Section_J.19_DELIVER_ _SCMS_PROJECTS'_ANNUAL_REPORTS.pdf

MARCH 2012

This publication was produced for review by the U.S. Agency for International Development. It was prepared by the

USAID | DELIVER PROJECT.

IQC Annual Report October 2010–September 2011

The authors' views expressed in this publication do not necessarily reflect the views of the U.S. Agency for International Development or the United States Government.

IQC Annual Report October 2010–September 2011

USAID | DELIVER PROJECT

The USAID | DELIVER PROJECT is funded by the U.S. Agency for International Development under contract no. GPO-I-00-06-00007-00, beginning September 29, 2006. The project is implemented by John Snow, Inc., in collaboration with 3i Infotech; Abt Associates; The Center for International Health and Development at Boston University School of Public Health; Crown Agents Consultancy, Inc.; FHI 360; Fuel Logistics Group (Pty) Ltd.; The Manoff Group, Inc.; MAP International; PATH; UPS Supply Chain Solutions; and U.S. Pharmacopeia. The project increases the availability of essential health supplies to clients and customers around the world by ensuring transparent and cost-effective procurement and delivery of commodities; strengthening and integrating national and international supply chains; creating more supportive national and international legal, regulatory, and policy environments; increasing coordination, commitment, and collaboration for commodity financing, procurement, and delivery; leveraging local resources to plan, procure, and deliver supplies; and enhancing the availability and use of information for supply chain planning and monitoring.

Recommended Citation USAID | DELIVER PROJECT. 2012. IQC Annual Report: October 2010–September 2011. Arlington, Va.:

USAID | DELIVER PROJECT.

Cover Photo: Staff person at a warehouse in Ethiopia.

John Snow, Inc.

1616 Fort Myer Drive, 16th Floor Arlington, VA 22209 USA Phone: 703-528-7474 Fax: 703-528-7480 Email: askdeliver@jsi.com Internet:deliver.jsi.com

IQC Annual Report: October 2010–September 2011 iii

Contents

IQC Vision

IQC Implementation Strengthen In-Country Supply Systems Improve Advocacy and Collaboration with Global and Regional Partners for Commodity Security Improve USAID’s Provision of Commodities to Programs Support to USAID’s Central Procurement System and Direct Procurement Services On Time Orders: Percentage of Orders Received by Desired Receipt Date (within the Time Frame Defined by Each Task Order) Supplier Fill Rate: Percentage of Purchase Orders When the Full Quantity is Made Available on Time by the Supplier (within the Time Frame Defined by Each Task Order) Management Information System MIS Highlights

Individual Task Order Achievements Task Order 1 and Task Order 4—Public Health Task Order 2 and Task Order 6—Emerging Pandemic Threats Task Order 3 and Task Order 7— Malaria

Task Order 5—Procurement and Distribution of Essential Public Health Supplies

IQC Financial Reporting Figures

1. Government Share of Total Spending for Public Sector Contraceptives, 2011

2. Task Order 2 and Task Order 6 Commodities Shipped

3. Total Commodities Procured, 2007‒2011

4. Task Order 3 and Task Order 7 Commodities Procured

5. Task Order 5 Commodities Shipped

Tables

1. IQC Objectives and Task Order Implementation

2. In-Country Technical Assistance Support

3. IQC Indicators

4. Orders for Contraceptives and Freight Issued by Task Order 5, FY2011

5. Expenditures, Obligations, and Ceiling by Task Order iv IQC Annual Report: October 2010–September 2011

IQC Annual Report: October 2010–September 2011 v

Acronyms

ACT artemisinin-based combination therapy

AI avian influenza

AIDS acquired immunodeficiency syndrome

AL artemether-lumefantrine

AMFm Affordable Medicines Facility for Malaria

AS/AQ artesunate/amodiaquine

AutoDRV (automated system for collecting essential logistics data in the field)

CARhs Coordinated Assistance for Reproductive health supplies

CCP Central Contraceptive Procurement project

CDC Centers for Disease Control and Prevention

CMS Central Medical Stores

COR Contracting Officer Representative

CPR contraceptive prevalence rate

CS commodity security

CSL Commodities Security and Logistics Division (USAID)

DLS Department of Livestock

DTP delivery-to-promise

DR Dominican Republic

DRC Democratic Republic of the Congo

EDI electronic data interchange

EPR Epidemic and Pandemic Alert and Response

EPT emerging pandemic threat

ERP Enterprise Resource Planning

ESAMI Eastern and Southern Management Institute

FDC fixed-dose combination

FHI 360 (formerly Family Health International)

FY fiscal year

GFATM Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria

GHS Ghana Health Service vi IQC Annual Report: October 2010–September 2011

GIS Global Information System

GOB Government of Bangladesh

GOI Government of Indonesia

H1N1 influenza A virus subtype (also called swine flu)

HIV human immunodeficiency virus

HMIS health management information system

IAPHL International Association of Public Health Logisticians

ILI influenza-like illness

ILS integrated logistics system (or Integrated Logistics System Gateway)

IPPF International Planned Parenthood Federation

IQC Indefinite Quantity Contract

IUD intrauterine device

JSI John Snow, Inc.

