title: Antiretroviral procurement and supply chain management.
abstract: Procurement, the country-level process of ordering antiretrovirals (ARVs), and supply chain management, the mechanism by which they are delivered to health-care facilities, are critical processes required to move ARVs from manufacturers to patients. To provide a glimpse into the ARV procurement and supply chain, the following pages provide an overview of the primary stakeholders, principal operating models, and policies and regulations involved in ARV procurement. Also presented are key challenges that need to be addressed to ensure that the supply chain is not a barrier to the goal of universal coverage. This article will cover the steps necessary to order and distribute ARVs, including different models of delivery, key stakeholders involved, strategic considerations that vary depending on context and policies affecting them. The single drug examples given illustrate the complications inherent in fragmented supply and demand-driven models of procurement and supply chain management, and suggest tools for navigating these hurdles that will ultimately result in more secure and reliable ARV provision. Understanding the dynamics of ARV supply chain is important for the global health community, both to ensure full and efficient treatment of persons living with HIV as well as to inform the supply chain decisions for other public health products.
authors.affiliation: Access Programs, The Clinton Health Access Initiative (CHAI), Boston, MA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Ripin
authors.forename: David
authors.initials: D
authors.lastname: Jamieson
authors.forename: Amy
authors.initials: A
authors.lastname: Meyers
authors.forename: Umesh
authors.initials: U
authors.lastname: Warty
authors.forename: Mary
authors.initials: M
authors.lastname: Dain
authors.forename: Cyril
authors.initials: C
authors.lastname: Khamsi
mesh_terms: D019380:Anti-HIV Agents / Q000191:economics / Q000600:supply & distribution*; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics*; D004345:Drug Industry / Q000458:organization & administration; D006078:Government Programs / Q000191:economics*; D017408:Guidelines as Topic; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D007391:International Cooperation; D016134:Organizational Policy; D011634:Public Health / Q000191:economics*; D055818:Public-Private Sector Partnerships / Q000191:economics; D000078329:Workforce; D014944:World Health Organization
chemical_list: D019380:Anti-HIV Agents