MINISTRY OF HEALTH PHARMACY DIVISION STOCK STATUS … SSR 1st October 2016.pdf · NMS is expected...

MINISTRY OF HEALTH

PHARMACY DIVISION

STOCK STATUS REPORT AS AT 1st October 2016

A Publication of The Ministry of Health Uganda The purpose of this report is to inform the Ministry of Health and all stakeholders of the stock levels in the country as a tool that enable appropriate logistics decisions making . This report highlights stock status, real challenges,

bottlenecks but also recommends potential solutions to mitigate stock outs and expiries of ARVs & HIV test kits, ACTs, Anti-TB medicines, Reproductive Health items, selected Laboratory commodities,Vaccines and selected

medicines for treatment of Opportunistic Infections In the Repubic of Uganda

This report serves to: - Act as an early warning indicator for potential stock outs and possible expiries of EMHS

- Identify challenges and recommendations to avert supply interruptions ·

- Encourage preparation and sharing of joint supply plans with stakeholders

- Identify strategies for regularly reviewing supply plans for all the commodities

- Encourage donors to honor their commitments in terms of quantities of products expected, timeliness of deliveries and flexibility.

Summary of Stock status as of 1st October 2016

This stock status report covers selected medicines categorized as Anti-retrovirals (ARVs), Anti-malarial, Anti-tuberculosis, medicines for treatment of opportunistic infections, family planning and

maternal health commodities and laboratory commodities. The stock status of these commodities as of 1st October 2016 is summarized below.

Anti-retroviral medicines

Joint Medical Stores (JMS) and Medical Access Uganda Limited (MAUL) that serve the PNFP and PFP sector are well stocked. The National Medical stores (NMS) responsible for procurement and

distribution of medicines to the public sector is however experiencing low stock levels for adult second line and pediatric second line formulations.

Commodities from the PEPFAR 8.6million USD donation to the public sector were delayed and are currently expected in November 2016 through January 2017.

The Global Fund orders to the public sector through the costed extension grant will be received starting January 2017. This will further improve stock levels.

The current stock outs for Abacavir/Lamivudine 600/300mg and Nevirapine 50mg will be alleviated when PEPFAR stock is received in November 2016.

New formulations of Abacavir/Lamivudine 120/60mg and Lopinavir 40/10mg will be received in January 2017.

Third-line ARVs at JCRC are adequately stocked except for Ritonavir 100mg which is at risk of stock out. Orders for all commodities have been placed with delivery dates yet to be confirmed by the

supplier.

In April 2016, Uganda applied for a donation of pediatric third line ARVs (Etravirine 100mg and Darunavir 50mg, 150mg and 300mg) through the Janssen New Horizon Collaboration for children 0-19

years of age. Uganda received the award for this donation and is in advanced stages of submitting this order. In line with the terms of the donation government and partners will need to provide

ritonavir.

Medicines for opportunistic infections:

All Cotrimoxazole formulations are well stocked across all warehouses. Fluconazole orders for all formulations under the Diflucan partnership were received in October 2016. This stock will be utilized

by health facilities supported by NMS and JMS for treatment of cryptococcal and esophageal candidiasis.

Family planning and maternal health commodities

The public sector is stocked out of most commodities except for Depo-provera, Implanon and Misoprostol.

The private sector is well stocked however; Depo-provera, Implanon Misoprostol and Jadelle have less than two MOS and stand the risk of stock out. Inter-ware house transfers will be done for

implanon and additional orders placed for the products low on stock.

A shortage of male condoms persists as products worth over 10.4 MOS are still under quarantine pending mandatory post shipment testing by NDA.

Antimalarial commodities

All Antimalarial commodities are well stocked at JMS through the rest of the year.

At NMS, there are stock outs of the AL 18's with minimal stock levels for AL 6's and AL 12's. Shipments are expected in Nov 2016 for all ACTs and Jan 2017 for the Malaria RDTs from Global Fund. Stock

out of 24’s pack may be experienced at end of 2016. NMS is expected to procure ACTs to improve the stock levels in the public sector.

Laboratory commodities

HIV test kits are generally below the minimum stock level of 3 MOS. There are risks of stock out of Determine at NMS and MAUL and a stock out of Stat Pak and Unigold at JMS. JMS will receive Stat Pak

and Unigold from NMS through the Inter-ware house transfer mechanism as they await receipt of their scheduled pipelines.

Viral Load, EID, chemistry and Hematology reagents will experience low stock levels between December 2016 and February 2017. Pipeline for these commodities is scheduled for March 2016 with the

exception of viral load reagents which have no confirmed pipeline.

Tuberculosis commodities

All TB medicines are well stocked except for Isoniazid 100mg, isoniazid 300mg, levofloxacin and pyrazinamide which are stocked out. Levofloxacin order through GDF has been delayed creating the

stock out. NMS is expected to procure Kanamycin, Levofloxacin and Pyrazinamide from GOU funding.

A detailed account is made for each of the commodities below.

