Leveraging Technology to Improve HIV Commodity Quantification in Nigeria

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With an estimated 650,000 deaths globally, the AIDS pandemic took a life every minute in 2021 despite effective HIV treatment and tools to prevent, detect and treat opportunistic infections. Of this number, about 51,000 persons reportedly died from AIDS-related ailment in Nigeria, which has an estimated 1.9 million persons living with HIV. Continuous availability of antiretroviral medicines has proven to be the best way of reducing HIV/AIDS-related mortality. Planning and quantification are two important aspects of the supply chain that ensures that the resources and commodity are readily available for the prevention of new HIV infections and improve the existing treatment, care, and support for those already infected by the virus. 

To ensure HIV commodity security, the Federal Ministry of Health in Nigeria set up the National HIV Quantification team to periodically review the HIV commodity consumption and procurement assumptions, commodity forecast accuracy, regimen spread, and alignment with actual laboratory testing protocol. The review is used to develop a forecast and a revised supply plan for the country, which informs commodity procurement by the government and funding organizations.  

Previously, the National HIV Quantification team generated the forecast for HIV commodities using Pipeline and Quantimed, computer-based software that calculates commodity needs using any of the three primary quantification methods: past consumption, morbidity patterns, and proxy consumption. The team also relied on an excel-based tool to generate forecasts for laboratory commodities.  

“We used to spend several days calculating the volume of commodities and funding requirements. The supply planning tools had limited features and required more manual and cumbersome operations,” Uzoma Atu, the Chief Pharmacist at National AIDS and STDs Control Program (NASCP) said. 

These challenges and the need for an improved web-based tool with significant offline capabilities that would enable seamless data exchange among key stakeholders and automate supply chain functions for end-to-end data visibility and evidence-based decision-making led to the development of the Quantification Analytics Tool (QAT).  

QAT is a modernized solution for country-led forecasting and supply planning. Funded by the United States Agency for International Development (USAID), the tool leverages new technologies and enhances the existing Pipeline and Quantimed tools. QAT enables program managers to easily build multiple forecasts for comparison and selection, optimize commodity procurement and delivery schedules, monitor the stock status of products, and share data with external platforms and key stakeholders. 

To set the pace for the rollout of QAT in Africa, in July 2022, USAID organized a five-day training in Lusaka, Zambia, for the first cohort of selected countries - Angola, Ethiopia, Ghana, Nigeria, Zambia, and Zimbabwe. Four staff of the USAID Global Health Supply Chain Program-Procurement and Supply Management project in Nigeria attended this training and were equipped with the required knowledge and skill to cascade the training to the government officials and other partners responsible for supply planning and forecasting of essential medicine in the country. 

In September 2022, the four participants at the Lusaka QAT training facilitated a five-day step-down training in Calabar, Cross River State. The training was organized by the Federal Ministry of Health with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The training was attended by 28 participants (21 males; 7 females), including members of the National HIV Quantification team and staff from various partner organizations, including the AIDS Healthcare Foundation, FHI 360, and Clinton Health Access Initiative. 

Having been well equipped to use QAT, the National HIV Quantification team organized a national semi-annual HIV products supply plan review meeting in Lagos in October 2022, where for the first time QAT was used to develop an 18-month (October 2022 – March 2024) HIV commodity supply plan for Nigeria. It was estimated that Nigeria would require $231,201,539 to procure and supply antiretrovirals and opportunistic infection medicines and $76,975,139 to procure laboratory commodities and equipment. 

“This is the first time we are using the QAT for our supply plan review. It is a very user-friendly tool. Previously, we would spend extra hours at the end of each supply planning review meeting calculating the commodities and funding requirements. However, using the QAT, we were able to finalize and agree on key outputs by the fourth day of our meeting. We no longer have to work extra hours,” Atu said. 

The use of QAT is transforming the forecasting and supply planning process and allows for greater integration and visibility for supply chain partners in Nigeria. The Federal Ministry of Health will be looking to adapt this tool in the supply planning of other essential medicines as it is hosted on the cloud as an open-source platform. When fully rolled out, the tool will contribute to USAID's goal of reducing stockout of lifesaving health commodities at the country level and improving the overall supply chain efficiencies by reducing inventory and storage costs over time.