The USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project joined global partners at this year's Health and Humanitarian Logistics (HHL) Conference to discuss the impact of COVID-19, and presented on Ensuring ARV availability for multi-month dispensing: Using supply chain constraint analyses to accelerate MMD during COVID-19 in low- and middle-income countries.
Multi-month dispensing (MMD) allows HIV/AIDS patients to receive several months of antiretroviral (ARV) supply at once, improving adherence and reducing cost to facilities and patients. Because of these benefits, many countries started scaling up MMD for ARVs in 2019 with support from GHSC-PSM. COVID-19 has imposed a need to accelerate MMD to reduce clinic visits and minimize exposure. Since dispensing decisions have profound effects on the supply chain, GHSC-PSM is supporting MMD scale-up in multiple countries and advising clinical partners on the challenges of an abrupt MMD scale-up. This includes managing multiple bottle sizes and an artificial "seasonal" demand pattern that could result in stock outs and high fluctuations in patient visits between months. Implementing MMD requires careful planning and policy development.
GHSC-PSM has supported government stakeholders, clinical partners and donors by providing MMD resources that allow countries to make data-driven decisions and manage supply chain constraints. The GHSC-PSM-developed Multi-Month Simulation (MuMS) tool for scenario planning facilitates data-driven conversations with local and international stakeholders on the feasibility of rolling out MMD for 3-6 months. The tool uses existing data and makes broad assumptions to model the potential effects of increasing the quantity given to each patient on current and future stock status.
Resources like MuMS and other rapid scenario planning tools can improve communication and decision-making between supply chain and clinical stakeholders to ensure commodity availability during COVID-19.