Established by the government of Malawi in November 2010, the Central Medical Stores Trust (CMST) replaced the old Central Medicals Stores (CMS) for better service to the nation.
The creation of the Trust, according to its Communications Officer Herbert Chandilanga, was amid serious operational, financial, and governance challenges which had led to equally serious and vastly publicized shortages of medicines and medical supplies, leading to, at its highest, a 95 percent stock-out by early 2013.
"On this occasion the Trust outlined its ongoing reforms aimed at ensuring the availability of sufficient quantities of good quality medicines and medical supplies in all public health facilities in Malawi, at affordable cost," he said.
REFORM AREAS
In March 2016, His Excellency the State President Professor Arthur Peter Mutharika approved various reform areas to be implemented by CMST amongst them being procurement, warehousing, distribution and joint strategy on Parallel Supply Chain Integration.
Transformation in procurement was intended to improve stock and performance of the procurement unit by establishing Framework Agreements (FA) with suppliers and manufacturers.
Chandilanga said this was aimed at ensuring speedy acquisition of supplies and acquiring to financial gains by procuring directly from manufacturers and global distributors.
He added that through warehousing reform, the main goal was improving warehousing facilities and conditions to ensure availability of adequate warehousing space and conditions in line with Good Warehousing Practices.
"Efficient distribution of medicines and medical supplies would contribute to seamless delivery of health services. Reforms in this area included outsourcing distribution, improving distribution logistics and fleet management and implementing tracking system for distribution trucks.
"The following was planned to achieve the above: outsourcing of distribution services, replacement of old distribution vehicles, creation of a logistics unit and installation of vehicle tracking and fuel management systems on all distribution vehicles," he said.
In the wake of several supply chains often procuring, warehousing and distributing the same items, the implementation of a Joint Strategy on Parallel Supply Chain Integration into the Trust’s system would pool all available resources into the CMST system for a better coordinated national supply system of all health commodities.
This, he said, would save resources and build the capacity of the Trust. Plannig, coordination and monitoring of all inputs into the national health care delivery system would be equally improved.
Achievements
The Trust has pursued implementation of these reforms in line with the Trust’s Corporate Strategy and Business Plan 2015-2020, guidance from the Public Sector Reforms Commission and support from various development partners and stakeholders.
"CMST’s quest for efficient and cost effective procurement of quality medicines and medical supplies directly from manufacturers and global distributors is guided by the provisions of the Public Procurement and Disposal of Assets Act 2017. CMST now has a draft procurement policy and the plans to have a procedure manual and standard operating procedures are at an advanced stage.
"Inadequate human resources and technical and strategic leadership have being some of the greatest challenges to have faced the procurement unit, plans to recruit a Procurement Director are at an advanced stage. The CMST Board has already approved recruitment of a Director of Procurement and plans to improve necessary human and technical capacity towards efficient procurements are in place.
"The use of prequalified suppliers and framework agreements has resulted in an improvement in the availability of medicines and medical supplies," said Chandilanga.
He said the Trust has undertaken improvements to the conditions of warehouses in line with Good Warehousing Practices.
Some of the improvements include such as signage and floor markings, installation of security and temperature control systems and improvement of warehouse management information system.
He also said that the completion of the National Pharmaceutical Warehouse (NPW) and its subsequent operationalization has brought in an additional 3000 cubic metres (cm3) of storage space, bringing the new total to 11150 cm3.
The NPW is fully racked, cold rooms are installed in addition to roof insulation, epoxy floor coating and external civil works.
"To comply with Good Warehousing Practices, for the rest of the warehouses, internal signage floor markings have been completed and security biometric access systems as well as CCTV cameras have been installed. Temperature control systems are being installed and private security guards including dog handlers as well as armed policemen are in place in all warehouses," he said.
Improvement in distribution efficiency has been key so that medicines and medical supplies reach all health facilities country wide in a timely manner, safely and cost effectively.
Following a distribution options study, Chandilanga said a hybrid distribution strategy was adopted in which the Trust ferries supplies from the central warehouse to the three regional warehouse as well as distribution to the country’s five central hospitals. The distribution to all district hospitals and health centers is outsourced.