LLIN long-lasting insecticide-treated bed net

LMIS logistics management information system

MIS management information system

MOH Ministry of Health

MOHCW Ministry of Health Child Welfare

MOP Malaria Operational Plan

MSL Medical Stores Limited

NEML national essential medicines list

NMCP National Malaria Control Program

PCR polymerase chain reaction

PMI President’s Malaria Initiative

PMI Project Management Institute

PPE personal protective equipment

PPMR Procurement Planning and Monitoring Report

PPMRm Procurement Planning and Monitoring Report for malaria

PRH Office of Population and Reproductive Health

PRISMA Proyectos en Informática Salud Medicina y Agricultura

PSM procurement and supply management

PSM WG Procurement and Supply Chain Management Working Group

RBM Roll Back Malaria (program)

IQC Annual Report: October 2010–September 2011 vii

RDT rapid diagnostic test (malaria)

RHCS reproductive health commodity security

RIDI Regional Institute Development Initiative

SARI severe acute respiratory illness

SCM supply chain management

SDLC System Development Life Cycle

SDP service delivery point

SOP standard operating procedure

SP sulphadoxine-pyrimethamine

SPS Strengthening Pharmaceutical Systems

STTA short-term technical assistance

TA technical assistance

TB tuberculosis

TO task order

U.S. United States

UNFPA United Nations Population Fund

USAID U.S. Agency for International Development

USG U.S. Government

VAT value added tax

WHO World Health Organization

WHO/AFRO World Health Organization/African Regional Office

YGC Yakubu Gowon Centre

ZIP/PHCP Zimbabwe Informed Push/primary health care package viii IQC Annual Report: October 2010–September 2011

IQC Annual Report: October 2010–September 2011 1

IQC Vision

The objective of the USAID | DELIVER PROJECT is to increase the availability of essential health supplies for public and private services and programs. The purpose of this Indefinite Quantity Contract (IQC) is to design, develop, strengthen; and, upon request, operate safe, reliable, and sustainable supply systems. The IQC provides a range of affordable, quality essential health commodities, including drugs, diagnostics, and supplies to clients in country programs. USAID field missions have indicated a strong desire for technical support to strengthen all aspects of in-country supply chains, including forecasting, procurement, distribution, management information systems (MIS), quality assurance, storage, and infrastructure. While family planning and reproductive health remain a priority in the field and for this project, field missions have also asked for supply chain systems that can manage a range of health products, including contraceptives and condoms, essential drugs; and select commodities for HIV and AIDS, malaria, maternal and child health, and infectious diseases. The goal of this project is to strengthen sustainable supply systems for all essential health commodities.

The project was awarded as an IQC; individual task orders were issued for specific scopes of work.

This IQC annual report shows how the project has responded to the overall mandate of the IQC from October 2010–September 2011. It addresses IQC-specific issues and cross-cutting themes.

Specific details about additional task orders are available from the individual task order annual reports. As of September 2011, this IQC has been awarded seven task orders:

Task Order 1, Public Health, on September 29, 2006, by the Office of Population and Reproductive Health to support public health programs, including family planning and reproductive health programs. The estimated end date is March 31, 2012.

Task Order 2, Avian Influenza, on March 21, 2007, by the Bureau for Global Health’s Avian Influenza and Pandemic Response Unit. This task order ended on March 18, 2011.

Task Order 3, Malaria, on April 6, 2007, by the Office of Health, Infectious Diseases, and Nutrition to support the President’s Malaria Initiative. The end date is April 4, 2012.

Task Order 4, Technical Assistance for Public Health, on September 30, 2010, by the Office of Population and Reproductive Health, builds upon Task Order 1 to provide technical assistance for supply chain strengthening and commodity security in public health.

Task Order 5, the Procurement and Distribution of Essential Public Health Supplies, was awarded on September 30, 2010, by the Office of Population and Reproductive Health to support public health programs. It continues the work of Task Order 1, Objective 3: Improving USAID’s Provision of Commodities to Programs.

Task Order 6, Emerging Pandemic Threats, on February 18, 2011, by the Bureau of Global Health’s Avian Influenza/Other Emerging Threats Unit.

Task Order 7 on March 28, 2011, continues support to the President’s Malaria Initiative, which began under TO3.

2 IQC Annual Report: October 2010–September 2011

Activities and results for TO1 and TO4, TO1 and TO5, TO2 and TO6, and TO3 and TO7 are provided in this report because of the similar objectives and overlap in time periods for the respective task orders.

Product availability is a simple yet powerful concept. At the IQC level, product availability is supported through the three IQC objectives:

1. Improve and strengthen in-country supply systems.

2. Improve advocacy and collaboration with global and regional partners for commodity security.

3. Improve USAID’s provision of commodities to programs.

This report summarizes the IQC, its task orders, and their accomplishments during the past year;

included is a description of progress against IQC-wide indicators.

IQC Annual Report: October 2010–September 2011 3

IQC Implementation

Each task order has an individual full-time management team. That team is the primary point of contact for the task order Contracting Officer Representative (COR); they work with the COR to set priorities, budgets, and workplans; and to monitor progress on deliverables, the quality of the work being conducted under the task order, and the spending against budgets and obligations. In addition to the task order (TO) management teams, several central service teams provide support to each of the task orders, including country programs, contracts administration, procurement, and supply operations. These teams execute many of the activities included in the TO workplans.

Each TO promotes improved product availability, but focuses on a set of products and customers and places a different level of emphasis on each of the three objectives. Table 1 summarizes the key activities across the task orders under the four IQC objectives.

Table 1 shows that each task order continues to emphasize the three IQC subcomponents differently. TO1 and TO4 continue to focus on the first two IQC objectives, with field-support funding, for in-country activities and core funding for new initiatives and research. The third objective, commodity procurement for the IQC, is now under TO5. Under TO2 and TO6 this year, in addition to the commodity provision subcomponent, the role of the TOs has expanded to include a broad array of technical assistance activities that support USAID’s Emerging Pandemic Threats (EPT) program, partners and projects in the areas of outbreak response, disease surveillance, and laboratory strengthening. Commodity funding also dominates TO3’s and TO7’s portfolio, although field-support funding and technical assistance are increasing.