A : National Medical Stores

Months of Stock at the end of the month

Product Name Unit of measure

Closing Bal at

30th Sept 2016 AMC Sept 2016 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17

Adult first line formulations

Efavirenz/Lamivudine/Tenofovir 600/300/300mg 1*30 tabs 231,777 252,901 0.0 1.7 0.7 3.0 4.4

Lamivudine/Zidovudine/Nevirapine 150/300/200mg 1*60 tabs 1,328,474 160,156 7.3 6.3 5.3 4.3 6.2

Lamivudine/Zidovudine 150/300mg 1*60 tabs 401,872 55,122 6.3 5.3 4.3 5.6 4.6

Tenofovir DF/Lamivudine 300/300mg 1*30 tabs 892,367 94,502 10.4 10.3 9.3 11.0 10.0

Nevirapine 200mg 1*60 Tabs 373,267 40,344 8.3 7.3 6.3 8.6 7.6

Efavirenz 600mg 1*30 tabs 764,267 100,976 7.7 7.8 6.8 5.8 8.1

Adult second line formulations

Abacavir/Lamivudine, Scored, 600/300mg 1*30 tabs 2,188 7,228 0.0 2.3 1.3 0.3 0.0

Atazanavir/Ritonavir 300/100mg 1*30 tabs 1,756 7,246 11.7 10.7 9.7 8.7 7.7

Lopinavir/Ritonavir 200/50mg 1*120 tabs 10 9,260 1.2 0.2 2.1 2.5 1.5

Pediatric first line formulations


Lamivudine/Zidovudine/Nevirapine 30/60/50mg 1*60 tabs 401,172 42,379 8.5 7.5 6.5 7.1 6.1


Nevirapine 10mg/ml 100 ml 1 bottle 55,651 5,556 9.0 8.0 7.0 6.0 5.0

Nevirapine 50mg 1*30 tabs - 11,942 0.0 0.3 0.1 0.0 0.0

Efavirenz 200mg 1*90 tabs 36 10,902 0.0 3.6 2.6 3.4 2.4

Pediatric Second line formulations

Abacavir 60mg dispersible 1*60 tabs - 211 0.0 0.0 0.0 6.8 5.8

Lopinavir/Ritonavir 100/25mg 1*60 tabs - 5,974 2.5 1.5 0.5 2.3 1.3

Lopinavir/Ritonavir 40/10mg (oral pellets) 1*120 caps 1,920 5.0 5.0

Lopinavir/Ritonavir 80/20mg/ml [KALETRA] 60ml 1*5 bottles 4,160 384 9.8 8.8 7.8 6.8 5.8 Min - 3; Max 6

Antiretroviral Medicines

Notes: ARV drugs for Public health facilities Over 60% of Adult are well stocked. There is a risk of stock outs for Abacavir/Lamivudine 600/300mg, Lopinavir 200/50mg and Tenofovir/Lamivudine/Efavirenz 300/300/600mg. This situation is expected to last the December 2016 . Supplies from PEPFAR expected between November 2016 and January 2017 will only ensure minimal availabilty of the commodities at risk of stock out during this period. Global Fund shipments will begin arriving in January 2017 through May 2017. No other shipments are expected beyond this period. Pediatric 1st line formulations of Nevirapine 50mg and Efavirenz 200mg are stocked out. Similary, Abacavir 60mg is stocked out with a risk of stock out for Lopinavir/ritonavir 100/25mg under the pediatric second line . All other peadiatric formulations are well stocked. Two new formulations have been introduced; Lopinavir/Ritonavir 40/10mg (oral pellets) replaces Kaletra syrup while ABC/3TC 120/60mg replaces ABC/3TC 60/30mg The sustainability of the test and treat approach will heavily depend on the funding availability for the procurement of commoditites especially in 2016/2017 where patient blip (mop-up of patients on pre-ART) is expected.

B : Joint Medical Stores


Closing Bal at


Efavirenz/Lamivudine/Tenofovir 600/300/300mg 1*30 tabs 165,566 35,994 3.6 2.6 1.6 0.6 2.2




Nevirapine 200mg 1*60 Tabs 105,256 5,550 18.0 17.0 16.0 15.0 14.0

Efavirenz 600mg 30 1*30 tabs 108,768 15,861 5.9 4.9 3.9 2.9 5.6



Lopinavir/Ritonavir 200/50mg 1*120 tabs 46,391 3,674 12.1 11.1 10.1 9.1 8.1

Efavirenz 200mg 1*90 tabs 8,384 518 15.2 14.2 13.2 12.2 11.2

Abacavir/Lamivudine, Scored, 60/30mg 1*60 tabs - 1,638 3.5 2.5 1.5 0.5 3.4


Lamivudine/Zidovudine 30/60mg 1*60 tabs 4,213 619 5.8 4.8 3.8 2.8 5.5

Nevirapine 10mg/ml 100 ml 1 bottle 33,943 461 72.6 71.6 3.1 2.1 1.1

Nevirapine 50mg 1*30 tabs 8,324 1,599 4.2 3.2 2.2 1.2 10.8

Lopinavir/Ritonavir 100/25mg 1*60 tabs 3,328 316 9.5 8.5 7.5 6.5 5.5

Lopinavir/Ritonavir 80/20mg/ml [KALETRA] 60ml 1*5 bottles 4 5 0.0 0.0 0.0 0.0 0.0 Min - 3; Max 6




Peadiatric second line formulations


Notes: ARV commodities at JMS Joint medical Store has sustained stable stock status for all commodities for the larger part of 2016. However, in this last quarter, there are risks of stock out of Abacavir/Lamivudine 600/300mg, Abacavir /lamivudine 60/30mg and Tenofovir /Lamivudine/Efavirenz 300/300/600mg which is due to shipment delays that are precipitated by the transition of procurement from Supply Chain Management System to Global Health Supply Chain. Shipments are expected in February 2017 and smooth procurement is expected thereafter. Interwarehouse transfers continue to work well for stocks that are required in limited quantities and those at risk of expiry . Under this mechanism , JMS is being replenished with Kaletra syrup from NMS New formulations of Lopinavir/ritonavir 40/10mg pellets replacing Kaletra syrup and Abacavir/Lamivudine120/60mg replacing Abacavir/lamivudine 60/30 are scheduled to arrive early 2017.

