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   Findings reports on ongoing operational, economic and sector work carried out by the World Bank and its
    member governments in the Africa Region. It is published periodically by the Knowledge, Information &
                             Technology Center on behalf of the Africa Region .



       The Sexually Transmitted Infections Prevention and Care Project,
                                 Zimbabwe

Increasing the Availability of Pharmaceuticals for Sexually Transmitted Infections
 - and Proving It: Project planning, implementation and evaluation processes that
                  are collaborative in nature and quick in pay off

Objectives : To quickly and effectively, estimate the medications needed to treat sexually
transmitted diseases (STDs) and AIDS-related infections over a five year period, procure the
drugs on international tender and survey drug availability among facilities before and after the
procured medications arrive in country and are distributed.

Impact on the ground : The Sexually Transmitted Infections (STIs) Prevention and Care
Project in Zimbabwe has decreased costs for pharmaceuticals by 60 percent and increased the
availability of STI drug in health facilities from 68 percent to 89 percent within the first two
years of the project.

Lessons Learned :

   ·   Collaboration is key. Project personnel benefited immensely, from the experience of
       others. For procurement needs, the project adapted for use in Zimbabwe, a methodology
       to estimate future cases of STDs that originated from WHO/Geneva and another
       methodology to estimate future cases of AIDS-related infections first tried in a World
       Bank/WHO sponsored study in Tanzania. For monitoring progress, the project used a
       methodology to assess drug availability from the Zimbabwe Essential Drug Program.
   ·   Strengthen capacity to procure internationally. Personnel in the Zimbabwe
       Government Medical Stores required significant support to prepare the tenders correctly
       and process them expeditiously. Technical assistance from DANIDA was a big help in
       providing this support.
   ·   Identify your indicators early on. Once project personnel had found consensus on
       what indicators would correctly show impact, the methodology to measure the
       indicators became clearer and baseline data were collected before the project-procured
       drugs arrived.

Decreased Costs and increased availability is only the beginning. The project is now facing
several challenges. Which STI drugs are the most appropriate is an ongoing question since
studies show inconsistent patterns of drug sensitivity. Persons with STI's need more than drugs,
they need medical personnel who are skilled in STI diagnosis, can motivate patients to adopt
preventive measures and are good listeners.

(To order copies of the publication, please telephone (703) 6611580 or fax (703) 6611501. For
related information, please write, telephone or e-mail P.C.Mohan, Rm. J5-171, 1818 H Street
NW, Washington, D.C. 20433; tel. no. (202) 4734114; pmohan@worldbank.org)