4 IQC Annual Report: October 2010–September 2011

Table 1. IQC Objectives and Task Order Implementation

TO1 and TO4 TO5 TO2 and TO6 TO3 and TO7

Start date TO1: September 29, TO4: September 30, TO5: September 30, TO2: March 21, 2007

TO6: February 18, TO3: April 6, 2007

TO7: March 28, 2011

USAID Technical Office

GH/PRH/CSL GH/PRH/CSL GH/AI GH/HIDN

Strengthen in-country supply systems

In-country supply chains strengthening (see table 2 for more details)

Technical assistance in 21 countries, with a budget of

$42,669,784 (TO1

and TO4) in FY2011 n/a Technical assistance in 3 countries, with a budget of $1,074,312 (TO2 and TO6) in

FY2011

Technical assistance or support in 13 countries, with a budget of $11,939,058 in FY2011

Improve advocacy and collaboration with global and regional partners for commodity security

Donor coordination, global advocacy, and resource mobilization (examples)

Provided data through the PPMR;

for global donor coordination through the Coordinated Assistance for Reproductive health supplies (CARhs) group.

Participated with over 15 global, regional, and local partners and organizations at meetings, events, and workshops throughout the world.

Used DFID funds to channel through USAID; procured and delivered contraceptives to Tanzania.

Presented at EPT partners’ quarterly meeting in Washington, DC.

Attended EPT partners’ Congo Basin regional meeting in Kinshasa, DRC.

Visited WHO/AFRO Brazzaville to discuss technical SOW for USAID/EPT program secondment through the TO to strengthen regional and national logistics capacity for outbreak response.

Shared USAID |

DELIVER PROJECT

laboratory supply chain resources with FAO and OIE to support laboratory capacity building for disease surveillance and outbreak response.

Participated in Roll Back Malaria (RBM) Procurement and Supply Management working group (PSM- WG) meeting, contributed to the Procurement and Supply Management of LLINs analysis;

presented at: GFATM Market Dynamics and Commodities Technical Meeting the Alliance for Malaria Prevention annual meeting, Tropical Medicine Annual Conference, and Health and Humanitarian Logistics conference

IQC Annual Report: October 2010–September 2011 5

TO1 and TO4 TO5 TO2 and TO6 TO3 and TO7

Improve USAID’s provision of commodities to programs

Product categories See TO5 Family planning and other public health commodities

Disease surveillance supplies (laboratory equipment, reagents, and consumables);

Outbreak response supplies (personal protective equipment, infection control and decontamination supplies);

cold chain equipment and vaccine ancillary supplies

Malaria prevention, detection, and treatment commodities

Value of commodities ordered from suppliers FY2011*

See TO5 $114,177,698— family planning &

HIV;

$967,300—other public health [Total:

$115,144,998]

$378,444

$138,283,135+

Number of orders shipped in FY2011

See TO5 365** 44** 162++

Value of orders shipped in FY2011

See TO5 $102,826,552*** $1,752,998*** $137,346,395

* Commodity procurement only; does not include the value of the freight forwarding and warehousing sub-contract.

** Total orders shipped in FY2011. An order may have multiple items and may have been delivered in multiple shipments.

*** Based on project information accessed January 20, 2012.

+ Based on project information accessed November 22, 2011.

++ Total number of orders placed in FY2011.

Note: All dollar amounts are U.S. dollars.

6 IQC Annual Report: October 2010–September 2011

IQC Annual Report: October 2010–September 2011 7

IQC Indicators

To measure progress against project objectives, each TO has a set of indicators, which are presented in the individual task order annual reports. In addition, a set of IQC indicators measure USAID’s provision of commodities to programs for each task order. We also present anecdotal evidence of progress in strengthening in-country supply systems, and improving advocacy and collaboration with global and regional partners for commodity security.

Strengthen In-Country Supply Systems Table 2 shows that the project continues to provide a variety of in-country logistics support across the task orders. For TO4, assistance is aligned with the President’s Global Health Initiative (GHI).

TO4 supports strengthening local capacity across the supply chain, as well as forecasting, financing, last mile distribution, supply chain innovations; and, to increase country ownership and commodity security, building sustainability by leveraging partners. By comparison, supply chain technical support under TO2 and TO6 has focused primarily on warehousing, distribution, logistics management information system (LMIS) implementation; including a web-based LMIS that monitors avian influenza (AI) commodities and capacity building; and the design and implementation of a laboratory logistics system and LMIS for a national influenza surveillance program. TO3 and TO7 have focused primarily on distribution, performance improvement, and LMIS and monitoring. For TO5, the main objective is to achieve a 95 percent delivery-to-promise (DTP) ratio for task order shipments and short-term technical assistance (STTA), upon request. In all cases, support is tailored to local priorities.

