BOX 4-1
Suggestions and Low-Hanging Fruit



•   Prioritize development of an operational strategy to improve demand forecasting.

•   Develop a mechanism for pooled procurement to increase predictability and volume of demand.

•   Maintain a buffer inventory of SLDs with optimal size, scope, and design to improve production efficiencies by smoothing demand, thereby reducing product costs and delivery lead times.

•   Use innovative mechanisms to facilitate long-term financing commitments and improve contracting structures.

•   Bundle SLDs with other well-established drug supply chains to lower costs and expedite delivery.

•   Improve flexibility and predictability of funding; facilitate reallocation of unused funds to avoid loss to use.

•   Develop in-country capacity and support system strengthening through training programs.

•   Facilitate regulatory harmonization to reduce delays in drug qualifications and approvals.

•   Increase level of engagement with private sector and governments in countries.

•   Mobilize public and private advocacy for MDR TB.

Low-Hanging Fruit

•   Develop a system of universal, standardized bar coding for products coupled with mobile information technology to track drug supply and prevent stock-outs.

•   Implement an EMR system for MDR TB programs.

•   Simplify regulatory dossiers and priority sequencing; consolidate and harmonize NTPs’ technical product specifications.

•   Facilitate regular interaction with manufacturers around demand forecasting.


a Identified by individual workshop participants.

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