C : Medical Access Uganda Limited


Closing Bal at



Efavirenz/Lamivudine/TDF 600/300/300mg 1*30 tabs 926,263 97,599 8.5 7.5 6.5 5.5 4.5















Nevirapine 10mg/ml 100 ml 1 bottle 8,698 1,128 6.7 5.7 4.7 3.7 2.7


Peadiatric second line formulations


Lopinavir/Ritonavir 40/10mg (oral pellets) 1*120 caps

Lopinavir/Ritonavir 80/20mg/ml [KALETRA] 60ml 1*5 bottles 8,698 1,128 6.7 5.7 4.7 3.7 2.7 Min - 3; Max 6

Min 3, Max 6


Notes: ARV commodities at MAUL Medical Access has maintained good stock levels all year round. In January and February 2017, there are risks of low stock le vels for over 50% of ARV formulations. MAUL is expected to place orders to replenish all stock levels above the minimum.

D: THIRDLINE ARVS


Closing Bal at


Etravirine (Intellence) 100mg; 120 tablets 1*200 tabs 675 81 7.3 6.3 5.3 4.3 3.3

Ritonavir (Norvir) 100mg; 60 tabs 1*60 tabs 572 128 3.5 2.5 1.5 0.5 0.0

Raltergravir (Isentress) 400mg; 60 tabs 1*60 tabs 1,451 199 6.3 5.3 4.3 3.3 2.3

Darunavir (Prezista) 600mg, 60 tabs 1*60 tabs 981 159 5.2 4.2 3.2 2.2 1.2 Min - 3; Max 6


Notes: Third Line ARV commodities These products are currently only available at Joint Clinical Research Centre. All thirdline Medicines are well stocked until February 2017 when stock outs are expected. Orders have been placed for all commodities pending confirmation delivery dates.

A: NMS

Category

Unit of measure

(Pack)

Closing Bal at


Artemether 20mg + Lumefantrine 120mg ( 6's) 1*30 strips 26,825 7,554 2.6 12.8 11.8 10.8 9.8

Artemether 20mg + Lumefantrine 120mg (12's) 1*30 strips 18,446 7,932 1.3 5.0 4.0 3.0 2.0



Artesunate 60mg Powder for Injection, 1 vial 1 vial 457,532 241,279 5.0 4.0 7.2 6.2 5.2

Malaria Antigen Rapid tests (25 tests) 1*25 tests 255,137 83,977 2.0 1.0 0.0 0.8 0.0 Min - 3; Max 6

B: JMS

Category

Unit of measure

(Pack)

Closing Bal at



Artemether 20mg + Lumefantrine 120mg (12's) 1*30 strips - 2,273 3.0 6.4 5.4 4.4 3.4

Artemether 20mg + Lumefantrine 120mg (18's) 1*30 strips - 2,321 7.0 10.3 9.3 8.3 7.3

Artemether 20mg + Lumefantrine 120mg (24's) 1*30 strips 528 3,921 7.0 6.0 5.0 4.0 3.0

Artesunate 60mg Powder for Injection, 1 vial 1 vial 614,545 91,653 13.6 12.6 11.6 10.6 9.6

Malaria Antigen Rapid tests 1*25 tests 33,516 6,535 6.6 5.6 10.8 9.8 8.8 Min - 3; Max 6

Malaria laboratory commodities

Malaria laboratory commodities



Antimalarial Medicines

Notes: Malaria commodities at NMS There are stock outs of the AL 12's and AL 18's with minimal stock levels for AL 6's, AL 12's. Pipeline are expected through GF PR1 in November 2016 for all Artemether/Lumefantrine 20/120mg formulations and in January 2017 for the malaria RDTs. The consumption for M-RDTs has increased drastically because high level facilities are using M-RDTs instead of the recommended microscopy. A MEMO is being drafting to this effect.

Notes: Malaria commodities at JMS All products are well stocked thus the PNFP sector is expected to be sufficiently served through the end of the year 2016 and early 2017. Orders through GF PR2 and PMI will be arriving in October for all pack sizes.

Category Unit of Measure

Closing Bal at


Determine HIV-1/2 Complete Kit, 100 Tests 100 Tests 37,429 11,993 2.1 5.1 4.1 3.1 3.5

HIV, Stat-Pak HIV 1 / 2 Kit, 30 Tests 30 Tests 21,526 1,949 10.0 9.0 8.0 7.0 6.0

HIV, Uni-Gold HIV Kit, 20 Tests 20 Tests 2,303 1,038 7.4 6.4 5.4 4.4 3.4

Roche Cobas AmpliPrep/Taqman HIV-1TesT, v2.0 48 Test-VL 48 Tests 1,965 480 3.1 2.1 1.1 0.1 0.0

Abbott RealTime HIV-1 Amplification Reagnt Kit,96Test,-VL 96 Tests 3,255 630 4.2 3.2 2.2 1.2 0.2

DBS collect.Kit VL sticker,50 Test, Single Use 50 Tests 3,824 1,300 1.9 0.9 0.0 0.0 0.0

Roche Cobas@KIT CAP-G/CTMHIV-1 QAUL 48 test CE-IVD EID 48 Tests 492 252 4.0 3.0 2.0 1.0 0.0

