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MDR-TB Strategic Rotating Stockpile

Fix the market for MDR-TB drugs with the first-ever rotating stockpile of anti-TB drugs

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Because of the challenges involved in supplying MDR-TB treatments, countries face the risk of stock-outs. MDR-TB regimens are comprised of at least four different classes of drugs, which are to be consumed for about two years. These costly drug courses are sourced from multiple manufacturers, in relatively small numbers, and pose a number of challenges in terms of varying shelf-life, quality assurance and dosing.

The Strategic Rotating Stockpile (SRS) is UNITAID’s response, consisting of medicines sufficient for 5,800 MDR-TB treatments which can be accessed by countries at short notice. Implemented by the Stop TB Partnership through its Global Drug Facility, it is the first global effort of its kind. The SRS permits emergency orders to be serviced with expediency and reduces lead times. It also facilitates the consolidation of market demand by permitting manufactures to produce medicines more efficiently. The SRS encourages generic manufactures with SNRA approval or WHO Prequalification to stay in the market by providing a source of regular orders for their quality products.

By 2011, the SRS had reduced lead times for urgent orders to around 30 days, from 101 days in 2007. SRS usage is at 68% per month for urgent and off cycle orders, above the target of 60% per year. Lead times for urgent orders are below the target of two months.     

Many national governments procure from local manufacturers at substantially lower prices than from GDF because the medicines that they buy are of unknown quality standard and could be one of the reasons they are cheaper to manufacturer. The idea of the rotating stockpile is to encourage generic manufacturers with high quality standards to stay in the market by providing a source of regular orders for their quality products.