Report Finds Positives, Weaknesses In US AIDS Relief Programme

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A US report released this week found that the President’s Emergency Plan for AIDS Relief (PEPFAR) has helped to make antiretroviral drug supply chains more efficient and reliable, but still contains several weaknesses that need to be addressed.

The US Government Accountability Office (GAO) has released a report [pdf] on the PEPFAR drug supply chain. GAO was asked to review PEPFAR-supported antiretroviral (ARV) drug supply chains and examined actions by PEPFAR to improve ARV drug supply chains and partner-country ARV drug supply chain operations. This is the last of three reports requested by Congress.

The report found that PEPFAR has taken three key steps to make ARV supply chains for treatment programs more efficient and reliable for all PEPFAR partner countries:

First, PEPFAR and USAID have consolidated supply chains for PEPFAR’s ARV drug procurement, enhancing efficiency and reducing operational costs. Second, PEPFAR has improved donor coordination by creating a network to facilitate information sharing and by developing an emergency procurement mechanism. Third, PEPFAR has provided partner countries with technical assistance, such as assessment tools and training, to help strengthen their supply chains and manage them more effectively.

 Meanwhile, weaknesses were found in inventory controls and record-keeping, including missing or inaccurate drug consumption data. These weaknesses can lead to shortages, waste and loss of resources, the report said. Human resource constraints also contribute to these weaknesses, and PEPFAR is making efforts to address them.

Another weakness was the fact that PEPFAR does not require country teams that support partner-country supply chains to develop and implement plans to strengthen partner countries’ inventory controls and record-keeping to reduce the risks of shortages, waste and loss in ARV drug supply chains. Because PEPFAR generally relinquishes control of the supply chain once the drugs reach a country’s central warehouse, it is essential that partner-country governments develop the capacity to manage their drug supply efficiently.

The report recommended the US Secretary of State to direct the Office of the US Global AIDS Coordinator (OGAC) to require country teams to develop and implement plans to help partner countries improve inventory controls and record-keeping. It should also require tracking of the progress partner countries are making in measuring ARV drug consumption, waste and loss, it said.

Brittany Ngo is currently completing her Master’s in Health Policy and Global Health at the Yale School of Public Health and previously obtained a Bachelor’s of Arts in Economics from Georgetown University. Through her studies she has developed an interest in health-related intellectual property issues. She is a summer intern at Intellectual Property Watch.

Brittany Ngo may be reached at

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