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Avian Influenza Commodities Update

Avian Influenza Commodities Update. October 15, 2008. William H. Johnson Director, Task Order 2, Avian Influenza. Overview. USAID | DELIVER PROJECT AI Commodities Update Shipments to Date Background Changes in the AI Commodity Stockpile Regional Distribution Center (RDC) Established

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Avian Influenza Commodities Update

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  1. Avian Influenza Commodities Update October 15, 2008 William H. Johnson Director, Task Order 2, Avian Influenza

  2. Overview • USAID | DELIVER PROJECT • AI Commodities Update • Shipments to Date • Background • Changes in the AI Commodity Stockpile • Regional Distribution Center (RDC) Established • Country Technical Assistance • Technical Assistance and Training Capacity (JSI) • Conclusion

  3. What’s New? • Decontamination Kit  3-D Kit and SBS Kit • New diagnostic Commodity Strategy • RDC in Bangkok • Selective country TA on case by case basis

  4. The USAID | DELIVER PROJECT • Five year Indefinite Quantity Contract (IQC) • Awarded by USAID to John Snow, Inc. Sep. 2006 $2.75 billion ceiling • Over 200 total staff • 19 field offices • Motto: “No Product, No Program” • Task Order 1 – Public health commodities Approx. Obligations to Date • Sep. 2006, 5 year contract • Core and mission funding $162 million • TA and procurement • Task Order 2 – Avian Influenza commodities • Mar. 2007, 3.5 year contract • OFDA Funding (no mission funding) $28 million • Very limited TA on case-by-case basis • Task Order 3 – Malaria prevention, treatment commodities • Apr. 2007, 5 year contract • Core and mission funding $125 million • TA and procurement

  5. The USAID | DELIVER PROJECT Purpose of Logistics System (6 “Rights”) • RIGHT QUANTITIES of the • RIGHT GOODS to the • RIGHT PLACES at the • RIGHT TIME in the • RIGHT CONDITION at the • RIGHT COST

  6. Shipments Prior to Task Order 2 • Prior contract with FOH through OFDA • 209,850 PPEs shipped to 65 countries • Majority small amounts as place holders • Indonesia received 100,000 of total • Most of previous shipment commodities have been used in the country • Shipping and tracking problems led to de-obligations • New procurement and shipping contract with DELIVER Avian Influenza Task Order March 2007

  7. Task Order 2 Contract in General • Began March 2007 • Procurement, shipping and tracking of USAID Avian Influenza International Stockpile (AIIS) commodities • $28.5M centrally funded for 3 years • Logistics technical assistance as required • MAP International runs warehouse in Georgia • UPS as shipping agent • Crown Agents, Fuel Group, PATH, FHI, Manoff Group, MAP International & UPS as sub-contractors.

  8. Task Order 2 SOW • Take over pre-existing inventory – 110 x 50’ semi-trailer trucks of commodity supplies – and re-process for shipping • 328,350 PPE kits shipped to 70 countries • Establish regional distribution centers as required • Facilitate periodic technical review of commodities • Regularly replace distributed stocks • Purchase and distribute additional commodities • Track and report on commodities used • Forecast and plan for expanded outbreaks • Provide logistics technical assistance as necessary

  9. Task Order 2 Distribution Approach • Pre-position 1-2 month supply in every country • Have back-up stocks pre-positioned in Bangkok RDC • Have back-up stocks in Savannah, Georgia • Emergency response – 5-7 days air freight • Immediate response – 7-14 days standard air • Pre-planned response – 6-8 weeks by sea freight • When necessary, 1 day warehouse response • Door-to-door delivery through UPS

  10. Order is received by TO Director / USAID/W mgmt. Order given to Fulfillment Team to determine fulfillment requirements. New procurement required or stock available? Standard Order Processing Workflow Begin procurement. New Existing Receiving Report is received from recipient verifying shipment arrival Order is sent to Demand Planner for processing, fulfillment coordination. Order entered, Delivery Note (DN) created. Freight Mgr. coordinates shipment to end destination, obtains POD. Freight Mgr. pre-shipment documentation prep and coordination. DN, Sales Order Confirmation sent to WH & freight manager. WH begins picking items, preparing shipment for transit. Challenges, questions arise. WH notifies Freight Mgr. and Operations, order shipment ready. Discuss w/ Fulfillment and TO mgmt. WH notifies Freight Mgr. and Ops. order is ready. Final freight charges approved by TO mgmt. Final shipment documentation is prepared/order is picked up from WH.

