1. Medicines Procurement and Supply Management Issues in Nigeria
WHO Technical Briefing Seminar
08-12 October 2006
Joel Ewuga Babakandzhi Adagadzu
Food and Drugs Services
Federal Ministry of Health
Abuja - Nigeria

2. Outline 1 Introduction Present situation Challenges
Selection
Procurement
Warehousing/Distribution
Financing issues
Challenges
Ongoing interventions
Future plans

3. Introduction 1
During the last 2 decades the medicines supply situation in Nigeria has deteriorated considerably
Medicines supply is now erratic and unreliable with widespread shortages or stock-outs in spite of the increasing availability of funds

4. Introduction 2
Increased allocation of health budget to medicines procurement has not improved the supply situation
Several development partners have been actively involved in providing support to the government with a view to improving the drug supply situation
Such supports are mainly in the form of provision of medicines and health commodities, capacity building, etc.

5. Selection 1 Presently selection not standardized and coordinated
Selection may be by partners, programs or health facilities
Selected medicines in most cases do not necessarily conform to the National Essential Medicines List
Nobody appears to be in-charge

6. Procurement (1) Reliable consumption data not available
Procurement plan not always available
Various partners and facilities procuring independently
Certain areas over supplied while others are undersupplied
Medicines procured are at an average of 3 times international prices
This leads to about 75% loss in savings
30% of medicines procured do not meet the 80% shelf life requirement for rational procurement

7. Warehousing/Distribution 1
Most procurements are done without prior plan for distribution as only 10% of delivered products have distribution plans
No budgets are provided for distribution
Consequently, procured medicines are often left for long periods in the stores before distribution resulting at times to expiry
Massive wastage of resources through uncoordinated and inappropriate distribution plans of medicines to the same health facilities by various partners and programmes

8. Financing (1) Health Care Structure in Nigeria comprises of:
Primary Health Care (Local govt)
Secondary Health Care (State govt)
Tertiary Health Care (Federal govt)
The Federal Government also provides both financial and technical support to the lower tiers of government in addition to the efforts of these governments
Various developmental partners also finance medicines procurement

9. Challenges 1 Sourcing of funds Development of logistics strategy
Training of personnel
Centralized procurement or pooled procurement
Quality concerns
Cost of medicines

10. Challenges 2 Monitoring and evaluation
Development of a sound information system
Public/private sector partnership
Effective management of the National Health Insurance Scheme, etc.

11. Key intervention programmes
Cost Recovery System or Drug (Medicines) Revolving Funds (DRF)
National Health Insurance Scheme
Public Private Partnership (PPP) for the financing of public medicines supply
Support by partners for various health programmes
Inflow of these resources uncoordinated and impact not commensurate

12. Ongoing Interventions
With the support of WHO, the following are ongoing:
Establishing a list of key Partners involved in Medicines procurement and distribution with aim of coordination to maximize use of resources
To carry our an in-depth assessment of the medicines procurement and distribution in the public sector so as to target interventions in addressing gaps.

13. Thank you