1. Getting the right products to the right people World Malaria Day April 25, 2011

2. Session Overview Background Buying quality products Getting them the first mile Ensuring availability at the last mile

3. Background: who we are, what we do John Snow, Inc. (JSI) –Public health consulting firm established in 1978 –Over 20 years experience working to ensure the availability of pharmaceuticals and other health supplies in Africa, Latin America and Asia USAID | DELIVER PROJECT, Task Order Malaria –Procured $260,000,000 worth of malaria products since 2007 for 21 African countries –Work to strengthen the public health supply chains in 12 African countries –Undertake global advocacy to address PSM bottlenecks

4. Procuring quality malaria products By the end of 2010, procured $260 million worth of malaria products –29 million bednets –100 million ACT treatments –23 million RDTs –44 million tablets of SP for IPTp

5. Getting product the “first mile”: Angola Background: significant losses at central medical store Consolidated shipment of ACTs and RDTs in Liege, Belgium Packed by province, 19 consignees for 18 provinces

6. Getting product the “first mile”: Angola In-country distribution, direct from Luanda airport to provinces, took 5 days (halved the distribution time from previous shipments) No central level warehousing: saved $50,000 in warehouse costs and $7000 in security No losses, no damage

7. Ensuring availability at the last mile: Zambia Conducted pilot to improve availability of malaria and other essential medicines (in partnership with DFID, WB, GOZ) 2 model and 1 control group of districts –Model A: districts hold stock and resupply health facilities –Model B: districts serve as cross-dock and facilitate transport of pre-packed commodities to health facilities Results –Both models improved availability (reduced stock outs) over the control, but Model B did better –Both models lessened days out of stock over the control, but Model B did better

8. Zambia supply chain pilot results Reduced stock outs

9. Zambia supply chain pilot results Reduced duration of stock outs (in days)

10. Conclusion Support PMI’s goal of reducing malaria burden in its focus countries through: –Procuring critical malaria products –Delivering to the intended recipient –Strengthening the in-country supply system to ensure that those requiring malaria products receive them

11. Thank you. Questions?