1. FIFTH MEETING OF HEALTH TEAM IHP+ COUNTRIES 2 – 5 December 2014, Siem Reap, Cambodia SESSION 7c) Managing Purchasing and Stock in Guinea-Bissau Current situation, priorities, possible roles for IHP+ 1

2. CURRENT STATE OF SUPPLY AND DISTRIBUTION CHAIN OF PHARMACEUTICAL AND NON- PHARMACEUTICAL PRODUCTS The medicines supply and distribution chain has four key levels of strategic action: ► Institutional, with the Department of Pharmaceuticals, Laboratories and Medicines (DIFARLM), the department of Pharmaceutical Inspection in the General Inspectorate of Ministry of Health and the national laboratory of public health; ► Operational through the medicines circuit, with the whole pharmaceutical chain, central CECOME – regional CECOMEs – healthcare training (hospitals, healthcare centres, healthcare points) for the public sector; ► Financial: the cost recovery system; 2

3. CURRENT STATE OF SUPPLY AND DISTRIBUTION CHAIN OF PHARMACEUTICAL AND NON- PHARMACEUTICAL PRODUCTS Absence of a centralised purchasing system Purchasing planning process inadequate Failings in drug quality control system with risks of buying low quality medicines; Storage conditions inadequate at all levels - Central, Regional and Local Poor stock management Failings in distribution systems Monitoring of actives insufficient 3

4. Recurrent problems (cont.) Lack of coordination of PSM activities Dependence on expatriate consultants Different opinions and expectations on role and function of Buying Group for essential medicines Lack of formal procedures and tools (Procedures to be followed, good distribution practice, inadequate IT system etc.) 4

5. Recurrent problems (cont.) Communication is very limited between the central and peripheral level; Inadequate management of patient information and inventory (consequence- shortage or over-stocks of medicines) 5

6. ACTIONS OF PTFs The World Bank financed the supply chain study The WHO provided technical and financial support, development and adoption of national medicines policy, medicines act, update of essential medicines list MISAP created DIFARLM – register and medicines safety monitoring 6

7. ACTIONS BY PTFs The Global Fund financed technical support to strengthen technical capacity and support the restructuring of CECOME A committee for the functional quantification of pharmaceutical and non-pharmaceutical products was created for the guidance and involvement of TFPs (Global Fund, WHO, UNICEF, PNUD and other TFPs), CEDEAO and UEMOA undertook to strengthen the regulations of member countries regarding medicines 7