8 IQC Annual Report: October 2010–September 2011

Table 2. In-Country Technical Assistance Support

Budget FY111 Country V er ti ca l In te gr at ed

C on tr ac ep tiv es H

IV

/A

ID

S

Es se nt ia l M ed ic in es In flu en za a nd o th er

E m er gi ng T hr ea ts

M al ar ia

T ub er cu lo si s Fo re ca st in g Fi na nc e P ro cu re m en t

St re ng th en in g

W ar eh ou si ng

D is tr ib ut io n P er fo rm an ce Im pr ov em en t

LM

IS

M on ito ri ng

SC

M

In no va tio ns C om m od it y Se cu ri ty

TASK ORDER 14 and 4 TO1 TO4

Budget FY111

Bangladesh 46,579$ -- Ethiopia 837,952$ 3,600,000$ Dominican Republic 176,435$ -- Ghana 449,701$ 2,100,000$ Honduras 280,000$ 300,000$ Jordan 37,585$ -- LAC Regional 52,927$ 450,000$ Liberia 55,400$ 210,000$ Madagascar 71,329$ -- Malawi 135,093$ 1,125,000$ Mozambique 664,415$ 775,000$ Nepal 124,700$ 1,000,000$ Nicaragua 77,451$ 1,065,020$ Nigeria 594,954$ 2,300,000$ Pakistan 1,475,917$ 2,000,000$ Paraguay 209,641$ 800,000$ Paraguay MCC 2,351,440$ -- Philippines 217,397$ 410,000$ Rwanda 276,970$ 1,329,000$ Tanzania 747,606$ 1,200,000$ West Africa 57,160$ Zambia 4,387,485$ 7,900,000$ Zimbabwe 1,777,627$ 1,000,000$

Type of commoditySystem Type of technical assistance provided

IQC Annual Report: October 2010–September 2011 9

Budget FY111 Country V er ti ca l In te gr at ed

C on tr ac ep tiv es H

IV

/A

ID

S

Es se nt ia l M ed ic in es In flu en za a nd o th er

E m er gi ng T hr ea ts

M al ar ia

T ub er cu lo si s Fo re ca st in g Fi na nc e P ro cu re m en t

St re ng th en in g

W ar eh ou si ng

D is tr ib ut io n P er fo rm an ce Im pr ov em en t

LM

IS

M on ito ri ng

SC

M

In no va tio ns C om m od it y Se cu ri ty

Budget FY111

TASK ORDER 2 and 65 TO2 TO6 Bangladesh 209,728$ 153,038$

Indonesia 493,595$ 189,000$

Nepal 28,951$ --

TASK ORDER 3 and 76 TO3 TO7 Angola 867,568$ -$ Benin -$ -$ Burkina Faso 533,926$ -$ Burundi 1,297,833$ -$ Ghana 1,395,750$ -$ Liberia 682,320$ -$ Madagascar 504,815$ -$

Malawi 467,443$ -$

Mozambique 1,210,755$ -$ Nigeria 2,240,951$ -$ Rwanda 370,038$ -$ Tanzania 818,916$ -$ Zambia 1,210,350$ -$ Zimbabwe 338,393$ -$ TASK ORDER 5 n/a

Type of commoditySystem Type of technical assistance provided

10 IQC Annual Report: October 2010–September 2011

Notes

1. Budget figures include FY2010 funding and carryover funding from previous years.

2. Influenza and Other Emerging Threats commodities include PPE, infection control and decontamination supplies; laboratory equipment, reagents and consumables; cold chain equipment; and vaccine-related auto-disable syringes and safety boxes.

3. This category does not include direct procurement services, only TA to strengthen local procurement capacity.

4. Budget figures for Task Order 1 include only carry over funding from previous year. All new FY2010 funding was awarded under Task Order 4.

5. In FY11, TO2 and TO6 EPT country activities for Bangladesh, Indonesia and Nepal were core funded.

6. All TA funding obligated into Task Order 7 was received after the end of the 2011 fiscal year and therefore not included in this report.

IQC Annual Report: October 2010–September 2011 11

Task Order 1 and Task Order 4 The core of the project’s work is using field support and core funds to improve and strengthen in-country supply systems. In fiscal year (FY) 2011, the project received $3,763,327 in core funds and $27,564,020 in field funds. During the fifth year of TO1 and the first year of TO4, the project provided technical assistance (TA) to 22 countries—including five GHI Plus countries (Bangladesh, Ethiopia, Malawi, Nepal, and Rwanda) and 14 family planning priority countries (Bangladesh, Ethiopia, Ghana, Guinea, Liberia, Madagascar, Malawi, Nepal, Nigeria, Pakistan, Philippines, Rwanda, Tanzania, and Zambia.) The project also made 74 technical trips (i.e., non-management) to these countries during FY2011, compared to 69 and 62 trips during the previous two years. During FY2011, Guinea and Ukraine received assistance for the first time. A key accomplishment of the project was the seamless transition from TO1 to TO4. Country and core teams recognize the change in emphasis for the new TO and the need to align work with GHI principles.

Examples of achievements from the reporting period include—

In Ethiopia and Rwanda, continued progress in strengthening the family planning supply chain has been crucial to the impressive contraceptive procurement rates (CPR) gains in those countries.

In Ghana, participated in supply chain strategy work to support the Ghana Health Service (GHS) and USAID Mission to identify possible actions to address problems with contraceptive product availability.

In Malawi, the establishment of the augmented supply chain, despite difficult circumstances, has helped ensure product availability even with a dysfunctional public sector system.

In Tanzania, development of the Integrated Logistics System (ILS) Gateway has helped improve reporting rates and accountability.

In Paraguay, according to an Abt Associates, Inc. assessment report, the project’s work has positioned the country well for graduation from USAID family planning support.

In Pakistan, adapting the web-based LMIS from Bangladesh has been a key south-to-south sharing that will increase data visibility.

Reporting Rates and Stockout Rates at All Levels of the System Served by the Project The project has routinely monitored contraceptive availability at the central and facility levels in most project-presence countries that receive TO1 and TO4 funding. During FY2011, the number of countries reporting in the Procurement Planning and Monitoring Report (PPMR) increased from 19 to 22, even though there was a loss of two countries because of the closing of the reporting agencies’ offices. The number of project presence countries in the report increased from 14 to 15.