DBS Collect.Kit for EID,50 Tests, Single Use 50 Tests 982 350 4.8 3.8 2.8 1.8 0.8

BD FACS, MultiTest CD3/CD8/CD45/CD4, 50 Tests 50 Tests 642 89 6.2 5.2 4.2 3.2 2.2

BD FACSCount CD3/CD4 Reagent Kit 50 Tests 50 Tests 584 96 5.1 4.1 3.1 2.1 1.1

BD FACS Flow Shelth Fliud 20L 285 60 3.7 2.7 1.7 0.7 0.0

Partec-CD4 % Easy Count Kit 100 tests 100 Tests 742 125 4.9 3.9 2.9 1.9 0.9

Pima Analyzer CD4 Cartridge Kit, 100 tests 100 Tests 675 250 1.7 0.7 0.0 0.0 0.0 Min - 3; Max 6

A: NMS PART A

Laboratory Commodities


HIV test Kits

viral load commodities

Early Infant Diognosis (EID) Commodities

CD4+ commodities

Notes: Laboratory commodities at NMS - Determine is at a risk of stocking out. Shipment of 4MOS are expected in November 2016. Unigold and Stat Pak are well stoc ked. - VL-Abbort reagents are fairly stocked ,while EID reagents are at risk of stocking out. All deliveries by SCMS, MAUL, and GF were made. - CD4 reagents are generally well stocked except Pima reagents which are at a risk of stock out.


Closing Bal at


Cobas, C311, Creatinine Jaffe' Gen2 (CREA-J), 700 tests 700 Tests 598 82 6.3 5.3 4.3 3.3 2.3

COBAS, C311, ALTL, 500 Tests 500 Tests 465 82 4.7 3.7 2.7 1.7 0.7

COBAS, C311, ASTL, 500 Tests 500 Tests 422 82 4.1 3.1 2.1 1.1 0.1

Human, Autocreatinine 700 Tests 832 136 5.1 4.1 3.1 2.1 1.1

Human, GOT (ASAT) IFCC mod LiquiUV Kit, 10 x 10mL 500 Tests 8 102 0.0 0.0 0.0 0.0 0.0

Human, GPT (ALAT) IFCC mod LiquiUV Kit, 10 x 10mL 500 Tests 8 102 0.0 0.0 0.0 0.0 0.0

Humacount Diluent 20L 20L 2,149 161 12.3 11.3 10.3 9.3 8.3

Sysmex, Cellpack, 20L 20L 480 46 9.4 8.4 7.4 6.4 5.4

Nihon Kohden MEK Diluent 20L 20L 550 45 11.2 10.2 9.2 8.2 7.2

Beckman Coulter, AcT5Diff, Diluent 20L 20 L - 24 2.0 4.0 3.0 2.0 1.0

GeneXpert catrigdes 50 Tests 910 97 8.0 7.0 6.0 5.0 4.0

Strong Carbol Fuschin 1000ml Solution (ZN) 1000 ML - 52 0.0 0.0 0.0 0.0 0.0

Blood Collection Tube, K2 EDTA, 4mL, Lav, 100 Pcs 100 pcs 12,624 4,430 1.8 0.8 0.0 0.0 0.0

Syphilis testing devices, 30 tests 30tests 19,406

Syphilis RPR Kit, 100 Tests 100 Tests 3,650 750 3.9 2.9 1.9 0.9 0.0 Min - 3; Max 6

Min - 3; Max 6

A: NMS PART B


Other commodities

chemistry commodities

Heamatology commodities

TB Laboratory commodities

Notes: Laboratory commodities at NMS - Chemistry and Hematology reagents are fairly stocked. - GeneXpert Catridges are well stocked; however with the change in TB testing algorithm, consumption will increase thus a risk of stock out in 2017. - ZN and FM reagents are still stocked out. NMS is expected to make a call off for Sputum containers and ZN reagents. - Blood sample collection materials and syphilis kits are at risk of stocking out. - Syphilis kits are well stocked up to the end of the year.


Closing Bal at


HIV test kits


HIV, Stat-Pak HIV 1 / 2 Kit, 20 Tests 30 Tests 1,010 415 1.4 0.4 0.0 0.0 0.0

HIV, Uni-Gold HIV Kit, 20 Tests 20 Tests - 334 0.0 0.0 0.0 0.0 0.0

CD4+ Commodities

BD FACS, MultiTest CD3/CD8/CD45/CD4, 50 Tests 50 Tests 109 10 9.9 8.9 7.9 6.9 5.9

BD FACSCount CD3/CD4 Reagent Kit 50 Tests 50 Tests 117 13 8.0 7.0 6.0 5.0 4.0

BD FACS Flow Shelth Fliud 20 Litres 299 36 7.3 6.3 5.3 4.3 3.3

Partec-CD4 % Easy Count Kit 100 tests 100 Tests 77 12 5.4 4.4 3.4 2.4 1.4

Pima Analyzer CD4 Cartridge Kit, 100 tests 100 Tests 42 30 0.4 0.0 0.0 0.0 0.0

Chemistry Commodities

Human Creatinine Liquicolor 250Ml 400 Tests 93 26 2.6 1.6 0.6 0.0 0.0

Human, GOT (ASAT) IFCC mod LiquiUV Kit, 10 x 10mL 500 Tests 32 16 1.0 0.0 0.0 0.0 0.0

