Factors that affect the commodity security of antiretroviral drugs in Rwanda: procurement perspectives

Abstract

ABSTRACT

According to the World Health Organization (WHO), access to essential medicines has been described as one of the six building blocks of the health system and has been set (as priority for all citizens in the sustainable development goals (SDGs) to be attained by 2030. While HIV/AIDS is on global priority agenda, all people living with HIV (PLHIV) are deemed to consistently access to antiretroviral treatment. This requires strong strategies to ensure commodity security of antiviral drugs (ARV) so that PLHIV can obtain and use ARV whenever and wherever he or she needs it.

This descriptive and retrospective study aimed at describing the factors affecting the commodity security of antiretroviral drugs in Rwanda with procurement perspectives. Accordingly, procurement proceedings, level of dependency towards suppliers and suppliers’ performance had been assessed to find areas needing improvements to attain the commodity security of ARVs.

Data were collected from procurement records for the period of January 2017 through December

2018, using MS Excel tools and analyzed to explore factors that affect the commodity security of antiretroviral drugs, in procurement perspectives.

We found that procurement proceedings are well performed, the lower number of available suppliers for antiretroviral drugs does not affect the availability of antiretroviral drugs. However, suppliers’ performance especially in terms of timely deliveries was found not satisfactory as the timeliness compliance was noted at 29% and 38% in 2017 and 2018 respectively.

The procurement of antiretroviral drugs in Rwanda is well established following the public law, regulations and Global Fund guidelines. This is to ensure access to safe, effective, quality and affordable antiretroviral drugs in Rwanda, which with other components of the health systems can help in attaining the commodity security, and this can be a starting point to build a well-established health system countrywide. Nevertheless, improvement intervention is recommended in suppliers’ performance to ensure orders fullness and timeliness