During this 12-month reporting period, seven project-presence countries had no stockouts at the central level: the Dominican Republic (this office has since closed), Ethiopia, Malawi, Mozambique, Nepal, Rwanda, and Zimbabwe. Eight of the 15 project-presence countries reported at least one stockout at the central level (Ghana, Honduras, Liberia, Nicaragua, Nigeria, Paraguay, Tanzania, and Zambia). Of these eight countries, Depo-Provera was the most common product to stockout because of the continuing after-effects of a product recall at the beginning of the previous year’s reporting period (FY2010), difficulty replacing the product, and production limitations caused by increasing global demand for this product. Depo-Provera accounted for 29 percent of all stockouts

12 IQC Annual Report: October 2010–September 2011 in FY2011. Intrauterine devices (IUDs) accounted for 15 percent of all stockouts. For most months, the eight countries had very few stockouts. In July, no stockouts were reported; in January, May, and September these countries reported only one stockout.

In addition to the project-presence countries reporting to the PPMR, eight of the same countries also submitted quarterly figures for contraceptive availability from the service delivery point (SDP) level; they are available through each country’s LMIS.

Countries with Procurement Plans Reviewed and Updated Semi-Annually Semi-annually, most project countries are expected to review procurement plans against current stock and to update the plans accordingly. All but one of the project presence countries reviewed procurement plans for family planning products in the first half of FY2011; two-thirds conducted a mid-year review in the second half of FY2011.

Project-presence countries include Ethiopia, Ghana, Honduras, Liberia, Malawi, Mozambique, Nepal, Nicaragua, Nigeria, Pakistan, Paraguay, Rwanda, Tanzania, Zambia, and Zimbabwe.

For additional TO4 in-country results and activities, please refer to the Task Order 4 Annual Report.

October 2010–September 2011.

Task Order 2 and Task Order 6 Core funding allocated to countries totaled $910,234 for FY2011 in Bangladesh, Indonesia, and Nepal, with core-funded TA to support the H1N1 pandemic influenza response under TO2; and to support the EPT program, partners, and projects under TO6.

Under TO2, the project continued to support the Government of Bangladesh (GOB) Department of Livestock Services (DLS) until the USAID|DELIVER PROJECT Bangladesh office closed in July 2011. To support the transition of key logistics activities to the DLS, the project, under TO6, contracted three consultants to continue STTA to the DLS through September 2012. This technical support will continue implementing and strengthening the local capacity to manage the web-based LMIS for outbreak response commodities at the central-, district-, and upazilla-levels. TO6 continues to support the GOB DLS in implementing the inventory management system and the Rapid Response system for outbreak response, which were designed and initiated under TO2.

Under TO6, since February 18, 2011, the project has continued to support the EPT partners and the Government of Indonesia (GOI). The project continued to provide procurement services and logistics technical assistance to the national Influenza-like Illness (ILI) and Severe Acute Respiratory Illness (SARI) laboratory surveillance system. This support included assessment, design, and the implementation of a laboratory logistics system to better manage supplies for specimen collection and transport from ILI and SARI sites; and an inventory control system and LMIS to monitor and manage resupply of polymerase chain reaction (PCR) reagents and supplies at the national reference lab and regional ILI and SARI testing labs. In addition, the Indonesia program has collaborated closely with international EPT partners to provide supply chain technical assistance for the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO)-funded influenza surveillance projects in Indonesia.

Task Order 3 and Task Order 7 An important part of TO Malaria’s work is to help strengthen and sustain local systems that are working with malaria commodities; establish and support procurement and delivery of commodities;

and, with other key malaria partners, reach those in need. The TO worked in 13 President’s Malaria

IQC Annual Report: October 2010–September 2011 13

Initiative (PMI)-focus countries and three non-focus countries (Burkina Faso, Burundi, Zimbabwe) in FY2011. TO Malaria has had a long-term presence in 11 of the 20 PMI-focus countries. To carry out workplan activities—improving in-country distribution, solving storage capacity problems, or conducting quantification exercises—TO Malaria provided STTA in Angola, Belgium, Benin, Burkina Faso, Burundi, Denmark, Ghana, Kenya, Liberia, Madagascar, Malawi, Mozambique, Nigeria, Rwanda, Sudan, Switzerland, Tanzania, Zambia, and Zimbabwe in FY2011.

Some examples of achievements from the reporting period include—

Burkina Faso: During FY2011, the National Malaria Control Program (NMCP) developed a malaria database to improve the reporting of statistics and logistics data in the country. An analysis of the reported data helped identify priority districts for action (i.e., to improve product availability, case management, data quality, and reporting). An important finding from the analysis was a discrepancy in the total number of cases of uncomplicated malaria, the number of cases treated, and the number of artemisinin-based combination therapy (ACTs) dispensed.

Malawi: In October 2010, at the request of the USAID Mission, an augmented system was designed and rolled out; the objective was to achieve commodity security for United States Government (USG)-procured products, starting with malaria commodities: ACTs, sulphadoxine-pyrimethamine (SP), and rapid diagnostic tests (RDTs). Because the augmented system performed well during the first quarter of the past fiscal year, the Global Fund recommended that the malaria commodities they procure for Malawi should be distributed through the same system. When commodities and fuel are available, the augmented system achieves countrywide distribution of commodities, to all facilities, within two weeks. When these conditions are met, stockouts are reduced. With malaria commodities, the augmented system, as mentioned above in the TO1 and TO4 section, also distributes USG-procured family planning commodities—male condoms and implants (Jadelle). Beginning in December 2010, the augmented system has successfully completed nine countrywide distributions. It also successfully distributed 6.3 million artemether-lumefantrine (AL) treatments and more than 1 million RDTs.

