Post 00906e : Wastage Rates

POST 00906E : WASTAGE RATES Follow-up on Posts 00889E, 00894E and 00899E 2 April 2006 _________________________________ This posting is a continuation of the discussion started by questions on a new WHO site by Femi Odegbami. In this posting Anthony Battersby (mailto:[email protected]) contributes further with comments on wastage rates. _________________________________ The arguments about "acceptable" wastage rates are as old as EPI. The point is that any level of wastage is acceptable provided it brings results and is within a framework that will bring it to affordable levels in a defined period of time or produces affordable levels of wastage nationally. For example if you have a nomadic population that represents say 5% of the population but is epidemiologically important and can only be reached by strategies that produce very high wastage, then high wastage for that group is perfectly acceptable. An example of what is not acceptable is illustrated below. In 2005 UNICEF, based on data supplied by NPI, ordered 17,122,166 doses of Hepatitis B vaccine. This quantity represents more than 20% of all global Hepatitis B vaccine bought by UNICEF in 2005. The following table shows the percentage of Hepatitis B vaccine which (from Monthly Routine Immunization Report, State Summary Reports) appears to have been wasted or unused in 2004. [DPT3 coverage from the National Coverage Survey 2003 is also shown.] Hepatitis B vaccine wasted or in the pipeline at the end of 2004 in eight States in Northern Nigeria visited by DFID team in February/March 2005 [and, for interest, DPT3 coverage from NCS 2003: DPT3 among surveyed cohort 12-23 months; and DPT3 before first birthday]. Note : the plain text format is likely to disrupt the table below. If it is unreadable, please open the attachment to this message, State HBV wasted DPT3 coverage Adamawa 82.6% [22.5%; 13.0%] Bauchi 67.4% [25.7%; 13.6%] Borno 82.2% [19.5%; 11.7%] Jigawa no data [15.9%; 4.0%] Katsina no data [21.8%; 11.9%] Sokoto no data [ 4.3%; 2.1%] Yobe 96.8% [ 6.5%; 2.8%] Zamfara 81.8% [ 7.8%; 2.9%] At least two of the eight States visited had no Hepatitis B vaccine at the beginning of 2005. In the preparation of the estimates for vaccine supply in 2005 UNICEF records zero balance of stock at the end of 2004 for Hepatitis B vaccine. The centralized PUSH system of stock management that has been adopted by NPI seems to have no provision for establishing current stock levels at Zonal or State stores. Vaccine was either wasted or was in the pipeline at State level or below. It is not clear what has happened to the wasted Hepatitis B vaccine, but it is valuable and sought after in the private sector. Public sector clients are sometimes asked to pay for their immunizations, so it is at least possible that vaccine intended for the public sector is being sold privately. The quantity of Hepatitis B vaccine "wasted" by Nigeria in 2004 would be enough to meet the needs of all the adjacent countries plus Togo, Guinea Bissau, Burkina Faso and Central African Republic. Nigeria's estimated "needs" for Hepatitis B vaccine in 2006 is 17,549,600 doses. As Jack Stack the author of "The Great Game of Business: Unlocking the Power and Profitability of Open-Book Management" said "We live in a complex world, don't simplify it, understand it." Best wishes Anthony ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de internationale en sant, Canada (http://www.ccisd.org) ______________________________________________________________________________ ##text##