HIV/AIDS COMMODITIES TRACKING TOOL
Development of the HIV/AIDS Commodities Tracking Tool (CTT) is a Management Sciences for Health Center for Pharmaceutical Management activity funded by the Bill & Melinda Gates Foundation and the U.S. Agency for International Development through the SEAM and RPM Plus Programs, respectively.
The purpose of the tool is to track funds requested and expended on HIV/AIDS-related pharmaceuticals and other commodities as well as the quantities of pharmaceuticals arriving in countries (including donated products) in support of global HIV/AIDS initiatives by various donor organizations.
** NOTE – The screen captures provided in the following pages include fictitious data for demonstration purposes only and in no way reflect the actual amount expended by the listed parties.**
Introduction Background:
On July 2, 2003, representatives from the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM), the World Bank (WB) and the U.S. Government (USG), including the State Department, the Centers for Disease Control and Prevention (CDC), HHS, HRSA, and USAID, met to discuss issues related to pharmaceutical
management at the country level in the face of the expected scale up of HIV/AIDS care and treatment programs. The Global Fund, the World Bank, and the USG HIV/AIDS initiatives all include funding that will be used to make HIV/AIDS-related commodities, including the necessary pharmaceuticals, more accessible.
The July 2nd meeting was meant to serve as a short, informal, initial discussion to agree on issues of common interest and concern and to develop a common approach for moving forward. The objectives of the meeting were as follows:
1. Identify HIV/AIDS commodities management issues of concern to key global partners;
2. Determine interest in promoting coordinated efforts in the area of HIV/AIDS commodities management system strengthening;
3. Discuss the potential for establishing an on-going process or mechanism for consultation, coordination, and information sharing.
Based on this meeting, Management Sciences for Health (MSH) through its Center for Pharmaceutical Management (CPM) made the decision to review options that would facilitate information sharing and to implement development of such a system for purposes of tracking initiatives that target HIV/AIDS-related pharmaceuticals and other commodities.
Need for Information Sharing:
In light of the HIV/AIDS epidemic, there have been a myriad of donor programs for developing countries that are targeting the supply and use of HIV/AIDS pharmaceuticals and other commodities. At the same time, the knowledge base for HIV/AIDS medicines is continually growing and changing, with information on the availability of and prices for new therapeutic agents, recommended prevention and treatment guidelines, and the adverse effects and other experiences associated with use of newer agents being in a state of continuous flux.
It is critical that this dynamic base of information be effectively catalogued, monitored, and shared so that policy makers and program managers in donor organizations, developing countries, and international support groups will be able to make the most appropriate policies and decisions relating to program funding and implementation. Although keeping track of all of this information is ultimately the responsibility of the various country and donor programs and the people working in those programs, the availability of a Web-based information sharing network for data collection and dissemination would facilitate the process greatly.
MSH Approach to Addressing the Need:
After an analysis of needs and options for addressing those needs, MSH determined that a Web-based information tracking system, centrally maintained and accessible to all stakeholders, was determined to be the preferred approach for keeping track of multi-faceted, rapidly changing information. Synergy International System’s commercial off-the-shelf Web database and Web portal Intelligent Data Manager™ technology
software was identified as the ideal platform on which to build this database. The initial work and purchase of the software have been funded by the SEAM Program, through a grant from the Bill & Melinda Gates Foundation.
Following a review of information needs, MSH staff worked closely with staff from Synergy International Systems to adapt their commercial-off-the-shelf software for the HIV/AIDS-related commodities tracking system. MSH staff will coordinate entry of the data into the system and provide its ongoing maintenance. This latter activity is being proposed for support and implementation through the USAID-funded RPM Plus Program.
As part of an ongoing monitoring process, the RPM Plus Program would review the information in the database to ensure that proposed procurements are in line with national standard treatment guidelines, and would provide estimates of the number of potential patients served based on projected purchases. Also, through the use of RPM Plus quantification tools, USAID missions would be alerted to potential local absorptive capacity issues for their respective countries.
The proposed initial focus is on those initiatives funded by the U.S. President’s Emergency Plan for AIDS Relief (The Emergency Plan) in its 14 target countries as well as other USG-funded initiatives deemed
appropriate for inclusion (e.g., PMTCT funding through USAID). The addition of HIV/AIDS initiatives funded by the World Bank and the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) will follow if those organizations wish to participate in the data maintenance and sharing.
Once the impact of the initial work has been evaluated, consideration will be given to the expansion of the database to include other HIV/AIDS donor programs and recipient countries; information on availability, price, and use of HIV/AIDS commodities, including standard treatment guidelines; and tracking the impact of donor programs through linkages to databases for national health statistics.
Benefits of the System:
Expected benefits resulting from the availability of the proposed Web-based information sharing network include:
1. Creation of awareness of regions where assistance is being adequately provided and areas where assistance may be needed.
2. Diagnosis and aversion of problems that may result from having excessive amounts of pharmaceuticals or other commodities provided to a region in the absence of a working infrastructure that would allow for the appropriate management and use of the products supplied.
3. Avoiding duplication of efforts by donor organizations due to the lack of a fundamental tracking system.
4. Creation of a centralized-base for information sharing to improve pharmaceutical and other health commodities management practices and patient care.
5. Improved estimatesof the number of potential patients covered by projected purchases of HIV/AIDS-related pharmaceuticals and other commodities.
6. Enhanced ability to determine whether proposed procurements are in line with national standard treatment guidelines.
The database is Web-based and can be accessed by users in disparate locations who have an Internet connection. As shown above, the database is password protected. Additionally, permissions can be set for each user or a group of users, which provides control over what information is seen and/or modified and by whom.
This is the introductory screen of the program. Currently, it is set to display summaries of the cumulative amounts requested from each initiative listed in the left-hand column. Detailed information of the data can be accessed by expanding the field using the ‘+’ icon next to each name.
The introductory screen can be modified to display any combination of a number of data elements by grouping (country, medicine, brand name, manufacturer, medicine group, supplier, and individual invoice). The columns displayed can also be changed to display other elements, such as brand name, country, data source, essential medicine, invoice number, product form, strength, purchased quantity, and many others.
Once fully expanded, users may view information pertaining to the selected organization at numerous levels of detail. (For example, this screen displays information by initiative, the various countries funded through the initiative, and the specific commodities that were allocated to each country. Additional fields to display and sort on include: brand name, manufacturer, medicine group, and supplier.)
Individual invoices can also be selected to disclose detailed product information pertaining to that particular invoice (medicine, form, strength, requested quantity, and requested price per unit).
EXAMPLE ONLY
[NOT ACTUAL DATA]
The query functionality of the database tailors to each user’s preference and priority by using various filters, including medicine by group, medicine list, keyword search, data source, country, year, manufacturer, and wholesaler.
In addition to simply listing results of a query, the database provides functionality for displaying any information selected pictorially. This includes different types of graphical presentations (i.e. line, pie, and bar graphs).
Graphical data for various categories may be selected using the menu option indicated above (i.e. country, data source, medicine group, brand name, manufacturer, and supplier).
Information can also be viewed as geographical representations (by selecting the map icon). The diagram above depicts regions where each donor’s initiative is involved. The donors are then represented by organizational icons.
Regional quantitative data may also be viewed by clicking on the ‘scale’ icon located in the top left corner, and selecting the presentation of data (i.e. total requested, total purchased, requested price per unit, purchased price per unit).
