it ensures that supplies are available at all sites in a timely manner.

Partnerships are essential
In Malawi, UNICEF works with many partners to improve the supply chain. The Government uses pool funding, which means that donors such as DfiD, NORAD, CIDA, USAIDS, the World Bank etc, as well as the Government itself contribute to the same project. The challenge now is to mobilise local resources so that Malawi does not rely on external funding. Sustainability is especially important for the HIV/AIDS programme as plans must be made for the long-term – HIV-positive people will continue to require ARVs over the years

“Since the Government of Malawi uses a lot of public funds (whether it comes from external donors or Malawi itself), we must be transparent and accountable. We must ensure that there are systems in place so that Malawi can report on the use of funds”, says Kaimvi. UNICEF and the Government of Malawi work together to harmonize their reports.

Future plans
Malawi does not plan to stop there. An additional 40,000 HIV-positive people will receive anti-retroviral therapy by the end of 2007, bringing the total to over 120,000. The number of site UNICEF Procurement Services delivers medicines to will increase from 140 to 184 by October 2007. There is also a deliberate effort to increase the number of HIV-positive children on treatment.

“Ideally, Malawi should procure medicines for its people on its own. We should have our own efficient systems. We need to develop them with help from UNICEF, so that UNICEF can focus its resources and assistance on other problems. Our partnership with UNICEF will evolve. Our objective is to increase the capacity and efficiency of the Central Medical Store, so that all HIV-positive people in Malawi can receive ART” concluded Kaimvi.

While fighting HIV/AIDS is a key priority in Malawi, the country also continues addressing other health problems such as malaria, which remains the main killer in Malawi. In 2006, the Government of Malawi procured some $5.6 million worth of mosquito nets, insecticide, antimalarials and malaria test kits through UNICEF.



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