Procurement and Supply

Management in Moldova

Laurentiu IONESII

Introduction

Main objective of the presentation is to show that Moldova has a

procurement system in line with international standards and guarantee
access to safe, effective and good quality medicines and commodities.
Procurement of medicines needs a more wide approach than procurement
of other commodities because:

Medicines save lives

Medicines are costly

Medicines are different from other consumer products

That is why we have to put the procurement in the PSM Cycle that includes:
Selection Procurement- Distribution Use.
All this rests on the Policy and Legal Framework and Institutional Capacity.

Policy and Legal Framework

Main elements are:

National Health Policy and the implementation plan 2008-2017
National Medicines Policy. Among other topics it includes:

Affordability;

Medicines financing;

Medicines regulation;

Rational use;

Research;

Selection of essential medicines.

Medicines act is formed of two laws 1) Law on pharmaceutical activity 2) Law concerning
medicines. Both these laws provide for : Establishment of a National Medicines Regulatory
Authority; Inspection and market surveillance; Quality control laboratory;
Pharmacovigilance; Medicines pricing.
Public Procurement Act is The Law on Public Procurement.

Institutional Capacity

Medicines Agency. Is subordinated to the Ministry of Health.The Medicines Agency

(M.A.) is the main institution with responsibility for pharmaceutical policy
implementation. It was recently restructured. Its functions are detailed below and
correspond more or less to the standard spectrum of M.A. responsibilities. The M.A. is
adequately staffed with technical people, including pharmacists, doctors and chemists.
The main functions of the MA are:

Development of pharmaceutical management-related policies and

regulations;

Regulate the public sector procurement and distribution system of essential

medicines;

Elaborate or contribute to the elaboration of the Essential Medicines List;

Regulate or participate in the regulation of medicines pricing in the public and

private sector;

Elaborate or contribute to the elaboration of Standard Treatment Guidelines;

Supervise pharmaceutical services of the public and private sector.

Institutional capacity

Agency for public procurement. Is subordinated to the Ministry of Finance. APP

implements the state policy in the field of public procurements and ensures regulation,
supervision, control and inter-ministerial coordination of public procurements. It has the
following functions:

Implementation of the laws in public procurement

Ensuring of transparency and ethics of PP
Ensuring competition and fighting against unfair competition
Monitoring and Evaluation of the performance and adherence of the Contract Authorities to the
procedures

To be able to implement its functions the APP has the following attributes:

Develops the standard documentation; provides to the local authorities methodological support;
issues the Public Procurement Bulletin; examines bidding documents and evaluation reports;
registers contracts concluded by the CA; examines and solves complaints and litigations; reports to
the Government.

Procurement planning

Procurements from public resources is done in accordance with the Law on Public
Procurements.
Principal recipients UCIMP and PAS do the procurements in accordance with their own
Procurement Manuals. Because prior to the implementation of the GF grants these
recipients implemented World Bank projects the Procurement Manuals are based on the
World Bank procurement Guidelines for Goods and for Consulting Services.
Procurement planning. The law provides for the CA to develop and publish in the Public
Procurement Bulletin the procurement plans for one year.
The procurement of medicines for the National Programs is done by the Medicine Agency.
In accordance with the regulation on the Procurement of Medicines and other medical
products for necessities of medical services by the 1 st of July each year the managers of
the health institutions determine the necessities of medicines for the next year based on
the list presented by the MOH. By the 1 of August each year the principal specialist of the
MoH will determine the necessity of medicines to be procured centralized for the national
programs.

Product selection. Development of specifications

Product selection and specifications are developed by a multidisciplinary committee from

various institutions. In accordance with the law the following rules apply to the
development of specifications:

The characteristics of the goods to be procured will represent an exact and complete description so
that every criterion required will be performed;
The characteristics of the goods must correspond to the requirement of the CA regarding the quality,
efficiency, testing, dimensions, packing, manufacturing processes etc;
The technical requirements will not make reference to trademarks, to a certain economic agent, will
not indicate an origin, a certain manufacturer;
The specifications will be based on National and international standards.

The selection of medicines is done by the working group of the clinical service in
accordance with the National Treatment Protocols and National Medical Essential List
The National Medical Essential List is a major component of the National Medicines Policy
and the selection of items is based on available resources, disease patterns etc.
Modova has STG for AIDS treatment that is updated each year and STG for the treatment
of OI.

Procurement methods

Procurement methods PR

Goods
International Competitive Bidding will be used for contracts equivalent or above 200
000USD.
Shopping procedure will be used for readily available off-shelf goods of standard
specifications. This procedure will require quotation from at least 3 suppliers.
Direct contracting. Will be used for upgrade or proprietary items.
Procurement form International non-profit agencies. Whenever feasible and particularly in
cases of medicines. GDF, GTZ, IDA, WHO supply division, UNICEF. Most of ARVs were
procured from international agencies.
Consulting Services:
Quality and Cost Based Selection.
Selection based on Consultancy qualification, up to 100 000 USD.
Selection of Individual Consultants. At least three CV.s are required.

Procurement process

A Government Decision of 29 May 2008 appointed a Committee on Public Procurement to

supervise the process of public procurement. APP reports to this Committee on public
procurement issues. The Committee have to report to Government every 6 months on
public procurement. The Committee are required to approve Contract Awards for Goods >
MDL 5,000,000 and for Works > MDL 20,000,000
The APP acts as independent commission to review procurement protests against
Contracting Authorities.
The Law specifies how and where contract awards are to be published and tender
opportunities are published on the APP website tender.gov.md
Law states that foreign suppliers rights to participate in the public procurement are similar
to the rights of Moldovan suppliers. There is no a requirement for association witj local
firms. There is a domestic preference of no more then 15%.
Article 44 requires the Contracting Authority to evaluate bids only against criteria described
in the tender documentation. Article 45 defines the decision criteria described as the most
advantageous in economic terms.

Distribution

Medical institutions act as independent contracting authorities procure and use

decentralized the medicines.
For national programs selection, forecasting, procurement and monitoring is centralized
but there is no a central store. The medicines are delivered from the stores of economic
agents to the destination. Except for TB program that has a centralized store and ARVs
( the store is being refurbished now).
For the TB there is an electronic system of logistics of medicines and supplies.
For HIV/AIDS there is a paper system and in short time a software will be developed.
The distribution system is Push and Pull.
The inventory management is based on principle FEFO.

USE

Ensuring rational use of medicines. The surveillance of the drug use, side effects, is one of
the activities of the Medicines Agency the department Clinical evaluation and
pharmacological vigilance.
In the activity of the medical institutions the system of pharmaco therapeutical formulary
will be applied.
The side effect report form is the instrument for reporting side effects. This form is
distributed to the public health institutions. All reports on adverse effects are analyzed at
the centre. These cases are reported to the MA, which has the role of evaluating the
quality of medicines. If the information presented has good evidence, the information is
sent to the WHO regional side effects monitoring unit.
Adherence. Implementing DOT treatment. Involvement of civil society.
With the support of USAID most of the treatment guidelines were updated.