Nigeria: A total of 16,294,606 long-lasting insecticide-treated bed nets (LLINs) were distributed in more than 18,000 distribution points across the states. Additionally, the project averted the potential wastage of several months’ supply of medicines procured through the Global Fund Primary Recipient, Yakubu Gowon Centre (YGC), but were stranded at the state capitals, because funds were not available for last mile distribution. The project supported the distribution of 311,100 doses of short-dated ACTs from the state Central Medical Stores to 1,030 service providers in six states. This support informed deliberations by NMCP and its partners, and facilitated the beginning of actions to correct the situation.

To manage and monitor malaria commodities, TO Malaria also developed and deployed several tools and approaches that would strengthen local capacity.

Analysis of health management information system (HMIS) and LMIS data. TO Malaria conducted an analysis of HMIS and LMIS data in one province in Zambia. The analysis looked at the differences between the data, investigated the root causes of discrepancies between the data, and proposed solutions for managing those discrepancies. Additionally, the report identified options to improve the link and use of these data for decisionmaking.

End-Use verification. Over the last year, TO Malaria continued quarterly rounds of data collection and reporting in Ghana, Tanzania, and Zambia; and added two new

14 IQC Annual Report: October 2010–September 2011 countries―Malawi and Mozambique. Findings from the End-Use activity are routinely shared with ministries of health and in-country stakeholders; they have also been used throughout this year in a number of presentations related to ACT availability at the country level.

Procurement Planning and Monitoring Report for Malaria (PPMRm). This tool provides data on central-level stock availability for malaria commodities, including ACTs, sulphadoxine-pyrimethamine (SP), and RDTs. The tool continues to play a critical role in identifying current or impending shortages, stockouts, and expiries. Data on RDTs and SP were added during the first quarter of FY2011. One non-focus country―Burundi―was added, as were three focus countries―Democratic Republic of Congo (DRC), Nigeria (including eight states), and Zimbabwe. Reporting to the PPMRm increased from 16 to 18 countries in FY2011.

For additional examples of TO Malaria country activities, please refer to the Task Orders 3 and 7 Annual Report, October 2010–September 2011.

Improve Advocacy and Collaboration with Global and Regional Partners for Commodity Security The following examples show how each TO, with global and regional partners, contributed to improved commodity security advocacy.

Task Order 1 and Task Order 4 The project worked with the International Planned Parenthood Federation (IPPF) to improve their capacity to quantify health commodities by conducting workshops and providing technical assistance to individual country member associations.

The project worked with several local and regional partners on capacity building activities, ranging from pre-service training for pharmacists and pharmacist technicians to supportive supervision in Burkina Faso, Mali, Rwanda, and Zimbabwe. As part of sustainability efforts, the project awarded more than $685,316 in subcontracts to local and regional institutions in seven countries to provide technical services to strengthen the projects supply chain activities in those countries.

The project contributed substantially to the RHSC Addis Ababa meeting and helped make that event a success by increasing attention to supplies by policymakers and advocates, which will be reflected in future funding and policy commitments.

The project worked with the People that Deliver initiative, helping to ground that movement with practical tools and experience from the field.

Task Order 2 and Task Order 6 From October 2010–February 2011, TO2 continued extensive collaborations with WHO and other international partners to implement the response to the H1N1 pandemic influenza. This activity supported the availability of laboratory equipment, consumables, and reagents to ensure the effective implementation of H1N1 influenza surveillance in sub-Saharan Africa. In addition, the procurement and distribution of ancillary vaccination equipment in support of the WHO-led H1N1 vaccination were a significant contribution to support commodity security. The virtual bundling of ancillary supplies and the stockpile of syringes and safety boxes by TO2 contributed to the success of a global vaccination campaign and recommended as actions to be replicated for future vaccination

IQC Annual Report: October 2010–September 2011 15 campaigns. TO2 participated in a WHO-hosted stakeholder meeting on the H1N1 global vaccination campaign, with representatives from the governments of Australia, Japan, Canada, the U.S., and the Netherlands, to discuss successes and review lessons learned from the campaigns.

Under TO6, meetings were conducted with the WHO/African Regional Office (AFRO) Disease Prevention and Control Cluster, and the Epidemic and Pandemic Alert and Response (EPR) Program team in Brazzaville, Republic of Congo; to discuss the selection, placement, and technical scope of work for a USAID EPT program consultant who works with outbreak response logistics.

The consultant would be seconded through the project to WHO/AFRO. Priorities for WHO/AFRO include developing a five-year regional outbreak response logistics strategy; and the need for a LMIS to strengthen decisionmaking and outbreak response capacity at WHO/AFRO regional and country levels. The TO6 and WHO/AFRO EPR program manager worked together successfully to recruit a candidate for the seconded position.

Task Order 3 and Task Order 7 As a member of the Roll Back Malaria (RBM), Partnership and the Procurement and Supply Chain Management Working Group (PSM WG), TO3 participated in the PSM WG meeting in February 2011. Of particular interest and concern to TO3 and PMI were the discussions on the RDT quantification; fixed-dose combination (FDC) artesunate/amodiaquine (AS/AQ) quantification, especially for the lower two weight bands; and the impact of Affordable Medicines Facility for Malaria (AMFm) on production capacity and supply chain for AL and FDC AS/AQ. As a result of the meeting, TO Malaria was asked to co-chair the PSM Bottleneck workstream from September 27–28, 2011. The TO presented plans for the PSM Bottleneck workstream and solicited input for future activities.

