Logistics Update IMS Meeting November 26, 2014

Key Progress Forward Logistics Base (FLB) Updates- 3 FLBs have all 6 required Mobile Storage Units erected and are operational (Voinjama, Zwedru, Gbarnga); 2 FLBs have been allocated land and will be completed next week (Harper, Buchana) Airport Constraints and storage augmentation- 4 MSUs have now been erected at the airport to increase capacity; Logistics Cluster regularly updating incoming flight schedule. Dispatch plans and the Main Logistics Hub –some difficulties encountered as some cargo remaining in the hub for lengthy periods of time; Logistics Cluster holding weekly dispatch planning meetings with partners to ensure rapid dispatch of supplies to Ebola and non-Ebola facilities Kitting & Supply Chain: Logistics Cluster, MoH, USAID, UNICEF, WHO and other key partners working together to establish kits per facility (ETU, CCC, RITE).

Key Challenges Lack of Information on Ownership of Facilities – It is difficult to obtain current information of who is doing what and when at all ETUs, CCCs. This is critical for planning purposes. Limited GOL Staffing at FLBs– MOH may need some support to staff people at the 5 FLBs Support for Fleet Management: MOHSW is seeking partner support for fleet management for the Ebola response (not for distribution of supplies, but for the entire response) Dispatch to regular health facilities: supplies exist at the hub in incorrect proportions for IPC; awaiting input on prioritization from MOHSW (county, type of facility, disease burden, etc) Supplies required for the immediate term: PPE Hoods, Impervious Gowns, Reusable Face Shields, Heavy Duty Reusable Aprons, Anti Fog Cleaner, Scrubs, DRUGS for ETUs/CCCs/RITEs

Stock Status for Critical Medical Supplies for facilities using MOHSW Supply Chain as of November 15 KEY: <1 week (7 days) supply <2 week (14 days) supply Scenario 1: Current Status 732 ETU beds (according to case management team) 90 CCC beds (according to CCC sub-committee) 462 non-ETU facilities open (according to MOHSW plans) Scenario 2: Mid-Scale Up Current ETU beds + Phase 1 ETU beds (1262 beds) Current CCC beds + one 30-bed CCC per county (520 beds) 657 non-ETU facilities open Scenario 3: Full Scale Up All Current ETU beds + Planned ETU beds (2292 beds) All current CCC beds + Planned CCC beds (1075) Forecast for household kits not included Forecast for burial team based off of IFRC consumption for Montserrado last month; estimated scale up needs based on increase in ETU beds Notes – Includes stock and pipeline information from IFRC, ICRC, MOHSW, US Gov’t, WHO. Pipeline includes information from 11/10-12/15. Assumes all facilities are operating at full capacity Scenario 1: Current Status: 343 ETU beds (at MOHSW-supplied facilities), 149 CCC beds, 303 non-ETU facilities Scenario 2: Mid-Scale Up: Current MOHSW-supplied ETU beds + ETU beds within next month (986 beds), Current CCCs beds + one 10-bed CCC per county (219 beds), 75% non-ETU facilities open

Logistics – clarity on partner support For each Facility (ETU, CCC, regular health facility), we need a comprehensive picture of who is supplying what. This is critical for our forecasts and dispatch plans. An excerpt of information we are trying to collect is listed below:

Logistics – progress, constraints and actions needed (1 of 2) Objective How well are we doing? Constraint What action needs to be taken, when and by whom? 1. Work with other sub-committees to clearly forecast the medicines and medical supplies needed for the Ebola response, including equipment for protecting health care workers in non-Ebola settings. Forecasts consolidated for ETUs, CCCs, non-ETU facilities. Supporting needs assessment for WASH associated with CCCs. [See stock slide] Unclear which partner-supported facilities will rely on existing supply chain for supplies (versus supplying their own) Very limited consumption data available from facilities which hinders the ability to properly update forecasts and dispatch plan Incorrect proportions of PPE complicate dispatching IMS to support consolidation of information regarding levels of partner support at various new facilities (see sample table) Case Management committee/County Operations to ask all ETUs/counties to submit stock status on weekly basis KITS must be developed to allow for more streamlined dispatch 2. To monitor the pipeline – and escalate where new supplies are needed Tracking Tool developed to monitor pipeline and shared weekly with Logistics Sub-Committee and other interested partners. Online tool currently under consideration Limited information has been submitted for the tracking tool –means estimates are incomplete Separate systems exist for health commodities and contribution through national task force Long lead time creates challenges in predicting arrival date for some supplies Global shortage of PPE – with partner organisations competing as well as national competition for supplies across the region Continue working with Donor Coordinator for Support Services to test online tool IMS to request that all partners/donors submit pipeline information for medical supplies, regardless of whether or not they are earmarked for their own purposes

Logistics – progress, constraints and actions needed (2 of 2) Objective How well are we doing? Constraint What action needs to be taken, when and by whom? 3. To manage warehousing and ensure supplies are received and distributed appropriately Logistics Hub is fully operational;. upcountry warehouse construction is in progress. 3 of 5 Forward Logistics Bases are operational; the remaining two will be complete by the end of November Dispatch to counties and ETUs is ongoing (in moderate quantities) Process to request supplies is shifting as items get consolidated at the hub but items are still dispatched from all warehouses Point people for teams (whom items can be consigned to) have not been identified; this results in duplication of requisitions and confusion Log Cluster/MOHSW/WHO to define SOPs for the supply chain system (push vs pull); outline will be complete by 24/11. All teams to submit a list of authorized point people to submit requisitions and collect supplies as well as allowable supplies per partner by 3/10 IMS TO MANDATE 4. Fleet Management Fleet management project plan was prepared by UNOPS including additional vehicles, radios and maintenance support; funding has not been secured yet UNMEER indicated proposed support in providing vehicles to the MoH Limited partner support for fleet management for overall Ebola response (beyond movement of goods) MoHSW has started working closely with UNOPS and USAID GEMS on fleet management and information management issues MOHSW is seeking partner support for fleet management for the Ebola response SCMU has seconded staff members to support fleet management