Securing timely access

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Global Drug Facility

• Securing timely access
• to high quality, affordable anti-TB drugs

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What is the GDF?

• An initiative of the Global Partnership to Stop
  TB
• Housed in WHO and managed by Stop TB Partnership
  secretariat
• Aims to supply quality assured, affordable drugs,
  where they are needed, when they are needed
• More than a traditional procurement mechanism
• A bundled facility not a procurement agent

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The GDF story

• 1998 The 1st Ad hoc committee on TB epidemic
  concludes that one of the six principle
  constraints retarding action by health
  authorities was lack of a secure supply of
  quality anti-TB drugs, and calls for the
  establishment of a Global Drug Facility (GDF).
• 2000 Health Ministers from 20 HBCs (80 of the
  TB burden) meet in Amsterdam and call for a GDF.
• 2001 Stop TB Coordinating Board endorse GDF
  prospectus. First drug delivery (Moldova,
  October).
• 2003 McKinsey independent evaluation of GDF
  concludes it has "demonstrated results in
  improving access to TB drugs in many countries".

4
What services does the GDF provide?

• Grant Service for first-line anti-TB drugs for
  countries and nongovernmental organizations
  (NGOs) that are donor-dependent for some or all
  of their drug supply and wish to expand or
  strengthen DOTS programmes.
• Direct Procurement (DP) Service for countries,
  NGOs and donors to buy first- or second-line
  anti-TB drugs for use in DOTS programmes i.e.
  for countries and NGOs that have sufficient
  finances but lack adequate procurement or quality
  assurance systems.
• Technical Support Service whereby Grant and DP
  services combine with technical assistance for a)
  in-country drug management and b) support to
  efforts to improve anti-TB drug quality
  assurance, primarily via WHO's TB
  Prequalification Programme.

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Why do we need a GDF?
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What will the GDF achieve?

• Supply treatments for 15 million patients by 2010
  and for 25 million by 2015
• Contribute to the achievement of the health MDGs
• Mitigate the emergence of anti-TB drug resistance
• Improve the quality of anti-TB drugs worldwide
• Rationalize procurement mechanisms
• Create successful model of cooperation to
  confront a global epidemic

7
How is the GDF governed?
8
How is the GDF organized?
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Who are the GDF's partners?

• Contractual Partners
• Procurement services -GTZ
• Manufacture - Lupin Ltd., Svizera Europe, Sandoz
  India, Cadila Ltd.
• Quality control/PSI Intertek
• Freight forwarding Geis-SGV
• Quality Assurance -
• WHO, SGS, Proxy
• Desk Audit - GLRA, MSH, STI

• Collaborating Partners
• Donors - CIDA, USAID,
• Govt. of Norway, Govt. of Netherlands, UNITAID
• Technical assistance - GLRA, IUATLD, KNCV, MSH,
  STI, JICA, World Vision, World Bank, WHO, JSI,
  LHL, Damien Foundation, CHD, Project Hope,
  OMS/EDM, Caritas Norway
• Coordination with countries -
• WHO Regional Offices,
• GFATM

10
How is GDF financed?

• Donor contributions fund GDF grants to countries.
  
• Donor funds added to Stop TB Partnership Trust
  Fund
• Established in 2005 at WHO
• Programme support costs for drugs procurement 3
• Programme support costs for other activities 7
• Of the remaining 90, 20 is used for GDF
  operational costs, quality control and technical
  assistance, and 80 is used for procurement of
  anti-TB drugs
• All WHO financial regulations and procedures
  followed for
• Internal financial control
• Payments
• Financial management reports prepared for donors
  by Stop TB Partnership Secretariat
• Countries can use their own money for placing
  drug orders through the GDF Direct Procurement
  Service.

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What has the GDF achieved so far?

• gt9 million patient treatments committed in 6
  years
• Deliveries to gt60 countries
• Value for money US 18-22 treatment cost per
  patient
• Annual procurement volume presently US 35 - 40
  million
• Introduction of innovative packaging gt 1 million
  Patient Kits delivered to Indonesia, Kenya
  Philippines
• Wide range of DP Clients GFATM, WHO, World Bank,
  German Bank for Reconstruction (KfW), Caritas
• gt200 monitoring and technical assistance
  missions conducted

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Who is receiving GDF support?
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What challenges does the GDF face?

• Increase in demand for TB drugs has reduced
  global availability of critical raw materials
• Slow responsiveness of manufacturers
  participating in TB Prequalification Project and
  resource constraints of Project
• Increasing number of monitoring missions requires
  increased partner support and funding
• Obtaining sustained, long-term, diversified,
  predictable funding for GDF grants
• Achieving successful convergence with
  DOTS-Plus/Green Light Committee

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What plans for the GDF future?

• Development of an application process for
  Diagnostic Kits and funding for same subject to
  Coordinating Board approval
• Brokering support to address Drug Management
  bottlenecks in GDF supported countries
• Implementation of a Technical Assistance service
  line
• Supply of paediatric TB formulations
• Regional decentralization

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Thank you for your support from the GDF Team!