the presentation here.

UNICEF Engagement in Pneumonia
Malaria Consortium Consultation
June 2014
Outline
About UNICEF
About UNICEF supply
About pneumonia …..
Realizing the rights of every child, especially the most disadvantaged
SURVIVE
TO THRIVE
FROM BIRTH
3
INTO ADULTHOOD
Realizing the Rights of Every Child
Supply in the UNICEF structure
UNICEF Supply Division, Copenhagen
What we do
Procurement, warehousing & logistics – UNICEF
programmes & for procurement partners
Market shaping – ensuring availability, quality, price
and right formulations of essential commodities
Ensuring local delivery of essential commodities to
children and families
Rapid emergency response
Partnerships, policy & monitoring
Innovation for children
6
UNICEF’s supply function vision
2005
Direct Delivery
Procurement Services
2008
Direct Delivery
Procurement Services
2010-11
Direct Delivery
CD
Procurement Services
IV
2012-13
Direct Delivery
Procurement Services
Capacity
Development
IV &
MI
2020
Direct Delivery
Procurement Services
Capacity Development
Innovation &
Mrket Influence
UNICEF Supply Strategies for 2014-2017
UNICEF Outcome Areas
Health
HIV/AIDS
WASH
Nutrition
Education
Protection
Inclusion
UNICEF Global Supply Strategie
Service Delivery
Emergency
Influencing Markets
Innovation
SD Supply Chain improvement initiatives
Strengthening & Optimising Supply Chains with Governments
Capacity Development
Supply Community & Professional Development
Monitoring:
(Performance Targets, Supply Outcome Targets, Results Matrix , PS)
Results-based management, reporting & project management
Partnership
UPSTREAM
Logistics & delivery
DOWNSTREAM
Monitoring &
Evaluation
Utilisation by
Beneficiary
(national,
provincial, district,
community)
Warehousing,
Distribution &
Re-ordering
Procurement
Inspection
Delivery &
Clearance
Planning
Procurement
Budgeting &
Planning
Definition of need
(i.e. timing/qty etc.)
Looking at the supply chain
M&E
A look into pneumonia…
- pneumonia diagnosis -
World Health Organization. Were, Qazi. June 2014
It is not only about the technology….
$1.23
….but about defining the functional requirements
based on user needs
ARI Timer Time Line ….
Aug 2005
•WHO and Save The Children (STC) exchange mails on inadequacy
of ARI timer for assessment by CHWs of fast breading.
May 2007
•UNICEF PD & SD invited by WHO, STC and Philips Philanthropic
Design Initiative (PPDI) to participate in designing a new
generation ARI timer.
March
2008
Nov 2008
Oct 2010
•Progress with newly designed timer stalls on (i) open source
discussion with PPDI, (ii) no funds to make a prototype, and (iii) no
funds for field testing.
•REoI to potential producers new ARI timer: 20 invited, 2 respond
(1 rejected, 1 current manufacturer Moneray). Monopoly PPDI /
Moneray not acceptable.
•Work on newly designed ARI discontinued, refocus on needs of
end-users.
ARI Timer Time Line (2) ….
Dec 2011
Q1+Q2
2012
Q2+Q3
2012
•RFI successfully scouts for potential technologies and
organizations working on a pneumonia diagnostic aid. All are
promising but very early initiatives.
•Evaluation of RFI selects most promising ones. During follow-up
all organizations request support, guidance and financial means.
•Field research with various concepts (by Innovation Unit ), creates
for the first time very good insight into ARI diagnostic
requirements at community level.
Jan 2013
•SD workshop with industry and academia, (i) creates personas, (ii)
common design denominators, (iii) need for short and long term
TPP, and (iv) creates frequent progress exchange with BMGF.
Q3 2013
•Parallel to the innovation track, in cooperation with supplier,
specifications of current S0845010 were updated. ARI timer, mark 2
is expected Q3 2014.
