BOX 3-1
Related Efforts in SLD Supply Chain and Access

Second-Line Drug Access Improvement Initiative (SLDAII)


SLDAII is a joint effort of many leading organizations from the public, private, NGO, and allied fields that was founded on the vision that all patients would be able to access affordable, QA treatment within a sustainable MDR TB SLD drug market. SLDAII focuses on developing the technical information and knowledge needed to make rational decisions and to document why certain risks need to be taken.

The initiative comprises six workstreams, concentrated on the supply side, which are each tied to a goal or set of goals. The manufacturer scale-up and operational forecast workstreams are connected to the goal of increased affordability of IQA SLDs. Supply chain diagnosis and financing mechanisms aim to increase the supply of IQA SLDs. The IQA recommendation and private-sector engagement workstreams target greater operational efficiency. Each goal is also underpinned with a set of specific outcomes that need to be accomplished in order to achieve each goal itself (Figure 3-4).


FIGURE 3-4 SLDAII vision and goals.

NOTES: Arrows represent connection between workstreams to different goals; IQA, internationally quality-assured; PQ, prequalified; SLD, second-line anti-TB drug.

SOURCE: Kimerling, 2012. Presentation at IOM workshop on Developing and Strengthening the Global Supply Chain for Second-Line Drugs for Multidrug-Resistant Tuberculosis.

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