The TO also presented summary findings from the detailed study of LLIN procurements to-date to the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) Market Dynamics and Commodities Technical meeting in February 2011; presented at the Alliance for Malaria Prevention activities; presented two posters at the Tropical Medicine annual conference; and presented at the Health and Humanitarian Logistics conference.

Improve USAID’s Provision of Commodities to Programs Common indicators across task orders are related to USAID’s provision of commodities, which were drawn from procurement records and ORION. See table 3 for a list of indicators.

16 IQC Annual Report: October 2010–September 2011

Table 3. IQC Indicators

Improve USAID’s Provision of Commodities to Programs

Outcome Indicator

1. Support USAID central commodity procurement system.

On-time orders: percentage of orders received by desired receipt date (within the time frame defined by each task order)

2. Establish an effective, competitive, transparent capability to procure required commodities compliant with U.S.

Government regulations.

Contract compliance: percentage of contracts adhering to all U.S. Government guidelines and requirements—compliance rate for this reporting period was 100%

Supplier fill rate: percentage of purchase orders where the supplier makes the full quantity available on time (within the time frame defined by each task order)

Support to USAID’s Central Procurement System and Direct Procurement Services During this reporting period, the Supply Operations team provided a broad range of services to each of the TOs. The team continued to provide support through the ongoing processing of orders, demand planning, and contract management. The project continues to manage funds, accounts, and invoices for both USAID and project contracts.

During this fiscal year, the Supply Operations team invited FHI 360 to do an internal audit of the team’s procedures. The report showed the Supply Operations team as “a high functioning organization that works extremely well facing daily challenges.” The report included general recommendations; all have been or will be implemented. The team will complete all remaining actions in FY2011.

The Management Information System (MIS) team modified the ORION Enterprise Resource Planning (ERP) system and the USAID | DELIVER PROJECT website to support the transition to the new task orders. This was complicated because we needed to transition over an extended period of time, while providing a combined view of orders and shipments across task orders.

Task Order 1 Objective 3/Task Order 5 To meet the goal of achieving 95 percent DTP ratio, the task order provides procurement, supply operations, MIS, and STTA, upon request.

During the period, the project completed 21 successful contract actions of CCP standard catalogue commodity items valued at $114,177,699; and shipped 365 orders to Mission programs in 48 countries, for a value of $116,494,336.

The procurement team worked in close collaboration with CSL to coordinate a smooth transition from TO1 to TO5. The foremost requirement for both task orders was to ensure that public health commodities remain available throughout the process.

Since its launch in October 2010, TO5 has made new long-term awards for the methods and products traditionally offered by CCP: male and female condoms, oral contraceptives, IUDs, lubricant, contraceptive implants, and cycle beads. Additionally, the TO made a long-term award for a new contraceptive implant and is undertaking ad hoc procurements of emergency contraceptives.

IQC Annual Report: October 2010–September 2011 17

The task order issued orders for these items, which were valued at $131,857,036 in FY2011 (see table 4). The task order is also doing one-off procurements for a variety of other commodities, including an ambulance and ready-to-use therapeutic food.

Table 4. Orders for Contraceptives and Freight Issued by Task Order1, Objective 3/Task Order 5, FY2011

Contracts Award Value ($)

Contraceptives implants 13,713,000

Oral contraceptives 16,230,074

Cycle beads 70,760

Female condoms 6,254,600

Emergency contraceptives 33,000

Intrauterine devices 1,052,793

Male condoms 29,573,810

Injectable contraceptives 47,049,373

Lubricant 200,288

Freight 17,679,338

TOTAL 131,857,036

For a graphic view of shipment values for all task orders, see the individual task order achievement section in this report

During FY2011, TO5 worked with CSL to develop and implement a new freight strategy.

Implemented in December 2010, the new strategy focuses on obtaining the best value for reliable shipping services that are consistently reaching the DTP goal, as well as to begin sub-contracting with a U.S. small business freight-forwarder. Between December 2010 and June 2011, the small U.S.

business freight-forwarder had 47 percent of shipments bid out. In July 2011, the TO and CSL modified the freight strategy, based on our experience during the first six months of implementation. A price reasonableness study showed that TO5 freight forwarding partners saved 15 percent on air shipments and 67 percent on ocean shipments.

Task Order 2 and Task Order 6 Under TO 2 and TO6, the project processed 10 direct procurement requests for laboratory diagnostic equipment and reagents, and cold chain equipment for EPT partners and projects, for a total value of $378,444. The project also distributed stockpile commodities (personal protective equipment [PPE], infection prevention and control supplies, laboratory equipment, and supplies) to complete 44 orders shipped to 19 countries in Africa, Latin America, and Asia: Angola, Bolivia, Brazil, Colombia, DRC, Ecuador, Ethiopia, Haiti, Indonesia, Malawi, Malaysia, Mexico, Mongolia, Mozambique, Peru, South Africa, Tanzania, Uganda, and Vietnam.

18 IQC Annual Report: October 2010–September 2011

Task Order 3 and Task Order 7 For Task Order Malaria, the project is actively involved in reviewing orders, clarifying specifications, and procuring malaria commodities; and working closely with PMI and the TO Malaria management team to track orders against the Malaria Operational Plan (MOPs).

