OSI Public Health Seminar

1. OSI Public Health Seminar Overview of the Framework Of the Supply Chain Including emphasis on Access and Use Kiev, Ukraine March 5-7, 2008 Paul S. Lalvani Executive Director RaPID Pharmacovigilance Program

2. DELIVERY SUPPLY CHAIN SCHEMATIC FOR MOVEMENT OF PRODUCT, FUNDS AND INFORMATION Demand Supply Deliver Other IPR Draft work by Paul Lalvani Prashant Yadav (MIT-Z) for CGD Patient Access Regulatory Policy

3. DELIVERY SUPPLY CHAIN SCHEMATIC FOR MOVEMENT OF PRODUCT, FUNDS AND INFORMATION Movement of Funds Demand Supply Movement of Goods Deliver Movement Of information Draft work by Paul Lalvani Prashant Yadav (MIT-Z) for CGD Patient Access

4. DELIVERY SUPPLY CHAIN SCHEMATIC FOR MOVEMENT OF PRODUCT, FUNDS AND INFORMATION In-country Activities Demand Supply Deliver Other IPR Draft work by Paul Lalvani Prashant Yadav (MIT-Z) for CGD Patient Access Regulatory Policy

5. DELIVERY SUPPLY CHAIN SCHEMATIC FOR MOVEMENT OF PRODUCT, FUNDS AND INFORMATION Demand Supply Deliver Managing 2 Confluence Points Other IPR Draft work by Paul Lalvani Prashant Yadav (MIT-Z) for CGD Patient Access Regulatory Policy

6. DELIVERY SUPPLY CHAIN SCHEMATIC FOR MOVEMENT OF PRODUCT, FUNDS AND INFORMATION Demand Supply SELL BUY • To be managed by the • Procurement Office • in coordination with: • donors • technical agencies • public health program • suppliers • public health facilities • private health facilities • Central and regional • medical stores for • distribution DISTRIBUTE Deliver Draft work by Paul Lalvani Prashant Yadav (MIT-Z) for CGD

7. DELIVERY SUPPLY CHAIN SCHEMATIC FOR MOVEMENT OF PRODUCT, FUNDS AND INFORMATION Health Professionals Delivery Health Prof. Supply • To be managed by the • Health facility (public • And private) • in coordination with: • implementing agencies • regional and district • health offices • public health program • central and regional • medical stores for • distribution • patients Patient Patients Draft work by Paul Lalvani Prashant Yadav (MIT-Z) for CGD

8. DELIVERY SUPPLY CHAIN SCHEMATIC FOR MOVEMENT OF PRODUCT, FUNDS AND INFORMATION Demand Supply Deliver Other IPR Draft work by Paul Lalvani Prashant Yadav (MIT-Z) for CGD Patient Access Regulatory Policy

9. SUPPLY SIDE API Manufacturer Generic / Originator Goods Manufacturer Exporter/ International Shipping Agents Supply side facilitators SELL Consider activities, bottlenecks, incentives for moving along the supply chain

10. DEMAND SIDE Financing Organization Buy-side facilitators National HIV/AIDS Program Procurement Office BUY Other Consider activities, bottlenecks, incentives for moving along the supply chain

11. DISTRIBUTE Private Sector Public Sector Importers/ Distributors Program Implementers Distributors/ CMS/ RMS Wholesalers Retail Outlets/ Clinics Health Facility Health Professionals Patients PROGRAMMATIC SIDE Consider activities, bottlenecks, incentives for moving along the supply chain

12. Summary of Tri-Linear Supply Chain Framework Segment activity into 3 broad categories: Supply, Demand, Deliver Ensure focus on Drug, Information and Funds Managing the 2 confluence points is the most critical part Think beyond ARVs—to ensure effective use of ARV, the supply chain must focus on all ancillary products too ( supplies, lab, diagnostics, etc).