Human, GPT (ALAT) IFCC mod LiquiUV Kit, 10 x 10mL 500 Tests 28 16 0.8 0.0 0.0 0.0 0.0

Heamatology Commodities

Humacount Diluent 20L 20 Litres 6 18 0.0 0.0 0.0 0.0 0.0

Sysmex, Cellpack, 20L 20 Litres 223 36 5.2 4.2 3.2 2.2 1.2

Other commodities

Blood Collection Tube, K2 EDTA, 4mL, Lav, 100 Pcs 100 Tests 3,524 635 4.5 3.5 2.5 1.5 0.5 Min - 3; Max 6

Min - 3; Max 6

B: JMS


Notes: Laboratory commodities at JMS Statpak and Uni-Gold are stocked out. JMS will receive Stat Pak from NMS to replenish stock levels. CD4 reagents are generally well stocked except Pima reagents Chemistry and Hematology reagents are running out very soon

mailto:Cobas@KIT%20CAP-G/CTMHIV-1%20QAUL%2048%20test%20CE-IVD-%20EID


Closing Bal at



HIV, Stat-Pak HIV 1 / 2 Kit, 30 Tests 30 Tests 2,066 327 5.3 4.3 3.3 2.3 1.3

HIV, Uni-Gold HIV Kit, 20 Tests 20 Tests 510 120 3.3 2.3 1.3 0.3 0.0

BD-MultiTest CD3/CD8/CD45/CD4% with TruCOUNT Tubes 50 Tests 1,867 107 17.2 16.2 15.2 14.2 13.2

BD-FACS Count Reagent Kit, (Single Tube) 50 Tests 638 89 6.2 5.2 4.2 3.2 2.2

BD-FACS Flow Shelth Fluid 20 Litres 253 27 8.4 7.4 6.4 5.4 4.4

Partec, Counter CD4, CD4% Easy count kit 100 Tests 29 9 2.2 1.2 0.2 0.0 0.0

PIMA Cartridges 100 Tests 7 23 0.0 0.0 0.0 0.0 0.0

Guava CD4/CD4% Reagent kit + Lysing Solution 100 Tests 1 5 0.0 4.0 3.0 2.0 1.0

Vacutainer Tubes EDTA 4ML 100 Tests 6,716 1012 5.6 6.9 5.9 4.9 3.9 Min - 3; Max 6

C: Medical Access Uganda Limitted

Other commodities

CD4+ Commodities

HIV test Kits


Notes: Laboratory commodities at MAUL HIV Test kits are fairly stocked with minimal risk of stock out. CD4 reagents are well stocked; however Partec, Pima and Guava are stocked out.

A: NMS


Closing Bal at 30th

Sept 2016 AMC Sept 2016 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17

Fluconazole 200mg Tab (Diflucan) 1*28 tabs - 13,039 1.8 0.8 0.0 0.0 0.0

Fluconazole 2mg/ml I.V. Infusion 100ml 1 - 1,500 7.6 6.6 5.6 4.6 3.6

Fluconazole POS 200ml 1 - 3,257 4.6 3.6 2.6 1.6 0.6

Cotrimoxazole 120mg, 1000 Tabs 1*1000 tabs 24,253 5,642 3.3 8.5 7.5 6.5 5.5

Cotrimoxazole 960mg Tabs , 1000 tabs 1*1000 tabs 78,702 20,272 2.9 6.8 5.8 4.8 3.8 Min - 3; Max 6

B: JMS


Closing Bal at 30th


Fluconazole 200mg Tab (Diflucan) 1*28 tabs - 1,095 0.0 0.0 0.0 0.0 0.0

Fluconazole 2mg/ml I.V. Infusion 100ml 1 - N/A 0.0 0.0 0.0 0.0 0.0

Fluconazole POS 200ml 1 - 225 0.0 0.0 0.0 0.0 0.0

Cotrimoxazole 120mg, 1000 Tabs 1*1000 tabs 2,728 450 5.1 4.1 3.1 2.1 1.1

Cotrimoxazole 960mg Tabs , 1000 tabs 1*1000 tabs 23,609 2336 9.1 8.1 7.1 6.1 5.1 Min - 3; Max 6

C : Medical Access Uganda Limited

Item description Unit of Measure

Closing Bal at 30th


Fluconazole 200mg Tab (Diflucan) 1*28 tabs 370 1,259 4.5 3.5 2.5 1.5 8.4

Fluconazole 2mg/ml I.V. Infusion 100ml 1 74 135 6.7 5.7 4.7 3.7 2.7

Fluconazole POS 200ml 1 68 75 12.7 11.7 10.7 9.7 8.7

Cotrimoxazole 120mg, 1000 Tabs 1000 3,551 717 4.0 3.0 2.0 1.0 0.0

Cotrimoxazole 960mg Tabs , 1000 tabs 1000 34,712 7,124 3.9 2.9 1.9 0.9 0.0 Min - 3; Max 6




Medicines for opportunistic infections

Notes: Medicines for OIs at MAUL: Cotrimoxazole formulations are well stocked. All fluconazole formulations are well stocked.

Notes: Medicines for OIs at NMS Cotrimoxazole 960mg and Cotrimoxazole 120mg are well stocked with pipeline expected in October 2016 . Fluconazole formulations are still stocked out at NMS as orders previously placed through the Diflucan partnership are still undergoing port clearence. Fluconazole is thus expected to be available at facilities early November 2016. NMS will be expected to transfer some of this stock to Joint Medical Stores Dates for delivery for the remaining fluconazole orders are yet to be communicated.

