The recent surge of drug-resistant TB has highlighted weaknesses in prevention, diagnosis, and treatment of the disease. For TB medicines to be effective, quality-assured drugs need to be taken in the correct doses and for the full duration of the prescribed treatment. However, significant gaps exist between what are known to be strong pharmaceutical management practices and their application by global initiatives and national TB programs. Even when countries are able to quantify their pharmaceutical supply needs, delays in the global availability of drugs, bottlenecks at the country level, or improper storage can prevent patients from accessing effective medicines.
MSH helps countries identify underlying pharmaceutical management challenges and design appropriate solutions to secure quality TB medicines. We develop tailored tools and trainings to help countries systematically collect data and improve decision making to effectively manage TB medicine supply.
We work with a variety of partners to develop collective solutions, including international TB initiatives, donors, national TB programs, and the private sector. We work closely with the Global Drug Facility, an initiative of the World Health Organization's STOP TB Partnership that procures quality-assured TB medicines at low cost.
Additionally, at the country level, MSH has promoted e-TB Manager, a web-based tool for managing information needed by national programs. This tool integrates data on all aspects of TB control — including suspected patients, confirmed patients, medicines, laboratory tests, diagnosis, treatment, and outcomes — into one database for a holistic approach to TB control management.
- At the global level, MSH is leading the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program, which strengthens health systems to expand access to lifesaving medicines and pharmaceutical services, including those that help to prevent and treat TB.
- SIAPS developed QuanTB — an electronic forecasting, quantification, and early warning tool designed to improve procurement processes, ordering, and planning for TB treatment. Using QuanTB acting as an early warning tool, SIAPS, working with the Bangladesh's National TB Program, was able to cancel, defer, or reallocate over 2.5 million doses of second-line TB medicines after a potential overstock was detected, saving the program nearly $900,000.
- In Ethiopia, through the HEAL TB project, MSH supports TB drug supply management. We have helped reduce the stock out rate from 22 percent in 2011 to less than 2 percent in 2015, and aided in the introduction of TB patient kits.
- In Uganda, MSH is strengthening TB supply chain management through the Uganda Health Supply Chain project, which includes providing support to facilities and quantifying and redistributing supplies for continuous availability at MDR-TB sites.