1. 1 | “SMS for Life” | Geneva, January 21st. 2010

2. Today, many health facilities suffer from stock-outs of malaria medicines Artemisinin: Plant Grow Harvest Chemical process: Arte Lume Tabletting & packa- ging of ACT’s Distri- bution to countries Ware- house Country ware- house District distri- bution Health Facilities & Health Posts Pharmaceutical Suppliers Procurement agents Patient National Malaria Control Programs Tenders The problem being addressed? Maintaining adequate supplies of anti-malarial medicines at the health facility level in rural sub-Saharan Africa is a major barrier to effective management of the disease. Lack of visibility of anti-malarial stocks at the health facility level is an important contributor to this problem.

3. Partnership NMCP In Country Project Leader: Winifred Mwafongo Program Director: Jim Barrington Technical Support: Kevin FerridayProject Support: Pete Ward Map Development: Ka-Ping Yee

4. Project Steering Committee Exec. Dir. Roll Back Malaria Partnership (Chair) Prof. Awa Marie Coll-Seck Tanzania Nat. Malaria Control Program ManagerDr Alex Mwita PSI Vice President and Global Malaria Control DirectorDr. Desmond Chavasse Director of the Swiss Tropical Institute Prof. Marcel Tanner CEO Novartis Foundation for Sustainable DevelopmentProf. Klaus Leisinger Exec. VP Novartis Malaria Initiatives Mr. Silvio Gabriel “SMS for Life” Program DirectorMr. Jim Barrington External Advisor: Bob Snow, Professor of Tropical Public Health, University of Oxford.

6. Pilot Districts Dar es Salaam : Training Sept 21st. 2009 MSD, NMCP, Warehouses Lindi Rural: Live Sept 28th. 2009 DMO, Dr. Nkungulwe 48 Health Facilities Ulanga: Live Oct. 12th. 2009 DMO, Dr. Bakari 30 Health Facilities Live Kigoma Rural: Oct. 19th. 2009 DMO, Dr. Edwin Kilimba 51 Health Facilities 9 weeksSurveilance Visits (3) November 23rd. (3) January 4th. (3) February 8th. 3 Districts 129 Health Facilities 226 Villages 1.2 million people.

7. Average response rate of 95% Data accuracy rate of 94% (physical count) Data accessed on a daily basis (system log)

8. Lindi Rural – % of the 48 facilities with a stock-out by ACT dosage form. ( 57% stock-out to 0% stock-out)

9. Ulanga – % of the 30 facilities with a stock- out by ACT dosage form (87% stock-out to 30% stock-out)

10. Kigoma Rural – % of the 51 facilities with a stock-out by ACT dosage form (93% stock-out to 47%)

11. All Districts – % of the 129 Facilities with a stock-out of Quinine Injectable (36% stock-out to 4% stock-out)

12. Results At the start of the Pilot only 29 of the 129 facilities had all 5 medicines in stock (77% stock-out) At the end of the pilot 96 of the 129 had all 5 medicines in stock(26% stock-out). A threefold or 300% improvement. At the start of the Pilot 26% of facilities had no ACT of any dosage form in stock. At the end of the Pilot 99% of facilities had at least one dose form of ACT in stock.

17. Recommendations from the Pilot Implement the SMS for Life solution in all districts of Tanzania. Encourage the use the SMS for Life solution to track other medicines of priority. Apply the SMS for Life solution to disease surveillance. Implement SMS for Life in other African or non- African countries that have a need to eliminate stock-outs at health facility level.

18. Positioning of “SMS for Life” We have a high quality solution that : –is proven to support the elimination of medicine stock-outs –is scalable to support any number of health facilities and countries –is easy to implement. One half day of training per district –is affordable. Total running costs of less than $100 per health facility per year) –is sustainable The solution is offered as a commercial service by Vodafone, the largest mobile phone operator in the world The project is a unique combination of technology to address supply management issues –The project proves a contribution in the goal of access to malaria medicines for everyone, when and where needed. The system is flexible to support access to other medicines –Once implemented, the system can be expanded to track other essential medicines.

19. 2011 – 2012 Tanzania should be the first Country to be complete by mid 2011 Four Pilot districts in Ghana, starting in November 2010 with a goal of countrywide scale-up in Ghana 2011/2012 We will continue to promote the solution to all countries who have stock-out problems. Our main limiting factor to further country implementations is funding. Implementing a country the size of Tanzania is approx. $950,000 including Pilot, and Zambia would be approx $550,000. On-going costs are approx $100 per health facility per year.

20. Prof. David Mwakyusa, Minister for Health & Social Welfare. “ I’m grateful for what you are doing for my country – I loose a child every five minutes which is a waste from a disease that is completely preventable. I cannot do it alone, I have to do it with people like you. This is a great project and an innovation that I support very much, it’s exciting to me.”