Overview of UNICEF procurement of Safe Injection Equipment · Overview of UNICEF procurement of ......
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Overview of UNICEF procurement of
Safe Injection Equipment
Safe Injection Equipment
Industry Consultation
21st – 22nd April 2015
Rob Matthews, HTC
Objective of Session
• Provide an overview of UNICEFs engagement in Safe Injection Equipment (SIE) procurement
• Strengths and Challenges faced
• Share Findings from Analysis undertaken
Source: UNIICEF Supply Division
Immunization Supplies
Vaccines
Safe Injection Equipment
Cold Chain Equipment
Safe Injection Supplies: US$ 42.2 million907
Million Pieces
doses
1320
Transactions2014
Countries UNICEF
procures Injection devices
on behalf of:
Full schedule
Partial schedule
Source UNICEF Supply Division
613
Shipments
UNICEF has a key role in Immunization procurement, including Vaccines, Safe Injection Equipment and Cold Chain Equipment; procuring immunization supplies on behalf of around 100 countries annually
Scope of Activities covered
Commercial
• Responsible for the supply operation including
strategic market intelligence, forecasting,
procurement, delivery, innovation and analysis of
product groups and procurement strategies
• Ensure on-time delivery and operational efficiency
• Collaborate with partners to increase access,
decrease prices, establish a healthy, competitive
supplier base and sustainable supply, including
that can be accessed by government buyers
• Ensure appropriate Emergency Response
• Support optimization projects
• Support knowledge sharing via communication
pieces on key products/markets and publication
of information
• Achieve targeted supply outcomes for relevant
result areas
Technical
• Quality Assurance
• Technical oversight and review
• Provision technical assistance and knowledge management
• Responsible for ensuring expertise on products
• Complaints Handling
• Support knowledge sharing via communication pieces on key products/markets and publication of information
• Product performance assessments
• Product Innovation
• Product Pipeline
• Engagement with Technical Partners
Safe Injection Equipment – UNICEF Product Scope
Contributing Directly to 2 MTSP Result Areas
Result 1: Survival during delivery and the neonatal period and living free from preventable diseases and disability;
Result 2: Protected from HIV infection and free from AIDS.
Commodity Overview
5 Commodity Groupings Programme Focus Areas Usage/ Application Product Strategic Profiling
Auto-Disable (AD) Syringes Immunization Injection for Immunization 29 Standard Stock Materials
All considered Strategic due to their role in
Immunization and Emergency response and
UNICEF’s role in the market
Primary Demand Immunization (>90%); Curative
Demand principally for Kits
Safety Boxes Immunization & Curative Safe Disposal of Syringes
Disposable Syringes Immunization & CurativeReconstitution of Vaccines; As
part of Health KitsRe-Use Prevention (RUP)
SyringesImmunization & Curative
Needles Curative Health Kits
Immunization Devices – UNICEF Product Scope
Injection Devices Supply Overview
What’s Good What’s Challenging
• Positive Market
developments
• Supply base for Injection
Devices is good*
• 5 year shelf life
• Comparative cost (to
vaccines)
• 0.5ml AD syringe used for
multiple vaccines
• Opportunities to improve
delivery efficiency
• Engaged Partners and
established partner forums
• Geographically spread supply base
• Sea Shipment lead times (2-4 months)
• Timely Funds Availability
• Poor Forecast Accuracy*, particularly for
supplementary activities
• Focus on Vaccines, not Injection Devices
• Large storage capacity required
• Demand driven by multiple vaccines &
programmes
• Technically acceptable supplier base for Safety
Boxes
• Price levels for RUP and SIP featured Syringes
• Bundled deliveries of all safe injection materials
• Effective Waste Management remains an
unsolved issue
Immunization – frequently cited as the most cost effective health intervention…..
• 32% of child mortality is from vaccine preventable diseases…
• Where safe injection equipment plays a key role
Procurement Value 2013
Procurement Volume 2013 Average shipment time excl. Order LT and FFwdr 2013 (Days)
No of Shipments 2013
Product Diversity within the Immunization Context
Profile Vaccines Injection Devices
Product profile Biological Plastics
Quality Assurance WHO PQ, GMP, Batch Release WHO PQS, UNICEF Tech. Assessment, Field Test, Inspection
Production Lead time 6-24 months 2-4 weeks
Storage requirements Temp controlled (Cold Chain) Dry Stores
Supply Base Restricted Healthy (Ability to respond dependent on forecast accuracy)
Shelf life 2 years 5 Years
Shipment Mode Air Sea
Influencing Markets
• AD Syringes– Reduction in the WAP (>10%), estimated savings >$5m for tender
period (2014-2015)– Implementation of Landed cost evaluation– Quality Assured supply base– Healthier market, 4 suppliers, more balanced– Injection Safety
• Programmatic Preference for disabling technology implemented on activation of Device
– Focus on Sustainability• All 0.5ml suppliers contracted > 1,3m pieces per 40’ Container
(Offers rcvd: 500k – 1.8m)
• Safety Boxes– Reduction in the WAP in prior tender round (>10%), estimated
savings >$500,000 for tender period– Implementation of Landed cost evaluation– Quality Assured supply base– Healthier market challenged by technically acceptable supplier
base
• Reconstitution Syringes– Demand moving towards Re-Use Prevention (RUP) syringes,
principally funded by GAVI, not countries– Pricing of RUP and RUP with SIP (stick-injury protection) remains a
barrier– WHO Policy issued for use of RUP and SIP featured syringes for
therapeutic markets– Manage the transition from Disposable to RUPs for Reconstitution
• Disposable Syringes and Needles– Highly volatile demand profile due to emergency response
AD Syringe Volumes and WAP 2005 - 2014
Safety Box Volumes and WAP 2005 - 2014
