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Group III: Demand Forecasting

Group III: Demand Forecasting. Demand forecasting. Objectives Minimum requirements Tools Gaps Recommendations. Demand forecasting Objectives. Global level: Advocacy for inclusion of children in treatment initiatives, including setting targets for children

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Group III: Demand Forecasting

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  1. Group III: Demand Forecasting

  2. Demand forecasting • Objectives • Minimum requirements • Tools • Gaps • Recommendations

  3. Demand forecastingObjectives • Global level: • Advocacy for inclusion of children in treatment initiatives, including setting targets for children • Advocacy for price reduction on pediatric ARV formulations for both high and low prevalence countries • Market development by the industry • National/Provincial/District level • Advocacy with national/provincial/district leadership for inclusion of children in treatment plans • Planning purposes

  4. Demand forecastingMinimum information requirements • Pediatric treatment goals/targets: • Estimated number of CLWHA needing RX • Country capacity to treat • Programming approach • Recommended drug regimens • Profile of children to be treated

  5. Demand forecastingMinimum information requirements • The number of CLWHA in need of RX: • Current estimates of number of CLWHA • Projected annual birth and death rates • HIV prevalence in ANC settings • MTCT rates • Breastfeeding practices • HIV-related morbidity and mortality rates • CD4%, TLC (Risk of under-estimation) • Existing care practices: CTX, nutrition etc…

  6. Demand forecastingMinimum information requirements • Programming approach: • entry points: PMTCT, pediatric wards, OPD, nutrition programs etc… • Implementation plan: where to start, expansion plan etc… • Expected uptake • Capacity to treat at all levels: • Human resources • Financial resources and price of drugs (generics versus brand names) • Systems and infrastructure, including laboratory capacity

  7. Demand forecastingMinimum information requirements • The recommended drug regimens: • National guidelines: • First line • Second line • Change in case of toxicity, TB etc… • Generics versus brand names • Patients’ profile: • Age and weight groups • % on first and second lines, • toxicity rate, • TB co-infection rate etc…

  8. Demand forecastingSpecial considerations for procurement of pediatric formulations • Lead time • Storage and distribution capacity • Generics versus brand names • Number of manufacturers to deal with • Buffer stock

  9. 2005 Target

  10. Tools • Age-specific quantification of disease burden tool • ART capacity assessment tool • Drug quantification tool (e.g. Clinton Model) • MIS tool to monitor program uptake, drug consumption and treatment outcomes,

  11. Gaps • Knowledge: • Age and weight distribution of HIV-infected children • Predictors of disease progression in resource-poor countries • Capacity to treat children • Laboratory diagnostic technologies in young infants below 18 months • Pediatric treatment goals not defined on many initiatives and programs • Current MIS do not include treatment outcomes • Age and weight-specific burden of disease ill-defined • Limited number of demand forecasting tools

  12. Advocacy statement • Of the estimated 1.9m children living with HIV/AIDS in sub-Saharan Africa approx 0.5m need treatment, which is about 16% of the adults who need treatment • Therefore of the 3m by 2005 to be put on treatment 450,000 should be children • This would also hold true in a national setting • Of particular importance are the infants under 1 yr, one-third of whom will die in the first year

  13. Recommendations • User friendly tool on CD to assess the child needs in ARV Tx which acknowledges that for planning purposes the first year is different from other years of enrollment • Need to improve diagnostic facilitgies, Access to antibody, PCR test to increase access to Tx • Drug supply chain • Communication

  14. Capacity • Set the minimum standards for the site to be able provide ART • Adapt adult ART sites assessment tools by adding pediatric part • Political will to create the requested capacity for ped ARV • Characteristic of the clinical sites • Training need • Prescription of the drugs • Family centered care cites, link child ARV and parent ARV • PMTCT, malnutrition clinics entry point

  15. Community involvement • IMCI, home based care to identify children in need • pediatric ART adherence support

  16. Agencies responsible for implementation • UNICEF – coordinate the work on development of forecasting model for ped TX, age specific burden of disease, capacity assessment tool, MIS tool in collaboration with other UN agencies • WHO – clinical diagnostic tool, facility assessment tool • AMDS – technical support • USAID funded FHI, JSI

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