Jan 2014
•TPP development starts
About the products
Pneumonia
Oximetry
Diagnostics
(respiratory rate
timers)
Pulse Oximetry
Amoxicilin DT
Oxygen
concentration,
Accessories
Also consider dispersible paracetamol for fever
management
Pneumonia Diagnostics
Current timing tool(s) for pneumonia diagnosis:
Basic supply for community health
ARI Timer
Watch
Different Pneumonia Diagnostic Aids
Device Name
Description
ARI Counting Beads
Counting beads designed as a simple, cheap and effective way to improve a CHW’s
ability to keep track and count a patient’s breathing rate. To be used in conjunction with
the ARI Timer. The beads are colour-coded to ease diagnosis.
Respiratory Rate
Application
A mobile phone application that tracks a CHW’s count rate using an “any button” press
function on the phone to count and then calculate a patient’s mean respiratory rate.
Solar and Cell Phone Pulse
A device powered by using old mobile phone batteries charged by solar cells measures
the saturation level of a patient’s haemoglobin. It determines whether a patient is
receiving sufficient oxygen through breathing, as well as the patient’s heart rate.
StethoCloud
A concept still in development which records the respiration rate through a stethoscope
attached to a smart phone or a cloud device. The data is processed against an existing
database used to diagnose pneumonia.
mPneumonia
An android prototype mobile phone application in development which uses the IMCI
pneumonia protocol, paired with a respiratory rate counter and pulse oximetre to guide
and inform diagnosis.
The Nossal ‘Smart Cable’
Project
A device that transforms a simple mobile phone into capturing data from three sensing
devices: oximetre, respiratory rate counter and thermometer.
The Phone Oximetre for
Sepsis
An oximetre device and application that attaches to a smart phone
and measures respiratory rate, peripheral blood flow and
heart rate, facilitating diagnosis.
Ref: Pneumonia Diagnostics: Current outlook and perspectives : UNICEF Supply Division - May 2013
Ongoing
developments
Pneumonia Treatment
Pneumonia: Treatment with Amoxi 250mg DT
Cost: Amox 125mg/5ml suspension (100ml) Versus Amox 250mg DT
UNICEF Catalogue Product
FCA lowest
Price (US$)
Amoxicillin 250mg DT
Treatment cost <
1 year olds
Treatment cost
1-5 years
S1505046 Amox 125mg/5ml Suspension
0.40
0.40
0.80
S1505043 Amox 250mg DT 10 X10 Pack
1.70
0.17
0.34
S1505044 Amox 250mg DT 10 X 2 Pack
0.37
N/A
0.37
S1505045 Amox 250mg DT 10 X 1 Pack
0.24
0.24
N/A
Amox 250mg DT: UNICEF Procurement Activities
Suppliers
Country
Microlabs
India
Medopharm
India
Medreich
India
Sandoz
Austria
Remedica
Cyprus
Fever Management
Fever: Treatment with Paracetamol DT
Introduction of 100mg & 250mg Paracetamol dispersible
tablets for the treatment of fever in under fives
UNICEF Product (material description)
Unit price
Cost of
treatment
S1555990 Paracetamol 125mg/5ml or.sol/BTL-60ml
0.43 USD
0.43 USD
S1555965 Paracetamol 500mg tabs/PAC-1000
5.48 USD
N/A
S1555978 Paracetamol 100mg tabs/PAC-1000
3.65 USD
N/A
S1555979 Paracetamol 100mg disp. Tabs 10X10 pack
0.75 USD
0.075 USD
S1555979 Paracetamol 250mg disp. Tabs 10X10 pack
0.81 USD
0.081 USD
Use of Paracetamol DT significantly reduces the cost of fever
treatment compared to the use of Paracetamol oral suspension
Pulse Oximetry
Pulse Oximetry
UNICEF Product (material description)
( Prices are indicative )
Unit price
S0002036 Pulse oximeter,spot-check,w/access,
300 USD
S0002033 Pulseoximeter,portable,w/access,
3,435 USD
S0002031 Monitor,patient,all vitals signs,portable,w/access
2,025 USD
S0002047 Oxygen concentrator/SET
880 USD
S0370100 Prongs,nasal,Oxygen,adult,s.u
0.21 USD
S0370110 Prongs,nasal,Oxygen,child,s.u
0.22 USD
S0370120 Prongs,nasal,Oxygen,neonate,s.u
0.21 USD
Questions ….