Notes: Medicines for OIs at JMS Cotrimoxazole formulations are well stocked. Orders have been placed to fill the pipeline for 2017 to avoid stock outs because of the long lead times experienced with this formulation. All fluconazole formulations are stocked out at JMS. Stock will be transferred from NMS once custom clearrance are concluded. Additonal orders were placed with PEPFAR pending communication on the status of dellivery .

Item description Unit of Measure

Closing Bal at


Penta vaccine (DPT- HEPB +HIB) 10 dose vial 1 vial 413,700 40,723 9.5 8.5 12.4 11.4 10.4

Bacillus Calmette -Guerin (BCG) 20 dose vial 1 vial 82,300 138,897 2.2 3.3 2.3 1.3 0.3

Hepatitis B Vaccine - 10 dose vial 1 vial 526,228 34,571 14.2 13.2 12.2 11.2 10.2

Measles vaccine - 10 dose vial 1 vial 10,690 16,116 6.5 5.5 4.5 3.5 2.5

Polio Bivalent vaccine (BOPV) 20 dose vial 1 vial 4,950 32,888 2.2 5.1 4.1 3.1 2.1

Inactivate Polio Vaccine (IPV) 1 vial 78,960 38,000 2.1

Human Papiloma Vaccine (HPV) 1 vial 1,043,470 187,190 6.4 5.4 4.4 3.4 2.4

Rabies Vaccine 10 dose vial 1 vial 8,889 2,071 4.3 3.3 2.3 1.3 0.3

Tetanus toxoid vaccine (TT) 20 dose vial 1 vial 41,655 17,585 4.6 3.6 2.6 1.6 0.6

Pneumococcal conjugate (PCV) 1 vial 1,484,200 233,654 8.6 7.6 6.6 5.6 4.6 Min - 3; Max 6


Vaccines

Notes: Vaccines Most of the commodities are well stocked. Orders are expected for Polio Bivalent and BCG vaccine. Additional orders need to be placed for Rabies.

A: NMS

Item Description Unit of Measure

Closing Bal at 30th


Depo-Provera 1 vial 753,600 74,364 9.1 8.1 7.1 6.1 5.1

Implants (Implanon) 1 vial 58,269 3,851 14.1 13.1 12.1 11.1 10.1

IUD - Copper Containing Device TCU380A*** 1 - - 0.0 0.0 0.0 0.0 0.0

Male Condom (52MM with and without Logo) 1 - 3,430,374 0.0 0.0 0.0 0.0 0.0

Mama Kit 1 116 39,498 0.0 0.0 0.0 0.0 0.0

Levonorgestrel 750mcg (Emergency Contraceptive)*** 2 - - 0.0 0.0 0.0 0.0 0.0

Misoprostol 200mcg Tabs 100 7,256 913 6.9 5.9 4.9 3.9 2.9

Combined Oral Contraceptives (Microgynon) 1*3 2 5,466 0.0 0.0 0.0 0.0 0.0 Min - 3; Max 6

Item Description Unit of Measure

Closing Bal at 30th


Depo-Provera 1 vial 143,175 177,108 0.0 0.0 0.0 0.0 0.0

Implants (Implanon) 1 42,492 31,099 0.4 0.0 0.0 0.0 0.0

IUD - Copper Containing Device TCU380A 1 110,749 16,050 5.9 4.9 3.9 2.9 1.9

Male Condom (52MM with and without Logo) 1 8,640,000 12,438,816 0.0 0.0 0.0 0.0 0.0

Levonorgestrel 1.5 mcg(Emergency Contraceptive) 1 64,056 10,644 5.0 4.0 3.0 2.0 1.0

Misoprostol 200mcg Tabs 100 18,252 5,833 2.1 1.1 0.1 0.0 0.0

Combined Oral Contraceptives (Microgynon) 1 1,482,972 29,721 48.9 47.9 46.9 45.9 44.9

Female Condoms 1 2,198,000 29,721 73.0 72.0 71.0 70.0 69.0

Norigynon 1 231,000 34,467 5.7 4.7 3.7 2.7 1.7

Noristerat 1 860,894 94,266 8.1 7.1 6.1 5.1 4.1

Jadelle 1 55,400 15,867 2.5 1.5 0.5 0.0 0.0 Min - 3; Max 6

Highlighted commodities are

transferrable to NMS

Highlighted commodities

are transferrable to NMS



Reproductive Health Commodities

B: UHMG

Reproductive Health Commodities at NMS Most of the reproductive health commodities are stocked out except for Depo-provera and Implanon that are over stocked. Male condoms, Emergency contraceptives and microgynon may be transferred from UHMG when required by NMS. Of the 129,593,808 pieces of Ministry of Health Global fund condoms, only 8,640,000 pieces are available for distribution while the reemaining quantities are under quarantine. Pipeline of 26 millions male condoms are undergoing port clearance while the 56 million pieces expected in December 2016. A call off for Maama kits is ongoing of 208,500 and 19,765 worth 5.8 MOS. 130,000 pieces of Implanon were transferred to UHMG. ***The uptake of these commodities in the public distribution channel has been slow thus NMS has not stocked these commodities. NMS will be picking required

Notes: Reproductive Health Commodities Private sector Depo-provera and implanon are stocked out while the rest of the products are sufficently stocked until December 2016. Orders for Microgynon and Jadelle have been placed. Expected dates of delivery are yet to be communicated. All the Implanon stock received from NMS was distributed to facilities. There need to access utilisation implanon at facility level.