A 30 tonner distribution truck, two 20 tonner trucks, three 15 tonner trucks and one cold chain van have been acquired so far. In addition the Ministry of Health with funding from World Bank has recently donated three 34 tonner trucks to CMST.
In 2012, a Joint Strategy for Supply Chain Integration in Malawi was launched. It defined 36 benchmarks in 4 Phases to be implemented by CMST and used for measuring its readiness to manage all commodities from all parallel supply chains once collapsed into the CMST.
In March 2016, an evaluation of the implementation of the Joint Strategy was undertaken. Overall CMST implemented 87% of the bench marks. Implementation of the strategy is therefore still work in progress particularly for Phases 3 and 4 on the integration of procurement functions and additional warehousing and distribution from the parallel supply chain.
"While the current Joint Strategy for Supply Chain Integration in Malawi has benchmarks for CMST, there are none for the various actors of the parallel supply chains.
'This is a challenge as there is no objective way of assessing the progress being made by them in moving towards the integration. There is also no defined pass mark for CMST and at which the integration will be triggered," he said.
Buy Malawi Campaign
The Trust is also implementing the pharmaceutical chapter of the Buy Malawi Policy following a Memorandum of Understanding [MOU] signed between the Government of Malawi and the four Members of the Pharmaceutical Manufacturers Association of Malawi [PHAMAM].
In line with this MOU, the Trust is expected to buy its full requirements of certain medicines exclusively from members of PHAMAM on the condition that they are manufactured locally. This is envisaged to contribute to saving foreign currency and growing the local pharmaceutical industry to the extent that the produced items are competitively priced and respond to national quality and other regulatory requirements as prescribed by the Pharmacy Medicines and Poisons Board.
Currently CMST is procuring 20 items under BMC. An additional 42 items have recently been submitted to the Ministry of Industry and Trade for approval and inclusion on the BMC list. Additional items including syringes, plastic aprons, blood collecting tubes, cotton wool, gauze, gloves and pill bags are being procured from another local manufacturer by virtue of an MOU signed with Malawi Government and subsequent Framework Agreement signed with CMST.
The creation of the Trust, according to its Communications Officer Herbert Chandilanga, was amid serious operational, financial, and governance challenges which had led to equally serious and vastly publicized shortages of medicines and medical supplies, leading to, at its highest, a 95 percent stock-out by early 2013.
"On this occasion the Trust outlined its ongoing reforms aimed at ensuring the availability of sufficient quantities of good quality medicines and medical supplies in all public health facilities in Malawi, at affordable cost," he said.
REFORM AREAS
In March 2016, His Excellency the State President Professor Arthur Peter Mutharika approved various reform areas to be implemented by CMST amongst them being procurement, warehousing, distribution and joint strategy on Parallel Supply Chain Integration.
Transformation in procurement was intended to improve stock and performance of the procurement unit by establishing Framework Agreements (FA) with suppliers and manufacturers.
Chandilanga said this was aimed at ensuring speedy acquisition of supplies and acquiring to financial gains by procuring directly from manufacturers and global distributors.
He added that through warehousing reform, the main goal was improving warehousing facilities and conditions to ensure availability of adequate warehousing space and conditions in line with Good Warehousing Practices.
"Efficient distribution of medicines and medical supplies would contribute to seamless delivery of health services. Reforms in this area included outsourcing distribution, improving distribution logistics and fleet management and implementing tracking system for distribution trucks.
"The following was planned to achieve the above: outsourcing of distribution services, replacement of old distribution vehicles, creation of a logistics unit and installation of vehicle tracking and fuel management systems on all distribution vehicles," he said.
In the wake of several supply chains often procuring, warehousing and distributing the same items, the implementation of a Joint Strategy on Parallel Supply Chain Integration into the Trust’s system would pool all available resources into the CMST system for a better coordinated national supply system of all health commodities.
This, he said, would save resources and build the capacity of the Trust. Plannig, coordination and monitoring of all inputs into the national health care delivery system would be equally improved.
