Technical Assistance to the National Malaria Control Program to Strengthen the Malaria Supply Chain in Niger

Malaria represents 31% of all morbidity recorded in 2013 and constitutes the first cause of death in all regions. In Niger, it is responsible for 57% of deaths overall and 76% of deaths among children under 5. The entire Nigerien population is exposed to malaria, with pregnant women and children under 5 years of age being the most vulnerable groups. The epidemiology of malaria in Niger is characterized by stable endemicity with a seasonal increase during and after the rainy season (June to December). The latest outbreak was recorded in July-August 2012 in the health districts of Niamey, Tillaberi, Agadez, and Abalak. Malaria endemicity is superimposed on the geo-climatic zones with three epidemiological patterns: a hypoendemic zone in the North, a mesoendemic zone in the intermediate Sahel region, and a hyperendemic area in the South. The National Malaria Strategic Plan 2011-2015, developed by the National Malaria Control Program (NMCP), highlighted the importance of maintaining constant availability of stocks and improving the current supply chain management system for malaria commodities. Support was requested and obtained from the US Agency for International Development (USAID) in the form of technical assistance to be provided to NMCP by the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. A SIAPS Supply Chain Technical Advisor was embedded with NMCP for 18 months to strengthen pharmaceutical management of health products used in the fight against malaria. The main technical activities realized during the first quarter of 2015 include supporting the development of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) Concept Note for the New Funding Mechanism (NFM) for the period 2016-2018, drafting terms of reference for a new technical committee focusing on supply chain management of malaria commodities, participating in the planning of the next campaign of seasonal malaria chemoprevention (SMC), and developing strategies to improve management of malaria commodities. The SIAPS Supply Chain Technical Advisor collaborated closely with Niger's NMCP during the first quarter of the project. Activities related to program management included introduction and orientation of the technical advisor to Ministry of Health authorities, USAID mission, and other stakeholders, and follow-up on the Management Sciences for Health registration process in Niger. The registration folder submitted to the Niger Embassy in the United States in February arrived in country during the last week of March 2015 and is now under review by the Ministry of Foreign Affairs department in charge of international nongovernmental organizations. The SIAPS Technical Advisor spent the first two weeks of February attending various meetings that allowed him to familiarize himself with the teams within the NMCP and the main partners involved in the supply chain. Individual meetings and working sessions took place with persons in charge of health or supply chain management at the following agencies and organizations: NMCP, USAID, Direction des Etudes et de la Programmation (Department of Studies and Planning within the Ministry of Health), Office National des Produits Pharmaceutiques et Chimiques (ONPPC [Central Medical Store]), WHO, and Catholic Relief Services (CRS). After several meetings with NMCP staff, the advisor noted that the current structure of NMCP does not allow the department in charge of managing malaria commodities to perform all of its functions properly. The advisor made recommendations relative to the structural organization of the program, with the goal of improving the various functions.