Storage

Health products are stored in various storage points along the national supply chain: they are usually stored in the national Central Medical Store (CMS) [1] after reception in-country, before being distributed to intermediate stores (regional and district stores), and then to health facilities where they are dispensed to patients. Health products for use in clinical laboratories may be managed through a dedicated national supply chain system due to temperature requirements and limited shelf-life of many reagents and consumables. Sometimes health products may even be delivered to the community level through community health workers or through non-government organisations (NGOs).

Considering the number of public health facilities storing health products in a country, it is beyond UNDP’s reach to guarantee good storage practices in all health facilities of a country. However, when working through the Ministry of Health supply chain (Central Medical Stores CMS, regional/district stores, health facilities), UNDP, as a development partner, should support the MoH in achieving the standards for good storage practices. This can be achieved through technical assistance and financial support, to the extent allowed by budget availability.

Using funds available under the Global Fund grant(s), UNDP COs can support activities that will help government and/or non-governmental organisations to achieve standards for GSP (e.g., QA and GSP training; procurement of temperature recording devices; procurement and installation of cooling units; etc). These activities should be primarily implemented at central level, and then cascaded down the supply chain to the extent the budget allows. GF grant funds may not be used to support system strengthening of private sector facilities.

Storage Facilities

Existing national storage facilities/warehousing system and distribution mechanisms for health products are the logistics channels of choice for UNDP programmes if they are adequate or if deficiencies can be remedied during the implementation of the programme. If these channels do not meet the necessary standards, storage facilities run by non-governmental organizations (NGOs), other UN agencies, or international organizations may be a viable alternative. It may also be possible to use private facilities and distribution networks run by commercial companies while national systems are being improved. sector institutions, including teaching hospitals, clinical laboratories, and other not-for-profit private Institutions.

In the context of Global Fund projects, or if UNDP is responsible for the storage of health products, the UNDP CO should ensure that the facilities are secure and compliant with storage requirement in WHO’s Good Storage and Distribution Practices.

At a minimum, it is expected that UNDP CO:

• Perform a formal assessment of storage conditions in storage entities that have a contract with UNDP CO (usually the CMS, but sometimes also some intermediate stores) on an annual basis (this verification is done using a standardized supervision form – see Storage and Inventory Management Checklist issued by GFPHST).

• Perform assessment of storage conditions during supervision visits in a selection of other stores (intermediate and peripheral) used in the project, on an annual basis.

• A more thorough assessment (covering a higher number of facilities) could also be funded with funds allocated in the grant, if any.

These assessments should be done jointly with a representative of the NRA (or other designated government entity responsible for GSDP standards) and the recommendations compiled in a report and implementation monitored by the NRA (or other designated government entity).

To support UNDP COs with engaging the CMS either through a SR Agreement or through a Service Contract, GFPHST issued a guidance note.

[1] The term “Central Medical Stores” (CMS) describes the national warehouse system that is mandated by the government to manage health products. The CMS is, generally, responsible for the procurement, storage, and distribution of pharmaceutical products and other health products such as HIV- and malaria- rapid diagnostic test kits, condoms, lubricants, and laboratory reagents to public sector institutions, including teaching hospitals, clinical laboratories, and other not-for-profit private Institutions.