  11. Historic Commodity Distribution

  12. AI International Stockpile (AIIS) Commodities Procurement pending

  13. AI International Stockpile (AIIS) Commodities • Standard Shipment – Historic • 4,500 PPE Kits • 40 Decon Kits • 1 Lab Kit • Standard Shipment – Future • 4,500 PPE Kits • 3-D Kits (procurement process underway) • SBS Kits (procurement process underway)

  14. AI Commodities Background • Decon Kit Review (Apr 2008) • Transition from Decon Kit to 3-D and SBS Kits (Apr – Sep 2008) • New Diagnostic Commodities Strategy (Sep 2008)

  15. Decon Kit Technical Review (Apr. 28 – May 1, 2008) • In response to feedback from the field, TO2 convened a meeting of hazardous materials response experts • Participants came from: private sector, academia, Federal contractor, USDA and USAID • Recommendations • Create prototype 3-D Kit and Surveillance Biosecurity Kit • Develop instructions for use of the new kits • Field test the prototype kits

  16. Decon Kit Technical Review (Apr. 28 – May 1, 2008) • Recommendations (cont’d.) • Develop a training manual • Develop a forecast and procurement strategy • Develop an approach to kitting the products

  17. Transition: Decon Kits to 3-D and SBS Kits * Special Order Items

  18. AI Commodity Changes *Special Order Items

  19. AI Commodity Changes * Special Order Items

  20. AI Commodities: Decontamination Kit (Discontinued) Items included in the 3-D Kit and/or SBS Kit

  21. AI Commodities: 3-D Kit Items recovered from Decontamination Kit

  22. AI Commodities: 3-D Kit (Cont’d.) Items recovered from Decontamination Kit

  23. AI Commodities: SBS Kit Items recovered from Decontamination Kit

  24. USAID AIIS Diagnostics Commodity Strategy • The USAID API Unit decided in Sep 2008 to – • Eliminate the Lab kit from the AIIS • Restrict the Poultry Rapid Antigen Test Kit to a special order item • Restrict the Universal Transport Medium (UTM) to a special order item • Maintain the Infectious Substance Shipper active in stock as a special order item • Maintain the Mask Fit Test-Kit as a special order item

  25. USAID AIIS Commodity Matrix 3-D and SBS kits not available before December 2008

  26. Bangkok Regional Distribution Center (RDC)

  27. Bangkok RDC • Established: January 2008 • Owned by: NEC Corporation • Managed by: UPS • Stocked on: March 21, 2008 • First shipment dispatched: August 24, 2008

  28. RDC: Project Stock

  29. Bangkok RDC: Freight Cost and Transit Time Analysis Point of Origin:Atlanta vs. Bangkok

  30. RDC – Order Fulfillment (12-24 hrs.) Collaborating Parties • American Embassy Bangkok • USAID/Washington • USAID/RDMA (Thailand) • USAID | DELIVER PROJECT • UPS (Bangkok) • UPS (Washington) Standard AIIS Ordering Process • CTO must approve each order • Project Supply Operations Team fulfills the order • UPS forwards freight

  31. RDC: Order Fulfillment (12-24 Hrs.) Export Sequence Summary • USAID/RDMA Alerts Embassy GSO of pending shipment • UPS (Bangkok) forwards freight documents to RDMA • RDMA emails official shipment request to GSO (Bangkok) • GSO obtains duty-free status from MFA • GSO creates packing list on Embassy letterhead • UPS (Bangkok) dispatches courier to pick up documents from GSO • UPS (Bangkok) alerts consignee • UPS (Washington) tracks shipment and updates all parties • USAID | DELIVER PROJECT coordinates customs clearance and delivery • UPS sends Proof of Delivery (POD) to all parties

  32. Technical Assistance by the USAID | DELIVER PROJECT • TO1 Technical Assistance • FY 08 field expenses of $22.10 million (est.) • TO2 Technical Assistance • FY 08 field expenses of $265,000 (est.) • TO3 Technical Assistance • FY 08 field expenses $5.5 million (est.)

