Leveraging our Network to Redistribute TB Medicine from Lesotho to Zambia and Haiti

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February 4, 2022
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Haiti and Zambia recently received donations of isoniazid (INH) 300mg TB medication from Lesotho after a stock redistribution exercise. In March 2021, the Lesotho Ministry of Health (MOH) Supply Chain department, in collaboration with GHSC-PSM, was tasked with conducting an assessment to establish the extent of overstocking at the service delivery points and recommending solutions. INH 300mg TB medication was found overstocked in Lesotho from 2019 to 2021. As a result, the MOH Supply Chain department and GHSC-PSM recommended that the MOH donate some of the product to countries experiencing shortages.

MOH’s plans to transition to torifapentine (RPT)—also known as the 3HP regimen—a shorter-course treatment, were hampered as a result. The overstock was caused by an anticipated backlog of patients, which was predicted by the MOH TB program. The TB program anticipated a high demand for INH 300mg and planned to use the commodity in campaigns to scale up its program. However, actual demand for the product was lower than projected and led to slow movement and risk of expiry of the overstocked product.

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Continuous and uninterrupted treatment
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GHSC-PSM in Lesotho then engaged the GHSC-PSM Headquarters Supply Chain Unit to help identify countries that were in need of the product. “On behalf of the Ministry of Health Zambia and indeed the National TB Program, we are very grateful for your efficient facilitation of the donation of the INH 300mg tablets from Lesotho. This will go a long way in covering the gap and the potential to avert the stock out of one key TB preventive treatment (or TPT) treatment option in the country. The donated tablets will help the program to completely treat about 30,000 TPT-eligible patients in our facilities”, said Zambia’s MOH representative.

Zambia and Haiti were the two countries identified. By the end of October 2021, the project in Lesotho had collaborated with the GHSC-PSM Headquarters Supply Chain Unit to facilitate all formal processes for the product donation to the two countries. Lesotho was finally able to donate IHM 300mg tablets—7,941x672 to Zambia and 1,000x672 tablets to Haiti—in November 2021.

To reduce the risk of latent to active TB, WHO recommends Tuberculosis Preventive Treatment (TPT) for people with HIV/AIDS, with the most common regimen for latent TB infection currently being isoniazid preventive therapy (IPT), as well as a new shorter regimen called 3HP (a weekly dose of rifapentine and isoniazid for 3 months), which significantly reduces treatment duration as well as pill burden for patients over the course of therapy.