1. XIX International AIDS Conference July 22, 2012 Dr. El Hadj Sidi Dah PSM Technical Officer Grant Management Solutions Voluntary Pooled Procurement: Country Perspective

2. Why VPP? Low capacity of the PR to procure and supply medicines and health products in a transparent and timely manner; Risk of misuse of funds intended for the supply of medicines and related products; Global Fund’s Additional Safeguards Policy in place Investigation by Global Fund’s OIG

3. What Do Countries Think of VPP? Complicated, not voluntary, not pooled, and more expensive than expected Lead time > 10 months Concurrent capacity building not always provided Unclear who is the process leader among the Global Fund, procurement agents, and PRs

4. Regular Supply Process Signature of grant October 2011/Q1 = T0 Procurement process November 2011/Q1 = T0 + 1 Receipt of products April 2012/ Q3 = T0 + 6 Distribution process to treatment sites May 2012/ Q3 = T0 + 7 Dispensing drugs to patients May- June 2012/Q3 = T0 + 8 Best-Case Scenario (in months) 6 months First results Q4

5. Supply Process through VPP Signature October 2011 Application to PSS November 2011 Request submitted to PSS (Quantification, technical specifications, incoterms,...... Quote Price sent to PSA and start of procureme nt process Proforma sent back to PR PSA submits proforma to PSS to receive payment in advance PSA confirms order with suppliers and programs delivery Sometimes more than 10 months Results in Q1 Year 2

6. Why Does VPP Take So Long? PRs may find these areas challenging: Quantification Developing technical specifications Validating PSM plans and resolving CPs Understanding how VPP works Communication (language) Lack of motivation (frustration) (continued)

7. Why Does VPP Take So Long? Many actors: PSS, PSA, PR, SR, suppliers, carriers, distributors… Inherent design of the process Lack of commitment of all actors on the ground (pharmacists, warehousing personnel, registration, tax authorities, PSM units, SRs) Lack of fitting procedures for VPP (continued)

8. Why Does VPP Take So Long? Weaknesses in the country’s pharmaceutical system (regulations, registration procedures, tax exemption procedures…) Storage and distribution challenges (norms and capacity) Delays in distribution planning for products before they are received

9. Recommendations 1.Simplify processes 2.Strengthen pharmaceutical systems 3.Develop capacities 4.Plan receiving and distribution of products 5.Continually assess how VPP works at country level and of how it can be improved