Ensuring a stable supply of new ARVs for uninterrupted patient access to treatment
Ensuring a steady supply of new optimal ARVs and uninterrupted patient access during phase-in and phase-out is critical and requires planning, coordination across stakeholders, and monitoring. A robust supply plan that provides a summary of confirmed orders, expected future purchases, and estimated lead times should be developed to provide full visibility across procurement partners and the product pipeline, and to identify any potential issues or shortfalls.
Procurement Planning Checklist
Use the national forecast to develop a procurement supply plan, factoring in key considerations described in the Procurement Planning chapter
Understand key procurement procedures, including donor and government procurement, and ensure procurement plans align with the associated requirements and timelines (e.g. Stringent Regulatory Authority or National Drug Regulatory Authority approvals)
Ensure new products are included within the supply plan and assess whether planned orders for products being replaced should be reduced
Obtain appropriate reviews and approvals for donor-funded procurement plans from local or central procurement offices, as required
Communicate procurement plans to donors and suppliers to support visibility of global demand
For countries using a tender process, reference the key considerations listed in the Procurement Planning chapter to ensure a fair, transparent, and competitive process
Benchmark procurement prices against reference pricing to ensure prices offered are, at a minimum, below ceiling prices
Factor clearance, shipping, and distribution costs - including relevant international commercial terms (incoterms) - into procurement costs
Place orders with suppliers, either directly or through local or global procurement partners
Confirm scheduled delivery date for order
Monitor order deliveries to ensure on-time in-full delivery
Should delays occur, request clear communication from procurement partners and suppliers on updated delivery timelines and seek remedial action if delays risk stock-outs (e.g. during internal stock transfers, request global procurement partners to prioritize orders if possible)
Procurement Planning Tools and Resources
The procurement of HIV commodities is a complex process that requires tools and use of market intelligence to ensure the timely and cost-effective supply of high-quality products. To conduct an effective procurement process that fulfills the needs of national treatment programs, countries need to be aware of the ARV market dynamics, available procurement mechanisms, and best practices of ARV procurement.
International Benchmark Pricing
Referring to reference prices can be a useful tool to estimate budgets required for new products, compare prices offered by suppliers to assess if pricing is fair, and include within national tenders to encourage competitive bids. Several reference price sources are available; the mostly widely used reference prices are summarized in the CHAI ARV Benchmark Comparison List.
Procurement Optimization Memos
There are several “quick win” opportunities for procurers to increase value for money and improve supply security. These include changes to shelf life and packaging requirements. These memos outline how these small changes to procurement practices, that are very easy to quickly adopt, can bring significant benefits to programs.
For countries receiving funding for ARVs through the Global Fund, or PEPFAR, procurement may take place through these donors' pooled procurement mechanisms or procurement agents. These resources provide guidance on the procurement practices of these groups.
Procurement Planning & Implementation Tools
Below are additional tools and resources to support with procurement planning and implementation. The ARV Procurement Working Group - a body that supports the ARV market in low- and middle-income countries via coordinated procurement and strategically managed demand - also has additional resources to support procurement planning.