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Making commodities available for countries: the AMD Service Strategic and Technical Advisory Committee for Making commodities available for countries: the AMD Service Strategic and Technical Advisory Committee for HIV/AIDS (STAC-HIV) 8 -10 November 2004 From AIDS Medicines and Diagnostics Service (AMDS) to AIDS Medicines and Diagnostics Service network

Making commodities available for countries : the AMD Service ÚThe AIDS Medicines and Diagnostics Making commodities available for countries : the AMD Service ÚThe AIDS Medicines and Diagnostics Service (AMDS) was launched in December 2003 as the access and supply arm of the 3 by 5 initiative. ÚThe objective of the AMDS is to expand access to quality, effective treatments for HIV/AIDS by improving the supply of antiretrovirals (ARVs) and diagnostics to developing countries

Making commodities available for countries : the AMD Service Partners group Ú UN Agencies Making commodities available for countries : the AMD Service Partners group Ú UN Agencies • WHO (EDM, EHT, CPS, Essential drugs and HIV RA in Regional offices), UNICEF, World Bank, UNAIDS, UNFPA, UNDP Ú Technical organizations and donor agencies • CCAR, CHAI, CPA, Crown Agents, EPN, Esther, FIP, GFATM, IDA, JSI, MEDS, MSH Ú Observers • MSF, US State Department ( PEPFAR), USAID Secretariat • AMDS unit of HIV Department of WHO

Making commodities available for countries : the AMD Service Progress so far Ú Clarity Making commodities available for countries : the AMD Service Progress so far Ú Clarity on procurement • Procurement of drugs/diagnostics on competitive basis through the AMDS supply partners UNICEF, IDA, and WHO/CPS. Ú Global clearinghouse started (www. who. int/3 by 5/amds and Sharepoint) • Information on the selection (regulatory status, pricing, patents, prescribing information), production (availability of APIs and standards for), and rational use of ARVs and HIV diagnostics • Information on capacity of and technical assistance available from partner organizations • Country information: procurement and supply management assessments, pharmaceutical sector analyses • Educational materials and supply management tools • News items and ad hoc technical guidance

Making commodities available for countries : the AMD Service Progress so far Ú Brokerage Making commodities available for countries : the AMD Service Progress so far Ú Brokerage of technical support (Myanmar, Vietnam, Sudan, …) Ú Support priority PSM work in partner organizations • UNICEF stockpile of ARVs • Support to WHO/EDM: 1 million USD for the PQ project and funding for 10 NPO's committed so far. Ú Initiation of capacity building efforts for PSM • In Dec. PSM workshops in Kenya, with AFRO, EPN, GFATM, World Bank, IDA, MSH, JSI, CHAI, UNICEF, and in Cambodia, with SEARO/WPRO and World Bank, for a total of 24 countries • Planning with World Bank for a series of PSM workshops in 2005 is ongoing • A training package to support PSM capacity building in health centres has been developed by EDM and AFRO Ú Round of discussions with R&D pharma on low and middle income country pricing is ongoing, supported by UNAIDS

Making commodities available for countries : the AMD Service The Challenge for AMDS Ú Making commodities available for countries : the AMD Service The Challenge for AMDS Ú Transform itself from a WHO department unit into network of technical organizations supporting PSM for HIV drugs and diagnostics, and move action to the country level Ú This approach enables WHO • To use the capacity of other organizations to support countries • To influence action when other forms of collaboration are difficult Ú Disadvantages are: • It is difficult to hold partners accountable for action, and • Consensus building and the need for ad hoc fund raising delay action • With a global level partnership it is not easy to support country level action Ú Critical impediments for greater impact are: • the relative lack of resources in WHO • the relative lack of technical capacity at the regional and country levels in WHO

Making commodities available for countries : the AMD Service Milestones AMDS; AMDS website Commodities Making commodities available for countries : the AMD Service Milestones AMDS; AMDS website Commodities obtained with technical support of AMDS (40/50) Supporting countries in all aspects of PSM through WHO teams (PSM plans: 10; National supply managers trained: 120/200; Capacity building plan: 2 countries resourced/49) Deploy integrated monitoring and quality improvement teams (EDM) Global/regional networks of buyers (AMDN partners group) Clarity on production costs of ARVs to inform country action (API mapping completed – on target for completion by Feb 2005) Report on Dx and ARVs sourced by country and by year (GFATM/comprehensive) Average price of Dx and ARVs (464 USD/50 -200 USD) Resource based forecast of demand

Making commodities available for countries : the AMD Service From the STAC we need Making commodities available for countries : the AMD Service From the STAC we need advice on: Ú The wisdom of the approach of soliciting the capacity of partners for technical support and capacity building for Procurement and Supply Management in countries Ú The size and composition of the partnership Ú What other actions the organization could undertake to increase its ability to support PSM for ARVs and HIV diagnostics