UNICEF Engagement in Pneumonia Malaria Consortium Consultation June 2014
Outline About UNICEF About UNICEF supply About pneumonia …..
Realizing the rights of every child, especially the most disadvantaged SURVIVE TO THRIVE FROM BIRTH INTO ADULTHOOD Realizing the Rights of Every Child 3
Supply in the UNICEF structure
UNICEF Supply Division, Copenhagen
What we do Procurement, warehousing & logistics – UNICEF programmes & for procurement partners Market shaping – ensuring availability, quality, price and right formulations of essential commodities Ensuring local delivery of essential commodities to children and families Rapid emergency response Partnerships, policy & monitoring Innovation for children 6
UNICEF’s supply function vision 2005 Direct Delivery Procurement Services 2008 Direct Delivery Procurement Services 2010-11 CD IV Direct Delivery Procurement Services 2012-13 Capacity IV & Direct Delivery Procurement Services Development MI 2020 Innovation & Direct Delivery Procurement Services Capacity Development Mrket Influence
UNICEF Supply Strategies for 2014-2017 UNICEF Outcome Areas UNICEF Global Supply Strategies Health HIV/AIDS Service Delivery WASH Emergency Nutrition Influencing Markets Education Innovation Protection SD Supply Chain improvement initiatives Inclusion Strengthening & Optimising Supply Chains with Governments Capacity Development Supply Community & Professional Development Monitoring: (Performance Targets, Supply Outcome Targets, Results Matrix , PS) Results-based management, reporting & project management Partnership
Definition of need Planning (i.e. timing/qty etc.) UPSTREAM Budgeting & Looking at the supply chain Planning Procurement Procurement Delivery & Clearance Inspection Logistics & delivery Warehousing, DOWNSTREAM Distribution & Re-ordering (national, provincial, district, community) Utilisation by Beneficiary M & E Monitoring & Evaluation
A look into pneumonia… - pneumonia diagnosis -
World Health Organization. Were, Qazi. June 2014
It is not only about the technology…. $1.23 ….but about defining the functional requirements based on user needs
ARI Timer Time Line …. • WHO and Save The Children (STC) exchange mails on inadequacy Aug 2005 of ARI timer for assessment by CHWs of fast breading. • UNICEF PD & SD invited by WHO, STC and Philips Philanthropic May 2007 Design Initiative (PPDI) to participate in designing a new generation ARI timer. • Progress with newly designed timer stalls on (i) open source March discussion with PPDI, (ii) no funds to make a prototype, and (iii) no 2008 funds for field testing. • REoI to potential producers new ARI timer: 20 invited, 2 respond Nov 2008 (1 rejected, 1 current manufacturer Moneray). Monopoly PPDI / Moneray not acceptable. • Work on newly designed ARI discontinued, refocus on needs of Oct 2010 end-users.
