Managing the stock and supply of medications is essential for the provision of health care, especially in resource-poor areas. This requires an effective system, either paper- or computer-based, for maintaining an accurate inventory of supplies as shipments of medications arrive at a central storage facility and are then distributed to clinics and pharmacies to be dispensed to patients.

Whether it is done electronically or on paper, all health care projects in developing countries need systems to track what drug supplies are currently available and to assess the quantities of medications that will be needed for the next six months or a year. The WHO has developed a collection of drug stock management support tools, including stock cards for use at warehouses and dispensaries and forms for daily use records and annual inventories. Other WHO tools include a spreadsheet for forecasting stock requirements for antiretroviral drugs (ARVs).

The standard approach to tracking the shipment and use of drug supplies, called the consumption method, is to calculate the amount of drugs that enter and leave the warehouse each month. This is typically accomplished with standard WHO stock cards that record the stock level for each type of product and all stock movements. A separate card is maintained for each product and is updated every time a shipment is received or supplies are dispensed to the pharmacy. In addition, the daily or weekly consumption of medications needs to be tracked in the pharmacies to assess upcoming demand for the warehouse. A full inventory should be conducted on an annual or semi-annual basis to reconcile the daily and monthly records and provide a reliable foundation for projections of orders and budgetary requirements.

Building on our experience with a web-based Electronic Medical Records (EMR) system for our HIV patients, Partners In Health has developed a comprehensive stock tracking system that is modeled on the appearance of the standard WHO stock cards. This system allows pharmacy staff at all clinics to enter stock levels and also to request drugs and track shipments. During the first two years after the system was launched in Haiti, use increased rapidly until it was being used to track 450 products supporting care for 1.78 million patient visits annually. Over the second year, drug stockouts were reduced from 2.6 percent to 1.1 percent and 97 percent of stock requests were shipped within one day after they were received. The EMR can also be used to project requirements and prepare orders for ARVs and TB medications.