Supply chain management for DR-TB commodities

Clinical description

Second-line anti -TB medicines and ancillary medicines Procurement and quantification of second-line anti-TB medicines is done at national level.

Procurement is mainly through the Global Drug Facility (GDF) using Quant - TB. For effective supply chain management, the following measures should be taken:

 Quantification should be reviewed based on the updated stock status and morbidity data.

National Tuberculosis Control Programme 67  Quantification team should regularly review the quantification  Staggering and accelerating of procurement should be guided by in-country stock status and enrolment.

 Storage of second-line TB medicines and other supplies is at Central Medical Stores Trust (CMST).

 Distribution to respective DR-TB registration sites should be monitored by NTP.

 District /zonal health officers should request second-line drugs from NTP based on their number of patients.

 District /zonal health officers should collect second-line drugs from CMST and distribute to DR-TB registration sites based on their consumption and enrolment data  All necessary arrangement should be made by the district health officers and MDR-TB registration sites for distribution of second-line drugs to respective DR-TB follow-up sites.

Gene Xpert machine, cartridges and TB infection control items

• The distribution of Xpert MTB/RIF cartridges and TB infection control items to health

facilities is through CMST based on target and actual consumption.

• N-95 masks are for health care workers; surgical masks are for TB patients.
• Patients must wear surgical mask throughout their stay in hospital and at home;

hospitals must supply adequate numbers of surgical masks for each patient.

General recommendation for use of respirators

• All technical, administrative and supportive staffs must wear N-95 respirators while

working in DR-TB wards and OPD. Staff must be supplied with adequate respirators.

• Care-takers are not encouraged to stay in the wards unless permitted by the clinician

and/or head nurse. When allowed to stay, they should also be supplied with respirators.