Afghanistan: CPDS, CSC, and ACSS Stakeholder Procurement, Distribution, and Quantification Activities and Functions Review. April 2012
(2012; 47 pages)


For largely historical reasons of development in a post- or ongoing conflict situation, the current essential medicines supply mechanisms in Afghanistan are characterized by multiple funding sources and a large number of active players, giving rise to fragmented and, currently, largely uncoordinated service from multiple, vertical supply streams of varying efficiency.

This is not to say that the medicines supply service has been unsuccessful—through the Basic Package of Health Services (BPHS) and Essential Package of Hospital Services (EPHS) schemes medicines are clearly reaching patients, which is a major achievement in such a complex and fragile operating environment. Clearly, however, if the service is to be expanded to meet increased health care provision and if significant improvements are to be made in the quality and reliability of that service, then improved oversight, good governance principles of management, and much greater coordination are needed.

As noted, the service is functional—medicines are reaching patients—but the operational environment is fragile. It will be imperative to ensure that any changes and developments do not threaten to disrupt existing operations and the security of medicine provision to patients. Change is essential to bring the necessary improvements, but that change must be designed and implemented in ways that maintain continuity of supply, and to achieve that aim, it will be essential to have a comprehensive understanding of the current essential medicines supply operations and long-term, multiyear strengthening plans.

As the responsible government body for public health, the MoPH in Afghanistan has recognized these challenges and, with the assistance of its implementing partners, has formulated an approach to address matters. It has adopted a CPDS mechanism for the promotion of good governance and supply chain oversight, and formed three advisory committees to carefully review the situation and undertake action plans for procurement and supply management (PSM) strengthening and development in each of the main areas of coordination development, systems strengthening, and commodity security.

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