In 2006 the national tuberculosis (TB) and HIV/AIDS programs in the Dominican Republic (DR) were experiencing disruptions in medicines supply and diagnostic commodities. Management Sciences for Health (MSH) through the USAID funded SPS Program conducted various assessments which presented technical findings and political arguments to implement improvements and changes.

A quick cost comparison assessment of switching from TB monotherapy to fixed-dose combinations (FDCs) as an alternative form of medication to treat TB justified the procurement of FDCs though the Global Drug Facility (GDF). Studies on the impact of the new procurement mechanism demonstrated savings of around 800,000 U.S. dollars   (USD) per year and a reduction of 5 percent in the treatment default rate. A similar study demonstrated stock-outs and high prices of locally procured reagents and commodities for TB smear diagnosis, leading to the decision to procure TB diagnostic kits through the GDF. Evaluations demonstrated increased availability of diagnostic materials and an approximate savings of USD 150,000 per year. 

In 2008, the DR HIV/AIDS program requested SPS' assistance in supporting a similar approach to improve the supply management of antiretroviral and diagnostic commodities. An assessment showed stock-outs of medicines and diagnostic materials due to deficiencies in the estimation of needs and distribution mechanisms. The SPS Program suggested a comprehensive approach to solve the pharmaceutical management problems in the Ministry of Health (MoH), instead of simply a vertical approach. A study of the MoH pharmaceutical system conducted by SPS in 2008 revealed multiple procurement mechanisms, high procurement prices, a fragmented distribution system, and poor storage practices, among other findings. A presentation of these results to MoH authorities and technical cooperation agencies led to the decision to implement a national pharmaceutical management system (Sistema Único de Gestión de Medicamentos e Insumos [SUGEMI]). The SUGEMI is recognized, through a Ministry Decree, as the most efficient and sustainable strategy to improve the pharmaceutical management of the TB, HIV/AIDS, and other MoH programs. By February 2011, standard operational procedures for all of the SUGEMI components were completed; the implementation is scheduled for the rest of 2011. An impact evaluation, based on the baseline information collected in 2008, will be undertaken in 2012.

Reports, Presentations & Publications

• Technical Assistance for Organizing a National Medicine Supply System in the Dominican Republic (English - PDF 503KB and Spanish - PDF 382KB]
  
• Planning the Purchase of Medicines and Medical Supplies for the Ministry of Health for 2012 and its Implications for Improving Supply in the Dominican Republic (English - PDF 375KB and Spanish - PDF 374KB)
  
• Technical Report: Medicines and Sanitation Supplies 2012 Program for SUGEMI in Dominican Republic (Spanish) [PDF-1MB]
  
• Impact of the Introduction of Sputum-Smear Bacilloscopy Kits for Diagnosing TB in the Dominican Republic (2010 English Version) [PDF-283KB]
• Baseline Study on the Supply Management of STIs, HIV and AIDS Medicines/ Estudio de línea basal sobre la situación de la gestión de suministros de ITS, VIH
  y SIDA en República Dominicana (2010 Spanish Version) [PDF-897KB]
• Assessing the Impact of the Introduction of FDCs in Those Who Abandoned TB Treatment in the Dominican Republic/Evaluación del impacto de la introducción de combinaciones a dosis fijas en el abandono del tratamiento de la tuberculosis en la República Dominicana (2009 Spanish Version) [PDF-168KB]
• Technical Report: Analysis of the Supply Chain Management of Medicines and Supplies in the Ministry of Public Health in the Dominican Republic/Informe
  técnico: Análisis de la gestión del suministro de medicamentos e insumos del Ministerio de Salud Pública en República Dominicana (August 2009 Spanish Version) [PDF-455KB]
• Progress Report on the Implementation of Supply Inputs Operational Procedures
  in the NTP Laboratories within the Dominican Republic/Informe de progreso sobre la implementación de los procedimientos operativos del suministro de insumos
  de laboratorios del PNCT en la República Dominicana (June 2009 Spanish Version) [PDF-163KB]
• SPS Dominican Republic Trip Report: February 2008/SPS Informe de Viaje a República Dominicana: Febrero de 2008 (Spanish Version) [PDF-345KB]

Events & Activities

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