A: NMS

First Line TB Medicines

Item Description Pack size

Closing Bal at 30th


Isoniazid 100mg Tablet,100 1*100 tabs 231 147 0.6 0.0 0.0 0.0 0.0

Isoniazid 300mg Tablet, 672 1*672 tabs 1,276 524 1.4 0.4 0.0 0.0 0.0

2-FDC RH (150/75) 150+75mg 28 Tablets ,24 1* 672 tabs 39,265 1,857 20.1 19.1 18.1 17.1 16.1

3-FDC RHE (150/75/275) 150+75+275mg Tablet 1* 672 tabs 992 234 3.2 2.2 1.2 0.2 0.0

3-FDC RHZ (60/30/150) 60+30+150mg Tablet 1* 84 tabs 11,432 678 15.9 14.9 13.9 12.9 11.9

2-FDC RH (60/30) 60+30mg 1* 84 tabs 23,249 1,262 17.4 16.4 15.4 14.4 13.4

4-FDC RHZE (150/75/400/275) 150+75+400+275mg 1*672 tabs 15,066 1,634 8.2 7.2 6.2 5.2 4.2

Streptomycin 1000mg Powder/Vial 1 1 vial 763,300 23,150 32.0 31.0 30.0 29.0 28.0 Min - 3; Max 6

MDR TB Medicines

Item Description Pack size

Closing Bal at 30th


Capreomycin 1000mg Powder for injection 1 1 vial - 504 8.7 7.7 6.7 5.7 4.7

Kanamycin 1000mg Powder for injection 1*10 vials 2,198 295 6.5 5.5 4.5 3.5 2.5

Cycloserine 250mg Capsule(s) 100 1*100 caps 4,407 463 8.5 7.5 6.5 5.5 4.5

Ethionamide 250mg Film coated tablet(s) 100 1*100 tabs 6,133 456 12.4 11.4 10.4 9.4 8.4

Levofloxacin 250mg Film coated tablet(s) 100 1*100 tabs 1,384 447 2.1 1.1 0.1 0.0 0.0

Moxifloxacin 400mg Film coated tablet(s) 5 1*5 tabs 377 18 19.9 18.9 17.9 16.9 15.9

P-aminosalicylate sodium salt 4000mg Powder 1*25 sachets 620 78 6.9 5.9 4.9 3.9 2.9

Pyrazinamide 400mg Film uncoated tablet(s) 1*672 tabs 357 90 3.0 2.0 1.0 0.0 0.0 Min - 3; Max 12



TB Medicines

Notes: First line anti-Tuberculosis medicine Most of the commodities are well stocked except for Isonaizid 100mg and Isoniazid 300mg tabs which are stocked out . Orders have been placed pendng confirmation of delivery date . RHE 150/75/275mg is at a risk of stock out. These shipmens are being brought forward to fill the curren gap RH 150/75 is at a risk of expiry in October 2017 due to delays and consolidation of deliveries.

MDR Tuberculosis medicines Most of the MDR-TB commodities are well stocked except for Levofloxacin and Pyrazinamide that are at a risk of stock out by Jan 2017. Clofazimine, Amikacin and Capreomycin shipments under the USAID mission donation are expected in country by end of October 2016. Levofloxacin pipeline of 12 MoS from GDF previously expected in August 2016 has been delayed with no expected time of arrival communicated by the supplier. GoU has requested NMS to fill a three months gap. Other commodities expected through the NMS gap fill include Pyrazinamide and Kanamycin. Moxifloxacin consumption is currently erratic due to its use in individualised patient regimen . Currently there is only one facility using this product. and with an expiry

Regimen Stock available AMC AMCNumber of

units in excessAMC

Number of

units requiredTotal Stock Net AMC MOS

Kanamycin 1g Vial 6,026 1,898 864 140 4,530 2,832 11,420 4,870 2.3

Capreomycin 1g vial 72 26 250 - 138 90 460 116 4.0

Ethionamide 250mg tab 18,606 5,640 26,750 5,380 21,450 21,690 66,806 32,710 2.0

Levofloxacin 250mg tab 38,450 12,960 31,540 6,170 9,377 17,400 79,367 36,530 2.2

Moxifloxacin 400 mg tab - - 0.0

P-aminosalicylate sodium salt 4000mg Powder/Sachet 600 540 600 540 1.1

Pyrazinamide 400mg 29,280 11,400 189,937 9,660 21,890 29,060 241,107 50,120 4.8

Cycloserine 53,349 22,120 30,010 6,090 6,273 4,590 89,632 32,800 2.7

Facility stock status report

MDR TB medicines facility stock status as of 1st August 2016

Min 2; Max 4

facilities with adequate stock Facilities With Excess units Facilities That Need StockTotal stock available

Facility MDR-TB stock status Most of the commodities are well stocked except fot Moxifloxacin 400mg and P-aminosalictylate 4000mg that are stocked out. Moxifloxacin will be replenished with supplies from NMS.