The principal activity of TO Malaria is to support PMI by procuring malaria commodities requested by USAID Missions; these are based on the needs outlined in the yearly MOPs. From October 2010–September 2011, TO Malaria continued to increase its procurement activities by providing $138,283,135 in malaria commodities to 24 countries; including $89,327,681 for LLINs (65 percent of the total); $36,603,419 for pharmaceuticals (26 percent); $9,947,241 for rapid diagnostic test kits (7 percent); and $2,404,794 for lab equipment (2 percent). During the 12-month reporting period, the value of procurements was 37 percent more than was procured during the preceding fiscal year, continuing the trend of increased procurement activities from year to year. Included in procurement figures for this reporting period are emergency orders from six different countries.

In FY2011, the project processed 123 procurement requests from 24 countries: Angola, Benin, Burkina Faso, Burundi, the DRC, Ethiopia, Ghana, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Nigeria, Rwanda, Senegal, Somalia, South Sudan, Tanzania, Thailand, Uganda, Zambia, and Zimbabwe.

On-Time Orders: Percentage of Orders Received by Desired Receipt Date (within the Time Frame Defined by Each Task Order) During this year, the project continued to measure performance against scorecard indicators, with a focus on the timely response to the commodity needs requested by country programs. The project monitors our responsiveness to the client by measuring on-time shipment rates. The difference between the desired receipt date and the actual receipt date is used as the basis for the on-time shipment analysis. While each TO defines on-time slightly differently, a summary of orders measured follows:

TO5: 77 percent of orders measured during this period (256 of 333) were received within 30 days of the desired receipt date.

TO2 and TO6: 82 percent of orders measured during this period (37 of 45) arrived at port in the destination country within the defined time frame, based on mode and urgency.

TO3 and TO7: 66 percent of orders measured during this period (117 of 177) were received within 30 days of the desired receipt date.

The 77 percent on-time rate for TO5 is an increase from the FY2010 overall on-time rate of 73 percent, based on the FY2010 Scorecard and the FY2011 Delivery-To-Promise Monitoring Tool.

This shows continued progress to meeting the task orders 95 percent DTP goal. The primary reasons for late shipments during FY2011 were, in descending order of importance: registration issues, the residual effects from a commodity recall for one of our primary products, delays in customs clearance, and shipping pre-approval delays. See the TO5 annual report for a list of the reasons for late shipment, by month.

A variety of reasons contributed to the 8 late shipments and 82 percent on-time rate for TO2 and TO6. In three cases, the supplier was late; in three cases, the delay was related to pre-clearance

IQC Annual Report: October 2010–September 2011 19 requirements; and, in two cases, the delay was due to customs clearance after the goods arrived in-country.

TO3 had 117 out of 177 shipments on time, resulting in only a 66 percent on-time delivery, because of many different reasons. The most significant was supplier production-related issues. Other reasons included pre-clearance delays in destination countries, customs clearance delays after the goods arrived in-country, in-country transportation for the final distribution, and quality assurance testing.

Supplier Fill Rate: Percentage of Purchase Orders When the Full Quantity is Made Available on Time by the Supplier (within the Time Frame Defined by Each Task Order)

Task Order 1 and Task Order 5 The procurement team routinely monitors supplier performance (goods released on time), quality assurance, and customer service and communication. We made regularly scheduled calls with all our vendors, and we made a management visit with our oral contraceptive vendor. Every week, we worked with all our vendors to ensure that we were informed of any production-line issues, including regularly scheduled maintenance and challenges associated with raw materials or packaging. We gave suppliers regular demand forecasts to help them plan production. Supplier performance, as evaluated by the DTP tool, is measured by percentage of orders that vendors release on time. During FY2011, on-time release of orders, by method, was as follows:

IUD orders were released 100 percent on time.

Contraceptives implants were released 92 percent on time.

Male condom orders were released approximately 88 percent on time.

One supplier released 100 percent of orders on time; other suppliers released 92 percent and 73 percent of orders on time, respectively.

Oral contraceptives were released approximately 84 percent on time.

One supplier released 100 percent of orders on time; other suppliers released 85 percent and 67 percent of orders on time, respectively.

Female condom orders were released 83 percent on time.

Injectable contraceptives were released 67 percent on time.

Each month, most vendors released their shipments on time. For seven of the past 12 months, all vendors released their shipments every month on time. Even when they were late, most orders were released within a week of the expected date, enabling us to deliver commodities, as promised, in most cases. If shipments were going to be delayed, we worked with CSL to prioritize the shipments to ensure that the countries with the greatest need received shipments first.

The overall supplier performance on TO2 and TO6 was very good. Only three shipments were delivered or released late by suppliers, causing the project to deliver the orders late. Two resulted

20 IQC Annual Report: October 2010–September 2011 from a paperwork error and the third from a packaging delay. Overall vendor performance was very good for this task order.

For TO3, supplier performance had a significant impact for on-time delivery. Most issues were, for various reasons, caused by the pharmaceutical manufacturer’s production delays. Additionally, there were delays with the rapid diagnostic test manufacturers, as well as some of the wholesale distributors.

Management Information System The MIS is always available for authorized users from the project, the USG, and partners, both centrally and in the field, through a secure web-based user interface—the My Commodities section of the USAID | DELIVER PROJECT website. The MIS uses project management standards as identified by the Project Management Institute (PMI); we use a standard System Development Life Cycle (SDLC). Periodic updates of the MIS, based on requests from internal and USG sources, ensure customer satisfaction.

Management Information System Highlights Modifications and Enhancements The MIS team modified the ORION ERP system and the USAID | DELIVER PROJECT website to support the transition to the new TO.

New reports were developed and implemented:

The Loan Status Report provides details on current loan status and projects which countries will need future loans, based on planned commodity use and estimated funding.

The European Union VAT Report shows details of each shipment into and out of…