Periodic Review ccm request template

A Draft Phase II Procurement and supply management plan is attached at RTC Annex 2. This plan will be finalised upon agreement of the final programme content. This draft plan includes updates to procurement and supply chain management that reflects experiences gained during the first phase of implementation and updated policies, guidelines and practices.

No significant procurement or supply chain management problems have been encountered during the first phase of the programme, other than would be expected during the initial operationalization of any new programme, and these include aspects of:

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  Product selection for procurement;
  
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  Procurement;
  
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  Forecasting;
  
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  Receipt, storage and inventory management;
  
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  Distribution;
  
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  Pharmaceutical Quality Assurance System;
  
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  Management information & reporting system; and
  
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  Coordination
  

	6.2 Financial Proposal
6.2.1 Resources available to finance the grant/SSF after cut-off date
The following tables show the available resources at grant cut off for the remainder of the duration of Phase 1. Table 46: Resources available to finance the grant/SSF after cut-off date
6.2.2 Summary funding request from cut-off date to end of next Phase/Implementation Period Table 47: Summary funding request from cut-off date to end of next Phase/Implementation Period
		6.2.3 CCM Budget Request for the next Phase/Implementation Period

RTC consistently and rigorously monitors both its own budgetary performance and that of its sub-recipients. Budget reallocations have been minimized through thorough and accurate planning. Continuous monitoring of innovations, new technologies and products allows for the adoption of best price practices that maximize impact of the resources deployed.

Economy, efficiency and effectiveness are factors driven by good programme management and include the following: (i) all procurement is subject to competitive procurement processes. All items that are envisaged to be procured are available in SA currently and therefore costly external shipment and delivery will be avoided. (ii) Supply of additional staff, goods and services in-kind. Outside of the limited project staff to be appointed, most staff will be drawn from the existing DOH pool. DOH facilities also provide all operational consumables generating considerable programmatic savings; space and utilities are provided at no cost; all laboratory and other tests are external to the programme as they fall within routine health facility operational costs; (iii) Cost-efficient technologies will be utilised (e.g. cell phone-based mobile and internet sites); (iv) Experience of operating in rural and remote sites has been shown to be cost-effective; (v) all salaries and benefits are benchmarked and all labour costs are subject to labour market conditions which are consistent with DOH rates. Staff productivity is monitored through established management processes and includes job descriptions, staff performance targets and time keeping records (including timesheets or electronic clock-in systems); (vi) all off-site costs/expenses are subject to scrutiny and validation with the strict application of policies that reduce cost and restrictions on per diem claims/payment. (vii) RTC operates an anti-fraud system and reporting telephone service and SRs will be supported in the development of anti-fraud measures; (viii) All travel is required to be at the lowest rate (e.g. economy air travel); (ix) Programme vehicles will be fitted with electronic vehicle monitoring systems to track usage coupled with logbooks. (x) Administrative overheads are limited to the minimum required for the purposes of providing the service and are subject to the same rules and regulations identified above. These systems ensure value for money and optimal use of resources and reduce the risk of fraud. Both RTC and SRs will be required to have annual audits with external auditors and both RTC and SRs will be subject to periodic financial compliance checks.

Current variances in budget performance have been explained previously and are a direct consequence of the delayed receipt of funds and resulting delayed implementation.

The budget requested is based fully on the actual costs incurred whilst implementing the first phase of the programme and on extensive planning (including supplier quotations, where relevant). All staff costs are benchmarked and, where relevant, aligned with government salaries.

6.3 Compliance with Focus of Proposal Requirement

South Africa (SA) has a two-tiered economy; one rivalling other developed countries and the other with only the most basic infrastructure. In 2011 SA had a Gini co-efficient of 63.1% (World Bank) making it the most unequal society in the world. One manifestation of this is the distribution of healthcare expenditure – whilst national GDP expenditure on health is 8.3%; 4.1% is through private medical schemes and supports 14% of the population whilst the remaining 4.2% is public healthcare supporting the needs of 86% of the population (CDE, 2011). Whilst major efforts are underway to address this imbalance, progress has been slow and consequently healthcare services for the poor are often comparable to those of least developed countries. SA is currently at the epicentre of the HIV pandemic and with 0.7% of the world population it carries 17% of the global HIV burden. SA has an estimated 5.3 million HIV infected people (UNAIDS, 2009). Young women (15-24) are four times more likely to have HIV than males of the same age (NSP 2012-16). Whilst HAART services are increasing with 1.4m people on treatment, this represents only 55% of those eligible under WHO guidelines. Opportunistic infections associated with HIV continue to increase with approximately 1% of the population developing TB disease every year. Off track MDGs are as a direct result of the high burden of HIV and disease.

The rationale underpinning the choice of the RTC SDAs is threefold:

1. 
   To target most-at-risk/key populations as defined by both UNAIDS and the NSP 2012-2016 (low socio-economic groups, MSM/LGBTI, and prisoners);
   
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   To target prevention (VMMC);
   
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   To ensure high-impact optimal treatment outcomes for the larger population (including key populations) through treatment adherence and drug resistance monitoring.