Achievements
The Trust has pursued implementation of these reforms in line with the Trust’s Corporate Strategy and Business Plan 2015-2020, guidance from the Public Sector Reforms Commission and support from various development partners and stakeholders.
"CMST’s quest for efficient and cost effective procurement of quality medicines and medical supplies directly from manufacturers and global distributors is guided by the provisions of the Public Procurement and Disposal of Assets Act 2017. CMST now has a draft procurement policy and the plans to have a procedure manual and standard operating procedures are at an advanced stage.
"Inadequate human resources and technical and strategic leadership have being some of the greatest challenges to have faced the procurement unit, plans to recruit a Procurement Director are at an advanced stage. The CMST Board has already approved recruitment of a Director of Procurement and plans to improve necessary human and technical capacity towards efficient procurements are in place.
"The use of prequalified suppliers and framework agreements has resulted in an improvement in the availability of medicines and medical supplies," said Chandilanga.
He said the Trust has undertaken improvements to the conditions of warehouses in line with Good Warehousing Practices.
Some of the improvements include such as signage and floor markings, installation of security and temperature control systems and improvement of warehouse management information system.
He also said that the completion of the National Pharmaceutical Warehouse (NPW) and its subsequent operationalization has brought in an additional 3000 cubic metres (cm3) of storage space, bringing the new total to 11150 cm3.
The NPW is fully racked, cold rooms are installed in addition to roof insulation, epoxy floor coating and external civil works.
"To comply with Good Warehousing Practices, for the rest of the warehouses, internal signage floor markings have been completed and security biometric access systems as well as CCTV cameras have been installed. Temperature control systems are being installed and private security guards including dog handlers as well as armed policemen are in place in all warehouses," he said.
Improvement in distribution efficiency has been key so that medicines and medical supplies reach all health facilities country wide in a timely manner, safely and cost effectively.
Following a distribution options study, Chandilanga said a hybrid distribution strategy was adopted in which the Trust ferries supplies from the central warehouse to the three regional warehouse as well as distribution to the country’s five central hospitals. The distribution to all district hospitals and health centers is outsourced.
A 30 tonner distribution truck, two 20 tonner trucks, three 15 tonner trucks and one cold chain van have been acquired so far. In addition the Ministry of Health with funding from World Bank has recently donated three 34 tonner trucks to CMST.
In 2012, a Joint Strategy for Supply Chain Integration in Malawi was launched. It defined 36 benchmarks in 4 Phases to be implemented by CMST and used for measuring its readiness to manage all commodities from all parallel supply chains once collapsed into the CMST.
In March 2016, an evaluation of the implementation of the Joint Strategy was undertaken. Overall CMST implemented 87% of the bench marks. Implementation of the strategy is therefore still work in progress particularly for Phases 3 and 4 on the integration of procurement functions and additional warehousing and distribution from the parallel supply chain.
"While the current Joint Strategy for Supply Chain Integration in Malawi has benchmarks for CMST, there are none for the various actors of the parallel supply chains.
'This is a challenge as there is no objective way of assessing the progress being made by them in moving towards the integration. There is also no defined pass mark for CMST and at which the integration will be triggered," he said.
Buy Malawi Campaign
The Trust is also implementing the pharmaceutical chapter of the Buy Malawi Policy following a Memorandum of Understanding [MOU] signed between the Government of Malawi and the four Members of the Pharmaceutical Manufacturers Association of Malawi [PHAMAM].
In line with this MOU, the Trust is expected to buy its full requirements of certain medicines exclusively from members of PHAMAM on the condition that they are manufactured locally. This is envisaged to contribute to saving foreign currency and growing the local pharmaceutical industry to the extent that the produced items are competitively priced and respond to national quality and other regulatory requirements as prescribed by the Pharmacy Medicines and Poisons Board.
Currently CMST is procuring 20 items under BMC. An additional 42 items have recently been submitted to the Ministry of Industry and Trade for approval and inclusion on the BMC list. Additional items including syringes, plastic aprons, blood collecting tubes, cotton wool, gauze, gloves and pill bags are being procured from another local manufacturer by virtue of an MOU signed with Malawi Government and subsequent Framework Agreement signed with CMST.
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