There are two mechanisms for TB program drug procurement. First line drugs (FLD) follows the e-catalogue or e-purchasing, using government funds/APBN. The e-procurement system consists of drugs sourced from manufacturers within the country and the process is managed by FARMALKES. While Second line drugs (SLD) and other commodities not funded by the government but through the Global Fund, are procured using the Special Access Scheme (SAS) through the Global Drug Facility (GDF) mechanism.
There was no episode of stock out of FLDs or SLDs in the past 12 months. However, pockets of stock out of INH 100mg & 300mg were noticed in some facilities while other facilities used INH 300mg in place of INH 100mg for the prophylactic treatment of children.
Generally, good infrastructure exists for the storage of medicines, however, the central warehouse used for the storage of SLDs and diagnostics has an inadequate storage area. Also, it was noted that some dispensing areas (where medicines stay up to one week) had no temperature monitoring equipment and poor ventilation was observed.
The pharmacies have a separate system for recording and reporting drug stocks (e-logistics for pharmacy) and this doesn’t connect automatically with SITT for FLD program reporting and e-TB Manager for SLD program reporting. Data for lab commodities are not captured in any of these systems.
Challenges
The daily treatment recommendation is not followed because the drug formulation (Rifampicin150mg/Isoniazid75mg) for daily dosing is unavailable. Local manufacturers are not producing it and building the capacity may take 2-3 years from product development to registration.
Some specialists at the treatment facilities still prefer to use single anti-TB formulations over the fixed dose combination (FDC). Some are of the view that single formulations still yield better clinical outputs than the FDCs. 

The targets set for treatment of DRTB patients for 2017 and 2018 are 2.8 and 5 times, respectively, more than the cases in 2016. (DRTB patients target to treat, 2016: 4,000 patients (1,800 actual enrolment); 2017: 5,200 patients; 2018: 10,500 patients). This poses a challenge in quantification of medicines because if the targets are not met, the medicines, with their short expiry dates, would be at risk of expiration. 

Logistics data monitoring and analysis are weak and the SITT electronic system is not good at re-organizing data so it could be used for decision making. There is a form for reporting and requesting first-line medicines but, there is no analysis of drug consumption, months of stock remaining, max/min stock levels, or buffer levels for drug quantification.