  33. Technical Assistance & Training Capacity John Snow, Inc. • Logistics Management Information Systems (LMIS) • Storage • Assessing Stock Status • Maximum-Minimum Inventory Control Systems • Commodity Security and Health Logistics Systems

  34. Technical Assistance & Training Capacity John Snow, Inc. (Cont’d.) • Quantification, Forecasting, and Procurement Planning • Forecast consumption • Estimate requirements • Logistics data • Service Statistics • Morbidity Data • Demographic Data • Estimate Cost • Adjust Quantity to Procure

  35. Technical Assistance & Training Capacity John Snow, Inc. (Cont’d.) • Monitoring and Evaluation • Adequate stock status • Stock out duration • Stock data quality • Storage conditions • Reporting Rates • Forecasting Accuracy • Multi-year supply plan • Stakeholder commitment

  36. Technical Assistance & Training Capacity John Snow, Inc. (Cont’d.) • Assessing Logistics Systems • Logistics Indicators Assessment Tool (LIAT) • Organization and Staffing • Information System • Product selection • Forecasting • Obtaining supplies

  37. Technical Assistance & Training Capacity John Snow, Inc. (Cont’d.) • Assessing Logistics Systems • Logistics System Assessment Tool (LSAT • Inventory control procedures • Warehousing and storage • Transport and Distribution • Organizational support for logistics • Product use • Finance/donor coordination/commodity security

  38. Technical Assistance & Training Capacity John Snow, Inc. (Cont’d.) • Assessing Logistics Systems • Logistics Management Information System (LMIS) • Amount ordered, issued and received at each level of the pipeline: essential data items for report • Stock on hand by product (beginning and end) • Issues or consumption • Losses and adjustments

  39. Country Technical Assistance Three general levels of assistance, approved on an individual basis by the API Unit. Tier One: • Countries currently experiencing widespread outbreaks of confirmed H5N1. • Consume large quantities of AI commodities. • May require at least two TA visits in the first year. Tier Two: • Localized outbreaks of H5N1 AI. • Consume significant numbers of AI commodities (surveillance, response).   • May require one TA visit for assessing current stock status, the supply chain and to forecast future needs and establish initial SOPs. Tier Three:   • Limited localized outbreaks of H5N1 AI or no outbreaks to date. • Consume few commodities or limited to training activities. • May receive limited TA.

  40. USAID API Unit Technical Assistance • Shipment Types • Pre-positioning • Emergency • Replenishment • Commodity Forecasting Tool • Information for replenishment shipment requirements • Under development • Piloted in Bangladesh and Nigeria • Guidance on reporting stock, inventory status, commodity requirements not yet available

  41. Forecasting Tool (under development) Commodity Status Report

  42. Forecasting Tool (under development) Estimated Commodity Needs AI Inventory and Forecasting Tool

  43. Forecasting Tool (under development) Data for Estimating Commodity Needs Emergency Outbreak Response • Average number of outbreaks per month • Average number of affected poultry per outbreak • Average number of surveillance site visits to locations neighboring infected area (per outbreak) • Average number of additional PPE used per outbreak (in addition to those already in 3-D and SBS kits) • Average number of additional Virkon pails used per outbreak (in addition to those already in 3-D and SBS kits) • Assumptions: • Poultry capacity of 3-D kit is constant variable • 4-5 PPE changes per person per 8-hour day

  44. Forecasting Tool (under development) • Data for Estimating Commodity Needs (Cont’d.) Routine Surveillance • Number of planned routine surveillance site visits per month • Average number of SBS kits used per surveillance site visit • Assumptions: • Number of persons involved per surveillance site visit may vary • Person to SBS kit ratio may vary (intended for 2-person team, but more people might use one kit) • 4-5 PPE changes per person per 8-hour day

  45. Forecasting Tool (under development) Data for Estimating Commodity Needs (Cont’d.) Routine Disinfection • Number of planned routine disinfection activities per month • Average number of SBS kits used per disinfection activity • Assumptions: • Number of persons involved per disinfection activity may vary • Person to SBS kit ratio may vary (intended for 2-person team, but more people might use one kit) • 4-5 PPE changes per person per 8-hour day Training • Types of training activities planned for next 6 months (outbreak response, surveillance, disinfection, etc.) • Number of planned training activities per month • Number of planned trainees per training activity per month

  46. Forecasting Tool (under development) Commodity Procurement Table

  47. Conclusion • USAID/API recognizes that the AIIS commodities must evolve to meet best practices and changing conditions in the field. • USAID/API has announced new policy on laboratory and decontamination kits to missions. • For those interested, recommended guidelines on field utilization of 3-D and SBS kits is available on CD. • The AI Product Catalogue is being amended and will be available on the USAID | Deliver TO 2 website http://deliver.jsi.com/dhome/taskorder/toavianinfluenza

  48. Conclusion (cont’d.) • Logistics publications and tools for supply chain essentials, policy and advocacy, organizational strengthening, and monitoring and evaluation are available on the website www.deliver.jsi.com • USAID |DELIVER TO2 is in a “reactive” rather than “proactive” response posture for technical assistance and training. We can only respond to field requests and SOWs that have been reviewed and approved by USAID/API and our CTO

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