Drug Supply Budget Line of Zambia

In Zambia, the availability of essential drugs and supplies in Zambia’s public health sector is a continuing problem due to several reasons (lack of an agreed procurement policy; lack of a single, Ministry of Health (MOH) led procurement strategy; lack of an integrated procurement approach (MOH+donors,NGOs, vertical programmes); lack of credible data and information for procurement planning; poor forecasting; funding structures and arrangements not always able to support procurement; ineffective procurement arrangements with suppliers; poor fund management; non-compliance to basic procurement rules and regulations; weak regulatory infrastructure/underpinnings; poor use of advisory services from cooperating partners; drawn-out MOH restructuring process). These issues resulted in regular emergency procurement activities with high costs. Hence, MOH and Cooperating Partners (CPs) came up with a system, Drug Supply Budget Line (DSBL) that would result in addressing factors that create a poor procurement and supply environment in the public health sector. The drug basket or drug supply budget line (DSBL) has been identified as the means to achieving a transparent, accountable and therefore efficient procurement and supply management platform at MOH, resulting in the continuous availability of affordable essential drugs supplies. The following system changes were incorporated with the help of DSBL:

I) Re-establishing firm procurement platform (e.g. by means of early planning, and early procurement as opposed to ‘emergency’ procurement; establishing MOH- led procurement plan and procurement strategies; joint- planning, liaising and coordinating with all MoH departments and partners linked to, supporting or conducting procurement; establishing better working arrangements and relations with industry; establishing a communication platform through- out MOH platform (online, phones))

II) Procurement arrangements (e.g. by means of targeting continuous availability of essential drugs and medical supplies in supply chain; coordinating and liaisoning with stakeholders at MOH (eg, Clinical Care/Diagnostics, etc) when triggering procurement; establishing long- term framework arrangements with local and international suppliers of goods and services; taking ‘partnership’ approach with CPs, NGOs and industry)

III) Fund Management (e.g. by means of working with Ministry of Finance and National Planning and recognising its role in public health; advocating for early and significant release of funds against Health budget; establishing transparency in management of Govt of Zambia / CP funds by establishing a dedicated DSBL Drug Account for procurement of goods and services; establishing policy of ring-fencing of funds dedicated for procurement of drugs / medical supplies and services; setting up virtual budget for each health facility against which supplies ‘procured’ from medical stores).