SCMS FY15 Q4 Quarterly and FY15 Annual Performance Report

SCMS procures and distributes essential medicines and health supplies, strengthens existing supply chains, and facilitates collaboration among key donors and service providers. The project is managed by the US Agency for International Development and is funded by the US President's Emergency Plan for AIDS Relief (PEPFAR). In FY15, SCMS delivered $433.5 million in products through 3,959 shipments, exceeding $100 million in each of the first three quarters. On-time delivery improved significantly from 78 percent in FY14 to 84 percent in FY15. SCMS achieved significant price reductions for Efavirenz/Lamivudine/Tenofovir Disoproxil Fumarate 600/300/300 mg tablets, resulting in total savings of $850,000 for restocking orders during the fiscal year. Supply shortages of Lopinavir/Ritonavir (LPV/r) were experienced due to manufacturing capacity constraints, enterprise resource planning (ERP) system challenges, active pharmaceutical ingredient (API) shortages, and excipients not meeting standard specifications. Innovator AbbVie increased quoted lead times to 20 weeks, and generic manufacturer Hetero announced delays of two months. AbbVie's goal is to decrease the lead times of LPV/r 200+50 mg and 100+25 mg to 12 weeks for fresh production. Limited manufacturing capacity also had a global impact on Atazanavir/Ritonavir (ATV/r) supply. Two additional manufacturers were tFDA approved during the year, alleviating these challenges. Emcure was approved by the US Food and Drug Administration (FDA) in March, joining Mylan as one of two tFDA-approved manufacturers. Subsequently, in Q4, Mylan reduced the price for ATV/r 300/100 mg tablets, 30 tabs, from $18 to $16.50 per pack. SCMS faced challenges in achieving the 5 percent target for in-country stockout rates at SCMS-supported sites. At 9 percent performance for FY15, countries reported LMIS challenges as the largest root cause of high stockout rates, including poor data quality and the inability of local stakeholders to make timely decisions based on available data. In Burundi, despite ongoing political instability, SCMS maintained the order fill rate above 99 percent for all PEPFAR-funded HIV commodities. In FY15 Q3, Zambia's transit warehouse was fully cleared for the first time in two years. SCMS cleared all shipments and delivered them to the Medical Stores Limited (MSL) Katanga warehouse. As a result of stakeholder collaboration, MSL agreed to prioritize the receipt and storage of SCMS- and USAID-procured commodities using the additional storage capacity at the facility. SCMS Quality Assurance (QA) Unit completed its transition to FHI 360, the Global Health Supply Chain (GHSC)-QA contractor. The final batch of samples under SCMS was analyzed, and all testing work completed by September 26, the last day of the laboratory contracts with PFSCM. SCMS also completed transitioning procurement of HIV rapid diagnostic tests (HRDTs) to Remote Medical International (RMI), the newly appointed USAID GHSC program contractor for this product category. In FY15 Q4, SCMS deliveries decreased significantly to $71.5 million, attributed to high volumes of orders placed against the initial transition final delivery date of June 2015. SCMS anticipates value and volume of deliveries to increase as they work toward the new transition date of June 2016. The percentage of unplanned orders was high at 46 percent, as expected, and SCMS anticipates this trend will reverse as they place the final round of deliveries in the next few quarters before June 2016 to ensure supply through the end of FY16.