18 September 2013 Christopher Game Chief Procurement Officer 1 Geneva 9 Sept Why getting the First Mile right, drives the Last Mile Challenge

What is The Global Fund ? 4.2 Million 4.2 Million People currently receiving ARV therapy 9.7 Million 9.7 Million New smear-positive TB cases detected and treated 310 Million 310 Million Insecticide-treated nets distributed Since its inception in 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria has become the main multilateral funder in global health. It channels 82 percent of the international financing for TB, 50 percent for malaria, and 21 percent of the international financing against AIDS. It also funds health systems strengthening, as inadequate health systems are one of the main obstacles to scaling up interventions to secure better health outcomes for HIV, TB and malaria. $3Bn 600 Employees

What started as a Procurement Transformation…….. 3 The Global Fund will become the benchmark organisation in the sector for Sourcing and Procurement Minimising waste and eliminating non value adding activities Using simple, clear leading edge processes and tools designed by and for the organisation Ensuring effective governance and watertight compliance With measurable performance in value and lives saved Building collaborative relationships with partner agencies suppliers and donors Are directly aligned to the Global Fund s strategy

Industry must love us as a sector ? 4 Or perhaps they dont ? We are silod We are fragmented We are impeded by process / bureaucracy We have poor funds flow Inadequate planning & forecasting Much of what we do is outsourced All of these carry a $ premium Risk increases with fragmentation Long lead times reduce system stress at manufacturers How can we become a customer of choice ?

What started as a Procurement Transformation…….. 5 Turned into a process for industrializing thought leadership I soon realised that we are not a customer of choice Many inputs, few outputs Data often out of date and not easily refreshable Slow and operating in silos' That too many are thinking and too few are doing Substantial amount of people feeding at the table Numerous barriers to improvement (agent structures and cash flow) Drugs often mid-late lifecycle Partial aversion or fear of the private sector……in the same sector Our behaviors may erode the incentive to innovate That upstream leverage irons out some downstream supply issues

Working Upstream to improve the Downstream 6 I am going to illustrate how upstream transformation can drive downstream performance What we soon realised :- Lack of Accountability High Agency Costs Multiple Agencies Incentive model Agency local versus Global expertise Poor visibility of lost innovation Lack of ownership / supplier relationships Poor funds flow driving wrong behavior Fragmentation = difficult to plan Little competition in pricing Role of many funders largely executional No volume leverage/Many spot purchases How we responded :- Subscription, (spend under control) driven by transparency and ease of application Leverage with other large funders / donors to become a customer of choice Agency accountability (track & trace) Vendors incentivized to innovate Creation of product market & supply chain experts Ownership of relationships, up and downstream Greatly improved funds flow ? Cash flow Simple user designed processes Comprehensive market intelligence Frequent price competition Scalable and can be leveraged COGS versus Market based costing

Fixing the Plumbing first ? Creating the Ecosystem 7 Upstream partnering facilitating downstream partnering creating the Ecosystem Funders Manufacturers / Logistics Countries Phase 1 : Creating Partnerships

A Single Ecosystem Fixing the Plumbing first ? Creating the Ecosystem 8 Upstream partnering facilitating downstream partnering creating the Ecosystem Funders Manufacturers / Logistics Countries Phase 2 : Creating Capacity and Capability Underscored by common systems and transparency Common Accountability for OTIF

The Principles of Our Approach 9 Fundamentally changing the way we work across the supply chain to increase access to products Earlier involvement and closer collaboration with manufacturers Improving our purchasing capability and changing our contracting models Optimising the international supply chain to reduce cost Better planning and scheduling to support continuity of supply Delivering more products at the right time and place to more people

How we are measuring this ? 1.Develop and implement comprehensive reengineering of the Procurement Operating Model and Organisation. 2.Develop Procurement as a strong partner to create and facilitate Best in Class solutions and delivery for the global fund. 3.Create additional Value of 8% per annum 4.Increase spend penetration by 20% per annum 5.On Time and In Full (OTIF) service to recipient countries to exceed 90 %

The Commercial Relationship 11 To ensure we maintain a competitive price in a longer term contractual framework we will need to change our commercial model.

i-Fund for The Global Fund 12 Equipment, Goods and Services team Health Products Team The Support Group SuppliersPartners GF PSMsSuppliers Knowledge & Collaboration Country Ownership & Supply Track & Trace

To Reflect – How does fixing the first mile influence the last mile ? 13 How upstream transformation can drive downstream performance Phase 1 (Upstream) :- Make the Public Sector a customer of choice for the private sector Leverage funders / buyers Harmonize specifications Improve forecasting View longer term replenishment cycles Improve planning Standardize track & trace Open leverage to smaller buyers +cost of doing business Pay on time Create transparency Phase 2 (Downstream) :- Use savings generated to build country level capacity Take an academic approach to buffering supply chains Harmonize regulatory landscape Create regional centers of excellence building on upstream partner leverage Make logistics partners accountable and KPI to that accountability

Thank You 14 Questions / Discussion