ARI Timer Time Line (2) …. • RFI successfully scouts for potential technologies and Dec 2011 organizations working on a pneumonia diagnostic aid. All are promising but very early initiatives. • Evaluation of RFI selects most promising ones. During follow-up Q1+Q2 all organizations request support, guidance and financial means. 2012 • Field research with various concepts (by Innovation Unit ), creates Q2+Q3 for the first time very good insight into ARI diagnostic 2012 requirements at community level. • SD workshop with industry and academia, (i) creates personas, (ii) Jan 2013 common design denominators, (iii) need for short and long term TPP, and (iv) creates frequent progress exchange with BMGF. • Parallel to the innovation track, in cooperation with supplier, Q3 2013 specifications of current S0845010 were updated. ARI timer, mark 2 is expected Q3 2014. • TPP development starts Jan 2014
About the products Pneumonia Oximetry Diagnostics (respiratory rate Pulse Oximetry timers) Oxygen Amoxicilin DT concentration, Accessories Also consider dispersible paracetamol for fever management
Pneumonia Diagnostics
Current timing tool(s) for pneumonia diagnosis: Basic supply for community health ARI Timer Watch
Different Pneumonia Diagnostic Aids Device Name Description Counting beads designed as a simple, cheap and effective way to improve a CHW’s ARI Counting Beads ability to keep track and count a patient’s breathing rate. To be used in conjunction with the ARI Timer. The beads are colour-coded to ease diagnosis. A mobile phone application that tracks a CHW’s count rate using an “any button” press Respiratory Rate function on the phone to count and then calculate a patient’s mean respiratory rate. Application Solar and Cell Phone Pulse A device powered by using old mobile phone batteries charged by solar cells measures the saturation level of a patient’s haemoglobin. It determines whether a patient is receiving sufficient oxygen through breathing, as well as the patient’s heart rate. StethoCloud A concept still in development which records the respiration rate through a stethoscope attached to a smart phone or a cloud device. The data is processed against an existing database used to diagnose pneumonia. mPneumonia An android prototype mobile phone application in development which uses the IMCI pneumonia protocol, paired with a respiratory rate counter and pulse oximetre to guide and inform diagnosis. The Nossal ‘Smart Cable’ A device that transforms a simple mobile phone into capturing data from three sensing devices: oximetre, respiratory rate counter and thermometer. Project The Phone Oximetre for An oximetre device and application that attaches to a smart phone and measures respiratory rate, peripheral blood flow and Sepsis Ongoing heart rate, facilitating diagnosis. developments Ref: Pneumonia Diagnostics: Current outlook and perspectives : UNICEF Supply Division - May 2013
Pneumonia Treatment
Pneumonia: Treatment with Amoxi 250mg DT Cost: Amox 125mg/5ml suspension (100ml) Versus Amox 250mg DT UNICEF Catalogue Product FCA lowest Treatment cost < Treatment cost Price (US$) 1 year olds 1-5 years Amoxicillin 250mg DT S1505046 Amox 125mg/5ml Suspension 0.40 0.40 0.80 S1505043 Amox 250mg DT 10 X10 Pack 1.70 0.17 0.34 S1505044 Amox 250mg DT 10 X 2 Pack 0.37 N/A 0.37 S1505045 Amox 250mg DT 10 X 1 Pack 0.24 0.24 N/A Amox 250mg DT: UNICEF Procurement Activities Suppliers Country Microlabs India Medopharm India Medreich India Sandoz Austria Remedica Cyprus
Fever Management
Fever: Treatment with Paracetamol DT Introduction of 100mg & 250mg Paracetamol dispersible tablets for the treatment of fever in under fives UNICEF Product (material description) Unit price Cost of treatment S1555990 Paracetamol 125mg/5ml or.sol/BTL-60ml 0.43 USD 0.43 USD S1555965 Paracetamol 500mg tabs/PAC-1000 5.48 USD N/A S1555978 Paracetamol 100mg tabs/PAC-1000 3.65 USD N/A S1555979 Paracetamol 100mg disp. Tabs 10X10 pack 0.75 USD 0.075 USD S1555979 Paracetamol 250mg disp. Tabs 10X10 pack 0.81 USD 0.081 USD Use of Paracetamol DT significantly reduces the cost of fever treatment compared to the use of Paracetamol oral suspension
Pulse Oximetry
Pulse Oximetry UNICEF Product (material description) Unit price ( Prices are indicative ) S0002036 Pulse oximeter,spot-check,w/access, 300 USD S0002033 Pulseoximeter,portable,w/access, 3,435 USD S0002031 Monitor,patient,all vitals signs,portable,w/access 2,025 USD S0002047 Oxygen concentrator/SET 880 USD S0370100 Prongs,nasal,Oxygen,adult,s.u 0.21 USD S0370110 Prongs,nasal,Oxygen,child,s.u 0.22 USD S0370120 Prongs,nasal,Oxygen,neonate,s.u 0.21 USD
Questions ….
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