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Welcome to Thailand

Welcome to Thailand. Welcome EPRUS Team Mr.Thierry COUDERT, Prefect, Managing director of EPRUS Mr.Jean-Marc SREISSEL, Logistician, Project leader transport Mr.Jean-Michel Sap , Financial and administrative manager. Phi Phi Island.

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Welcome to Thailand

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  1. Welcome to Thailand Welcome EPRUS Team Mr.Thierry COUDERT, Prefect, Managing director of EPRUS Mr.Jean-Marc SREISSEL, Logistician, Project leader transport Mr.Jean-Michel Sap , Financial and administrative manager Phi Phi Island

  2. Organization of the stockpile of antivirals and Personal Protective Equipment (PPE) At the Department of Disease Control (DDC), Ministry of Public Health(MoPH),Thailand 14 August, 2012

  3. Overview of Antivirals and PPE logistic system History of Antivirals and PPE use in Thailand Logistic system & Distribution Warehouse at Department of Disease Control (DDC)

  4. Area : 198,114 square miles, the size of the state of Texas. Population (as of 2011): 64.07 million, about 8 million live in the capital city of Bangkok <5 yr =13 million 15-59 = 48 million 65 + = 5 million Ethnics: Thai (80%), Chinese (10%), Malay (3%) Religions : 95%Buddhism Languages : Thai Climate : warm and humid China Myanmar Laos . Bangkok Cambodia Vietnam Malaysia Thailand

  5. Jan-Nov 07 Jun-Aug 06 Jun-Oct 04 Jul-Nov 05 Jan-May 04 Confirmed case Suspect case Poultry outbreak Distribution of AI in poultry and human cases, 2004-2012 Total 25 cases / 17 deaths Human - July 2006 Poultry - November 2008

  6. Stockpiling and logistics Personal Protective Equipment : PPE Oseltamivir also provided to migrants / displaced people through local health authorities & international partners 3 Mar 06

  7. Oseltamivir Stockpile 2004 Outbreak of AI - set up Tamiflu (R) stockpile with WHO support 2006 Bought Tamiflu (R) fromDiethelm Company 2007Set up Vendor management inventory (VMI) 2008 Filling capsule - Oseltamivir (GPO-A-flu (R)) by Government Pharmaceutical Organization (GPO) ReceivedTamiflu (R) from ASEAN stockpile VMI system Completed 2009Pandemic (H1N1) 2009 crisis, Distributed GPO-A-Flu by VMI system (operated by DDC & GPO) Bought Zanamivir formGSK Company Now Purchased by DDC Produced & distributed GPO-A-flu by VMI system

  8. Ministry of Public Health Professional Councils National Health Board Office of the Minister Government Pharmaceutical Organization : GPO (State Enterprise under MoPH) Permanent Secretary Cluster of Medical Service Development Deputy Permanent Secretary Cluster of Public Health Development Deputy Permanent Secretary Cluster of Public Health Service Support Deputy Permanent Secretary Department of Disease Control : DDC Office of the Permanent Secretary Department of Medical Services Department of Health Service Support Provincial Administration Department of Thai Traditional and Alternative Medicine Development Department of Medical Sciences Department of Health Food and Drug Administration Department of Mental Health Structure of Ministry of Public Health : MoPH

  9. Department of Disease Control : DDC Administration Development System Section Internal Auditor Section Office of the secretary Personnel Division Finance Division Planning Division Bamrasnaradura Institute (Infectious Hospital) Rajprachasamasai Institute (Leprosy Hospital) Office of Disease Prevention and Control 1-12 Bureau of Epidemiology Bureau of Occupational and Environment Diseases Bureau of General Communicable Diseases Bureau of Vector-Borne Diseases Bureau of Non-Communicable Diseases Bureau of AIDS and STDs Structure of Department of Disease Control Bureau of Emerging Infectious Diseases Bureau of TB Bureau of Public Relations

  10. Flow of Oseltamivir Distribution Upstream Middle stream Downstream GPO Warehouse Hospital Purchase VMI Patient • - DDC Regional Office 1-12 • Provincial Health Offices • Large Provincial Hospital • include Bangkok • Provincial & Community • Hospital DDC Clinic - GPO • Private company • Other sources Private Hospital bought from GPO

  11. Oseltamivir Stockpile , as of 14 august 2012 Zanamivir (inhaled) Population 64.07 million - Oseltamivir 2,739,070 capsules 2012 : Coverage 4.27 % of all population

  12. Country Olseltamivir Stockpile Stockpiles sites: by VMI system GPO (national level), 12 DDC regional offices, 77 provincial health offices, all district, general and regional hospitals , Other MoPH hospitals and other offices in Bangkok , Total 1,277 sites Objectives : - For treatment of Avian Influenza patients - For rapid response and containment of pandemic influenza near its source

  13. Minimum requirement recommended for Oseltamivirstockpile in each level

  14. VMI Management : Vender Manage Inventory From Offices and Hospital

  15. Warehouse Summary of Oseltamivir Registration : 2004-now No date capsules cost/caps total(baht) expire date lot remark Oseltamivir Registration

  16. Dispensation Registration Date time Code no Record date Lotno billno Total key balance Cost / lot

  17. Management of Oseltamivir by VMI : Vender Manage Inventory Inventory Drug Dispensation

  18. Personal Protective Equipment • PPE • Objectives : • For rapid containment • (Provided by DDC) • 2. For health care worker protection • (Purchased by hospitals with National Health Security Office (NHSO) support List of PPE 1) Goggles 2)Face shield 3) protective gown 4) Reusable surgical gown 5) Disposable surgical gown 6) Disposable safety coverall 7)Face mask etc.

  19. PPE….what we have PPE….how we get Purchased by hospitals with National Health Security Office (NHSO) support for health care worker protection Supported by JICs through ASEAN regional stockpile 2008 Provided by DDC for rapid containment

  20. Minimum requirement recommended for PPE stockpile in each level

  21. DDCsupported sites • 1 National • 12 Regional • Provincial Total90 sites Risk groups : - Poultry worker - Surveillance Rapid Response Team (SRRT)

  22. PPEStockpile , as of 14 august 2012 + Hospital purchasing

  23. GPO & DDC Warehouse : antivirals and PPE Antivirals PPE at DDC BEID GPO

  24. Room PPE at 1 floor BEID building Room Temperature

  25. Conclusion • History of Antivirals and PPE use in Thailand • Antivirals & PPE stockpiles were set up since AI outbreak in 2004 with purchasing , support from WHO and domestic manufacturer (GPO-A-Flu) • PPE has been use for 2 purposes : Rapid containment and health care worker protection • Logistic system & Distribution • Antivirals have been distributed by Vendor management inventory (VMI ) system to all levels for maintenance of minimum requirement recommended. • PPE supplied for rapid containment has been distributed by Department of Diseases Control (DDC) whilst for HCW protection, hospitals has purchased with National Health Security Office (NHSO) financial support • DDC Warehouse • Quick Rotation Warehouse (Goods requiring prompt distribution)

  26. Merci Thank you

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