The procurement of ARVs will be done by the Medical Stores Department which will then distribute the medicines to all the accredited facilities across the country. Requisition of antiretrovirals from the facilities will follow the normal procedures except that a separate requisition form will be used.
On receipt of the drugs at the facility, the pharmacist should check the ARVs brought by MSD and sign the delivery note.
Closely monitored adequate buffer stock must be kept at all times to avoid stock outs.
Ordering of ARVs will be done by the pharmacist using the "Integrated logistic system" register which is made of Form A1: Dispensing Register for Antiretroviral drugs (ARVs) and Form A2: Report and Request for Antiretroviral drugs (ARVs). The built-in inventory control system is designed to ensure that drugs are ordered monthly based on existing stock levels and not on morbidity data. Relevant data on the consumption of the antiretroviral medicines must be kept and sent to the Ministry of Health every month, according to the MSD indent format.
Orders to the Medical Stores Department (MSD) should be made timely and well in advance to allow supplies to reach the facilities in time.
Collaborating with clinical staff
While the pharmacist will not re-order ARVs based on morbidity data because consumption data will be available, the pharmacist should be prepared to work with clinical staff to obtain an estimate of the number of patients expected to be enrolled on therapy.
The pharmacist should keep the clinical staff informed on the current stock levels of ARVs, particularly on items nearing stockout. In the event of national-wide supply shortage of which the pharmacist may be the first person to know, this information should be communicated to the clinical staff so they can pursue the best course of action.
Monitoring of adverse drug events
Monitoring and reporting of adverse drug events should follow the Tanzania Food and Drug Authority guidelines. Adverse drug reactions reporting forms will be distributed to facilities as they become certified to deliver ART.
Procurement, storage, distribution and dispensing procedures and records as well as stock on hand will be subject to internal and external audit. Given the cost and complexities of handling ARVs, frequent auditing is anticipated.