Disposable and RUP Volumes and WAP 2005 - 2014
5ml Reconstitution Syringe Volumes and WAP 2005 -2014
Needles Volumes and WAP 2005 - 2014
Value of UNICEF SIE procurement 2005 - 2014
2005
Joint UNICEF, WHO, UNFPA
Policy Issued
Auto-Disable (AD) as a step-
stage technology (added
attribute to already established
technology)
1999
AD @ start
RUP
SB
AD
RUP/SIP
UNICEF Expressed preference for
early activation of the disabling
mechanism (to reduce risk of reuse)
leading to redefining technology and
improve product design
AD
AD @ start
2009 Adequate Supply
Available with
preferred AD
mechanism for full
award - with multiple
suppliers
2008
Introducing the RUP &
RUP/SIP feature for
reconstitution of freeze
dried vaccines
RUP/SIP
RUP
2015
Introducing the RUP &
RUP/SIP in therapeutic
injections- WHO Policy
issued in Feb 2015
Needle-free
devices
NEW
Safe Injection Device Development and Innovation
Service Delivery
Opportunity for Efficiencies,
expansion, refinement
Key Success factor, critical
management and monitoring
The Dream The Reality
The Dream The Reality
The ordering process by design creates an increasing number of activities
Country Example
Service Delivery: ensuring focus on the whole supply chain, engaging all Stakeholders
Throughout the process collaborative planning is key:Campaign Safe Injection Equipment order timelines
• Scheduled Campaign date January 2015; Devices indicated to arrive in February 2015
• Orders driven by funds release, not program needs and realistic lead times
• Reprioritising orders of routine orders impacts other countries supplies – where planning was adequate
• Alternative remedies sought - Potential use of local stock to be investigated
• Risk of poor results, delayed campaigns which could be avoidable through better planning; earlier funding
• Increased Advocacy with key stakeholders required
2014: Changed operating approach to consolidate GAVI shipments (50% of total orders)
Country Example
Opportunities for Supply Chain improvement initiatives
UPDATE
Procurement development over the past 5 years
GAVI playing an increasing role
Consolidation of shipments shows a reduction in Shipments, most notably for GAVI
Savings gained in the last tender round reflected in the Value/ Volume statistics
Data Source: UNICEF SD ZSOS based on PO Year – covering all IID products
LTA Supply Base
AD Syringes
Reconstitution
Syringes
AD and Reconstitution
Syringes
Safety Boxes
AD and Recon
Syringes and
Safety Boxes
Demand Profile by
Region
Shown as a
Percentage of
total UNICEF
demand by
UNICEF Region
40%
7%
26%3%
2%
13%
Source: UNICEF SD PO quantities by region 2010- 2014
XX
%
9%
Supply and Demand Mapping of AD Syringes; Safety Boxes; Reconstitution Syringes
Analysis of Sea shipment lead times for Injection Devices over a 4 year period (2010 - 2013)
A wide range of transit times, depending on source and consignee country with an average of 43 days and a standard deviation of 24 days.
Freight Forwarder lead times for securing shipments is 14 days.
Supplier lead times vary from 10 – 30 days for forecast demand following placement of the order, depending both on the supplier and the order volumes.
Using a 20 day order lead time, 14 freight planning, 43+24 shipment transit time - assuming no delays, and not considering customs clearance and in country distribution requirements gives a lead time of : 20 + 14 + 43 + 24 = 98 days
Country Specific Shipment Lead times
Products are sourced Globally
Order lead times are supplier specific
Shipment lead times are supplier –consignee specific
Safe injection Equipment is sourced globally by product and often not consolidated across products before shipment, unless shipped from SD Warehouse or suppliers contracted for multiple products
Supply Chain strengthening through collaborative planning
Myanmar MR Campaign. Target Population17.5mLogistics challenge: Insufficient warehousing capacity for dry stock; Bottleneck at Central level
Solution: Share regional distribution plans before order placement; Procure containers; Pack for direct regional distribution; Combine all devices (AD’s Recon syringes, Safety Boxes) at central level for onward distribution
Enabler: Early planning and Funding, Collaboration across stakeholders along the supply chain
Changing Focus - Engaging partners along the supply chain to address challenges and country constraints
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Developing synergies improving the overall performance of the supply chain
SCSC
Supply Chain improvement initiativesStructured framework and iterative approach for Forecast Improvement
Prioritize & Identify Key
Drivers
Engage Stakeholders
Structured Empirical
Methodology
Adjust & Develop Forecast
Methodology
Undertake Forecast Exercise
Monitor Forecast Accuracy
Analyze
Identify causes of variance/ volatility
Identify & Implement Corrective
Action
IMPROVEMENT
Past 3 years forecast accuracy > 20% variance
Reviewed Forecast approach for Injection Devices
Performance Monitoring On Time Arrival
Performance Monitoring On Supplier performance
Emergency Response
• Emergency response provisions in established LTAs
• Stocks in Copenhagen warehouse for emergency response
• Forecasting and Warehouse replenishment for emergency demand challenging – identified risk area
2014 Performance
9 of 40 Emergency response lines
late
6 shipments, All ex-warehouse,
Due to consolidation and closed
borders (CAR)
2015 UNICEF Supply Focus Areas
Engage Key Countries, Donors and Industry to address Supply related issues – along the whole supply chain
• Key Countries – Work together to Improve forecast accuracy
• Key Donors – Leveraging funds – early order placement; improve contractual terms
• Industry – Engage industry in addressing challenges, improving program results
• UNICEF Supply Division – Develop a Procurement Strategy to address program needs
• Opportunities for improving operational efficiency
• Leverage Partnerships