ARV facility stock status as of 1st October 2016

Closing Balance AMC Closing Balance AMC Closing Balance AMC Total Stock Net AMC MOS

Abacavir/Lamivudine (ABC/3TC) 600mg/300mg 9,186 3,615 45,733 4,121 1,634 2,493 56,552 10,229 5.5

Atazanavir/ritonavir (ATV/r) 300mg/100mg 18,309 7,180 34,319 3,250 5,114 4,514 57,742 14,944 3.9

Efavirenz (EFV) 600mg 135,867 54,182 318,248 36,854 32,774 36,833 486,889 127,870 3.8

Lopinavir/Ritonavir (LPV/r) 200mg/50mg 26,008 10,525 25,676 2,917 6,131 4,751 57,815 18,192 3.2

Nevirapine (NVP) 200mg 74,493 30,978 220,334 15,182 23,453 21,588 318,280 67,748 4.7

Tenofovir/Lamivudine (TDF/3TC) 300mg/300mg 144,375 60,485 329,558 39,265 43,554 45,647 517,487 145,397 3.6

Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV) 300mg/300mg/600mg 437,229 183,090 527,915 75,342 103,852 111,073 1,068,996 369,505 2.9

Zidovudine (AZT) 300mg 120 50 4,663 32 204 231 4,987 313 16.0

Zidovudine/Lamivudine (AZT/3TC) 300mg/150mg 74,902 31,856 288,194 27,047 18,032 17,256 381,128 76,158 5.0

Zidovudine/Lamivudine/Nevirapine (AZT/3TC/NVP) 300mg/150mg/200mg242,341 98,494 409,232 49,289 43,819 50,888 695,392 198,670 3.5

Abacavir (ABC) 60mg 24 10 1,096 22 23 35 1,143 67 17.2

Abacavir/Lamivudine (ABC/3TC) 60mg/30mg 36,782 14,302 208,451 15,525 8,538 10,700 253,770 40,527 6.3

Efavirenz (EFV) 200mg 7,800 2,927 59,540 3,311 1,658 3,078 68,998 9,316 7.4

Lopinavir/Ritonavir (LPV/r) 100mg/25mg 7,126 2,483 26,442 1,393 1,022 1,700 34,589 5,575 6.2

Lopinavir/Ritonavir 80/20ml oral syrup 183 70 8,188 474 934 1,851 9,305 2,394 3.9

Nevirapine (NVP) 10mg/ml oral susp. 608 141 18,194 2,257 5,856 3,363 24,658 5,761 4.3

Nevirapine (NVP) 50mg 11,214 4,569 46,431 2,724 4,117 7,406 61,762 14,699 4.2

Zidovudine/Lamivudine (AZT/3TC) 60mg/30mg 8,045 3,161 124,170 8,306 2,734 3,400 134,949 14,867 9.1

Zidovudine/Lamivudine/Nevirapine (AZT/3TC/NVP) 60mg/30mg/50mg 37,349 14,780 217,458 18,609 13,743 13,696 268,550 47,085 5.7

Fluconazole 200mg 3,306 1,286 20,627 1,268 1,556 3,982 25,488 6,536 3.9

Fluconazole IV 218 88 5,084 90 151 548 5,453 725 7.5

Fluconazole oral solution 271 117 4,282 128 126 280 4,679 525 8.9

Cotrimoxazole 120mg 3,089 1,183 17,086 1,526 1,354 1,937 21,530 4,646 4.6

Cotrimoxazole 960mg 27,078 10,252 26,994 3,464 11,116 10,756 65,188 24,472 2.7

Item Description

Adult formulations

Pediatric formulations

Medicines for Opportunistic infections

Normal Over Stocked Under stockedTotal stock available

ICCM Program Stock status

A : National Medical Stores /UNICEF

Product Name

Unit of measure

(Pack)

Closing Bal at 26

th October

AMC October

2016 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17

Co-packaged ORS and zinc tablets (2 sachets ORS/10 tab zinc) 1 pack 749,289 228,665 3.3 4.9 3.9 2.6 1.6 0.6

Amoxicillin 1*10 Tablets Pack of 10 - 182,932 0.0 3.2 3.2 2.6 6.5 5.5

Amoxicillin 1*20 Tablets Pack of 20 - 228,665 0.0 3.2 3.2 2.6 6.5 5.5

Amoxicillindispersible tablets Pack of 100 253,620 64,130 4.0 3.0 2.0 1.0

Amoxicillin envelopes Red Pack 1,512,300 182,932 8.3 7.3 7.8 6.8 5.8 4.8

Amoxicillin envelopes Green Pack 1,838,500 228,665 8.0 7.0 7.6 6.6 5.6 4.6

Artemether/Lumefantrine 20mg/120mg 6 pack 1*30 strips 20,846 7,622 2.7 2.5 1.9 0.9 1.7 0.0

Artemether/Lumefantrine 20mg/120mg 12 pack 1*30 12,399 7,622 1.6 1.4 1.0 0.0 1.7 0.0

Malaria RDTs ( Combined iCCM ) 1*25 tests - 45,733 0.0 1.1 0.1

Safety Boxes Piece - 45,733 0.0 1.5 0.5 0.0 0.0 0.0

Examination gloves Box of 50 pairs 156,485 45,733 0.0 0.8 0.0 0.0 0.0 0.0


Non malaria commodities iCCM

Malaria commodities

iCCM supplies

Notes: ICCM New additional 10 northern districts expected to start implementtaion in Dec Non malaria commodities expected awaiting confirmation of delivery dates. Amoxiciliin repackaged in 100 pack size to be used in place of 10s and 20s till early next year. ORS stock sufficient, Facilities reported to have over stocks . Artemether Lumefantrine ; Additional orders placed awaitng confirmation of delvery dates. Safety boxes and Gloves; Awaiting confirmation of orders placed. There are plans to revise Kit using morbidity data repoted

MINISTRY OF HEALTH PHARMACY DIVISION STOCK STATUS … SSR 1st October 2016.pdf · NMS is expected...

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