1 | “SMS for Life” | Geneva, January 21st. 2010

Today, many health facilities suffer from stock-outs of malaria medicines

Artemisinin:

• Plant• Grow• Harvest

Chemicalprocess:• Arte• Lume

Tabletting& packa-ging ofACT’s

Distri-bution tocountries

Ware-house

Countryware-house

Districtdistri-bution

HealthFacilities& HealthPosts

Pharmaceutical Suppliers

Procurement agents

Patient

National Malaria Control Programs

Tenders

The problem being addressed?

Maintaining adequate supplies of anti-malarial medicines at the health facility level in rural sub-Saharan Africa is a major barrier to effective management of the disease. Lack of visibility of anti-malarial stocks at the health facility level is an important contributor to this problem.

Partnership

NMCP In Country Project Leader: Winifred Mwafongo

Program Director: Jim Barrington

Technical Support: Kevin Ferriday Project Support: Pete Ward

Map Development: Ka-Ping Yee

Project Steering Committee

• Exec. Dir. Roll Back Malaria Partnership (Chair) Prof. Awa Marie Coll-Seck• Tanzania Nat. Malaria Control Program Manager Dr Alex Mwita• PSI Vice President and Global Malaria Control Director Dr. Desmond Chavasse

• Director of the Swiss Tropical Institute Prof. Marcel Tanner • CEO Novartis Foundation for Sustainable Development Prof. Klaus Leisinger • Exec. VP Novartis Malaria Initiatives Mr. Silvio Gabriel• “SMS for Life” Program Director Mr. Jim Barrington

• External Advisor: Bob Snow, Professor of Tropical Public Health, University of Oxford.

Pilot Districts

Dar es Salaam:

Training Sept 21st. 2009

MSD, NMCP, Warehouses

Lindi Rural:Live Sept 28th.

2009 DMO, Dr. Nkungulwe48 Health Facilities

Ulanga:Live Oct. 12th.

2009 DMO, Dr. Bakari

30 Health Facilities

Live Kigoma Rural:

Oct. 19th. 2009DMO, Dr. Edwin Kilimba

51 Health Facilities

9 weeksSurveilance Visits(3) November 23rd.(3) January 4th.(3) February 8th.3 Districts

129 Health Facilities226 Villages1.2 million people.

Average response rate of 95%Data accuracy rate of 94% (physical count)Data accessed on a daily basis (system log)

Lindi Rural – % of the 48 facilities with a stock-out by ACT dosage form.

(57% stock-out to 0% stock-out)

Ulanga – % of the 30 facilities with a stock-out by ACT dosage form

(87% stock-out to 30% stock-out)

Kigoma Rural – % of the 51 facilities with a stock-out by ACT dosage form

(93% stock-out to 47%)

All Districts – % of the 129 Facilities with a stock-out of Quinine Injectable

(36% stock-out to 4% stock-out)

Results

• At the start of the Pilot only 29 of the 129 facilities had all 5 medicines in stock (77% stock-out)

• At the end of the pilot 96 of the 129 had all 5 medicines in stock(26% stock-out). A threefold or 300% improvement.

• At the start of the Pilot 26% of facilities had no ACT of any dosage form in stock.

• At the end of the Pilot 99% of facilities had at least one dose form of ACT in stock.

Recommendations from the Pilot

• Implement the SMS for Life solution in all districts of Tanzania.

• Encourage the use the SMS for Life solution to track other medicines of priority.

• Apply the SMS for Life solution to disease surveillance.

• Implement SMS for Life in other African or non- African countries that have a need to eliminate stock-outs at health facility level.

Positioning of “SMS for Life” • We have a high quality solution that :

– is proven to support the elimination of medicine stock-outs

– is scalable to support any number of health facilities and countries

– is easy to implement. One half day of training per district

– is affordable. Total running costs of less than $100 per health facility per year)

– is sustainable The solution is offered as a commercial service by Vodafone, the largest mobile phone operator in the world

• The project is a unique combination of technology to address supply management issues– The project proves a contribution in the goal of access to malaria medicines for

everyone, when and where needed.

• The system is flexible to support access to other medicines– Once implemented, the system can be expanded to track other essential

medicines.

2011 – 2012• Tanzania should be the first Country to be complete by mid 2011

• Four Pilot districts in Ghana, starting in November 2010 with a goal of countrywide scale-up in Ghana 2011/2012

• We will continue to promote the solution to all countries who have stock-out problems.

• Our main limiting factor to further country implementations is funding.

• Implementing a country the size of Tanzania is approx. $950,000 including Pilot, and Zambia would be approx $550,000 . On-going costs are approx $100 per health facility per year.

Prof. David Mwakyusa , Minister for Health & Social Welfare.

“I’m grateful for what you are doing for my country – I loose a child every five minutes which is a waste from a disease that is completely preventable. I cannot do it alone, I have to do it with people like you. This is a great project and an innovation that I support very much, it’s exciting to me.”