quantification: historical procurement informing forecasts ... · core diagnostic challenges:...
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Quantification: Historical procurement informing forecasts and programmatic influencers
April 9-10, 2015
Jason Williams, Principal Laboratory Advisor
WHO Meeting with Diagnostic Manufacturers and Stakeholders
Overview
• Core diagnostic challenges
• Forecasting related challenges
• Effect of rapid scale-up, acceleration plans
• Effect of introducing point of care (POC)
• Actual procurement variance versus forecasts
• What will CD4/VL transitions look like?
• Where do we want to be?
2
Core diagnostic challenges: scale-up
• Donor funding vs. government commitments
• Increased treatment targets vs. shrinking budgets
• Program and laboratory and logistics interface
• Increased access, priority populations, and/or targeted
response
• Mixed model approaches — conventional and POC
• Country ownership and donor agendas
• CD4 or viral load monitoring of HIV
• Centralization or decentralization
Forecasting in-country challenges
• Conflicting donor priority areas of focus
• Responding to dynamic public health programs
• Parallel funding streams, procurement, and distribution
systems
• Disconnect between programmatic expectations vs.
laboratory service delivery
• Need to fully institutionalize quantification efforts
• Need for enhanced communication and strategic
coordination across all program implementers — working
from one strategic framework
• Need to leverage data from all key stakeholders to assist
in programmatic planning
4
CD4: Rapid scale-up ambitions, reduced uptake (Country A)
5
Introducing CD4 POC: Impact on conventional platforms (Country A)
6
CD4 tests procured vs. forecasted: Country A Procurement quantities can cross years
7
CD4 tests procured vs. forecasted: Country B Introducing new instruments
8
Introduction of 148
new instruments
CD4 tests procured vs. forecasted: Country C Realigning forecasts based on service delivery
9
Realigning forecasts due to
greater data availability
CD4 tests procured vs. forecasted: Country C Programmatic expectations versus service delivery
10
What will CD4/viral load transitions look like? Need for active monitoring
11
Actual?
Forecasting: Where do we want to be?
• Improved data management associated with scale-up
implementation
• Need to institutionalize laboratory quantification
efforts, aligned with HIV RTKs and ARVs
• Consensus-driven approach on developing
assumptions and validating final forecasts
• Multi-method approaches for comparative purposes
(ForLab)
• Enhanced programmatic involvement (RTKs, ARVs, lab
linkage)
• Development of coordinated national supply plans
12
Questions/comments
13
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