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NEW SUPPORT MODALITYUNDP UKRAINEEXPERIENCEZAFAR YULDASHEVPROJECT COORDINATORUNDP UKRAINE
BACKGROUND The challenges and failures of the Ministry of Health’s public procurement andsupply programme resulted in a two-year gap of available medicine in the countryfrom 2013-2015. May 2015 - MOH invited agencies to assist with procurement of health products May-Sep 15 – UNDP assists in amending local legislation Aug 15 - Internal consultations and meetings with key partners Oct 15 – UNDP signs PRODOC and CSA - I with MOH of UKR (7 stateprogrammes) Nov 15 – Funds transferred to UNDP Dec 15 – CSA – II for vaccines signed between UNDP and MOH of UKR (39,2 MUSD) NB. Extremely complex political environment, strict regulations, differentexpectations of parties
UsualChallengesCHALLENGES Stock out situation Lack of clear requirements Different expectations of the parties CSOs, MOH, Pharm mafia,numerous media attacks, tender complains Short time to implement cases Sabotage at different levels Bid complains to slow the progress of UNDP Usual challenges Credibility of UNDP on the ground
PROJECT IMPLEMENTATION New corporate initiative, new approach was needed Consultations with HQ departments/ GF HIST / GPU Procurement Road Map / Ex-ante review (FTP) Bidding ishNotice 2-Feb-1617-May-1628-Feb-16
CYCLE II – 78 M USDList of programs for procurement with 2016 funds: 11.Medicines for treatment of patients with mucopolysaccharidosis 1.Medicines and medical products for patients in pre- and posttransplant period 12.Medicines and medical products for patients withepidermolysis bullosa 2.Chemotherapeutic agents, radiopharmaceuticals and supportdrugs for treatment of cancer patients 13. 14.Anti-D immunoglobulin for the prevention of hemolytic diseaseof the newborn 3.Medicines and medical products for treatment of children withoncology and oncohematology diseases 4.Reagents for neonatal screening for phenylketonuria andcongenital hypothyroidism 5.Medicines for treatment of children with cystic fibrosis 6.Medicines for children with primary (congenital)immunodeficiency 7.Medicines for children with cerebral palsy 8.Medicines for children with dwarfism of various origins 9.Medicines for children with mental and behavioral disorders ofautism spectrum 10.Medicines for treatment of children with resistant juvenilerheumatoid arthritisMedicines for patients with pulmonary arterial hypertension15.Medicines and small laboratory equipment for female infertilitytreatment by means of assisted reproductive technologies16.Medicines for adults with hemophilia 17.Medicines for treatment of patients with multiple sclerosis 18.Medicines for patients with orphan metabolic diseases 19.Medicines for children with chronical viral hepatitis 20.Tests, supplies for the diagnosis of tuberculosis 21.Medicines for children with hemophilia type A or B orWillebrand disease 22.Medicines for treatment of tuberculosis (TB) 23.Medicines for adults with hemophilia
RESULTS & SOURCESPATIENTS WITH HEMOPHILIA WILL RECEIVE HIGH-QUALITY EUROPEANMEDICINESOleksandr Shmilo, chairman of the All-UkrainianAssociation of Hemophilia:"The process and outcome of tenders forhemophilia medicines correspond to Europeanstandards. This is the first tender in Ukraine, whichwas conducted entirely in the interests of patientswith hemophilia."Project web site click hereLink to announced ITB
LOT1Product descriptionPharmaceutical PresentationStrengthRequested QTYAdult Hemophiliaampule, vial, syringe1000 IU and more9,322,713ampule, vial, syringe1000 IU and more5,594,998ampule, vial, syringe1000 IU and more3,246,1152 mg (100 KIU or 100,000 IU),5 mg (250 KIU or 250,000 IU)10,390,0003Coagulation factor VIIICoagulation factor VIII and von WillebrandfactorCoagulation factor IX4Eptacog alfa activated (recombinant factor VIIa)ampule, vial, syringe56Anti-inhibitor coagulant complexDesmopressinampule, vial, syringeampuleChild hemophilia500 IU, 1000 IU15μg, 1ml539,5003337Coagulation factor VIII (recombinant)vials250 IU683,0008Coagulation factor VIII (recombinant)vials500 IU1,907,6009Human coagulation factor VIII (plasma)vials250 IU565,25010Human coagulation factor VIII (plasma)vials500 IU7,904,13211Human coagulation factor IXHuman coagulation factor VIII and human vonWillebrand factorHuman coagulation factor VIII and human vonWillebrand factorHuman coagulation factor VIII and human vonWillebrand factorHuman coagulation factor VIII and human vonWillebrand factorvials500 and/or 600 IU2,469,736vials500 IU1,293,000vials1000 IU1,511,400vials500 IU319,500vials1000 IU673,00016Human coagulation factor VIII (plasma)vials1000 IU1,595,00017Eptacog alfa activated (recombinant factor VIIa)vials2 mg (100 KIU or 100,000 IU)17,420,00018Eptacog alfa activated (recombinant factor VIIa)vials5 mg (250 KIU or 250,000 IU)24,167,000192021Anti-inhibitor coagulant complexAnti-inhibitor coagulant complexDesmopressinvialsvialsampule, vials, syringe500 IU1000 IU15μg, 1ml240,570445,000227212131415
COOPERATION LOCAL PATIENT ORGANIZATIONS UNDP – EHC MOU successful cooperation is ongoing Review of ITB and support in evaluation of received bids UNDP facilitated the meeting with MOH of Ukraine EHC – PARTNERS Programme
PRIORITIESE-tendering and SustainableProcurement E-tendering and Sustainable procurement Build the structural and human resource capacity for supply, planning, forecasting, andmonitoring and evaluation for transparent and cost-effective procurement at MOH. Assist MOH in establishment of Procurement Agency and gradually hand overprocurement function Introduce Digital stock management software Conduct periodic efficiency assessments Encourage local manufacturers to discover world market Support MOH further reform of the national procurement and quality assurance systemand capacity development processes.
LESSONS LEARNT Carefully consider the local context (requirements, customs, QC,storage, distribution, acceptance by beneficiaries, otherregulations) Closely work with MOH to solve the issues at early stages (VAT,Registration of new products, flexibilities with quantities of medsto be purchased etc.) Utilize Bid security and Performance bond tools Collaborate with known Associations in development of biddocuments and technical evaluation, reference prices etc.
LESSONS LEARNT Collaborate with local patient organizations Involve line experts appointed by MOH as – visiting experts Engage MOH into decision making process in each step, ensureownership Encourage world known manufacturers participation in UNDPtenders Maintain proactive clear and concise Communication Centralization of procurement function Establishment of LTAs
Oct 15 -UNDP signs PRODOC and CSA - I with MOH of UKR (7 state programmes) Nov 15 -Funds transferred to UNDP Dec 15 -CSA -II for vaccines signed between UNDP and MOH of UKR (39,2 M USD) NB. Extremely complex political environment, strict regulations, different expectations of parties
