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Dealing with large-scale supply lines when introducing new regimens

Malati, Christine; Rosenfeld, Joshua; Mowafy, Sherif; Rittmiller, Trevor; Kuritsky, Joel; Crowley, John

Current Opinion in HIV and AIDS: July 2017 - Volume 12 - Issue 4 - p 408–413
doi: 10.1097/COH.0000000000000387
TOWARDS A UNIVERSAL ANTIRETROVIRAL REGIMEN: Edited by Charles W. Flexner, Willem D.F. Venter, and Polly Clayden
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Purpose of review As programs plan the introduction of a new antiretroviral as part of a regimen for HIV treatment, supply chain considerations need to be taken into account. The key to success is balancing the introduction of a new regimen with the phasing out of an old regimen in a manner that does not result in either a shortage or an excess supply of either product while ensuring that patients continue receiving their medications. This necessitates that country programs, donors, and procurement entities possess an appreciation of the global antiretroviral market and understand the dynamics that the manufacturing of new antiretrovirals will have on the transition.

Recent findings Supply, demand, and financial considerations affect the capacity of the supply chain to facilitate a successful antiretroviral transition. Although this commentary draws on United States Agency for International Development experiences under the President's Emergency Plan for AIDS Relief from earlier antiretroviral treatment shifts, the approaches are applicable to other institutions and to future transitions. Three approaches were employed: ensuring the engagement of all key stakeholders in transition planning and execution, including clinicians, advocacy groups, supply chain professionals, ministry, and donors; conducting and updating regularly the national quantification and supply plans for all regimens; and introducing antiretroviral products into programs from regional warehouses based on firm orders.

Summary Extensive planning and accounting for supply chain factors is essential to ensuring a smooth transition to a new regimen and to enable the global antiretroviral market to respond adequately.

Division of Supply Chain for Health, Office of HIV/AIDS, United States Agency for International Development, Bureau for Global Health, Washington, District of Columbia, USA

Correspondence to John Crowley, Division of Supply Chain for Health, Office of HIV/AIDS, United States Agency for International Development, Bureau for Global Health, Washington, DC 20523, USA. E-mail: jcrowley@usaid.gov

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