Rwanda: Pooled Procurement and Capacity-Building Help to Scale Up Treatment (April 2007)

The Rwandan Government and its international and implementing partners have pioneered an effective and accountable system to jointly procure antiretroviral drugs (ARVs) for Rwanda. Project partners include the U.S. Government, the Global Fund, the World Bank, and others.

In October 2004, the Rwandan Ministry of Health issued a Ministerial Order requiring that all ARVs be procured through the Centrale d'Achats des Medicaments Essentiels Consommables et Equipements Medicaux du Rwanda (CAMERWA), the national pharmaceutical procurement agency, in order to maximize purchasing power.

The CAMERWA-coordinated procurement in February 2006 included support from program partners, which purchased portions of Rwanda's overall ARV needs while adhering to their individual procurement requirements. PEPFAR funds were used to buy HHS/FDA-approved ARVs for first- and second-line treatment, while the Global Fund, World Bank and others purchased other WHO-prequalified drugs for first-line treatment. As a result of this new system, CAMERWA now distributes ARVs to pharmacies according to their patients' needs, regardless of which donor supports the site.

There are several benefits associated with the combined procurement system. Rwanda obtains a better price for the ARVs, due to the large quantities being ordered, and money is also saved through lower management costs and reduced transportation costs. The coordination also has a clinical benefit: since drugs are packaged with different shapes, quantities and inscriptions, leading to confusion and potential non-adherence, the coordinated procurement program reduces the risk of confusion.

In addition, the Partnership signed a landmark sub-agreement and Memorandum of Understanding with CAMERWA on November 13, 2006. The sub-agreement enables SCMS to contract with CAMERWA to provide port clearance, storage, and distribution services for all Emergency Plan commodities in Rwanda. The Memorandum of Understanding defines the roles and responsibilities of both CAMERWA and SCMS, in a collaborative relationship that will promote sustainable improvements to the HIV/AIDS commodity supply chain in Rwanda. SCMS will provide technical support, to enhance the capacity of CAMERWA so it can qualify to become a direct recipient of USG funds in the future.

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