Primer- Lessons Learned from Latin America and the Caribbean for Improving Contraceptive Procurement

Publication date: 2011

Primer Lessons from Latin America and the Caribbean for Improving Contraceptive Procurement U SA ID | D EL IV ER P RO JE CT 2 00 9 Work group discussing procurement mechanisms during the Developing Alternatives for the Acquisition of Contraceptive Supplies in Latin America and the Caribbean regional workshop (Cartagena de Indias, Colombia. September 2009). The contraceptive procurement process is carried out by professionals and experts who have overcome challenges and improved processes, and are committed to achieve CS. MAY 2011 This publication was prepared for consideration of the U.S. Agency for International Development. It was developed by the USAID | DELIVER PROJECT, Task Order 4. Individuals responsible for managing reproductive health supplies and contraceptives in many countries are often deeply committed to achieving contraceptive security. To help contribute to that goal, this primer includes guidance and recommendations based on a compilation of experiences and practices described in the study, The Procurement of Contraceptives in Latin America and the Caribbean: An Analysis of Current and Future Options in Eight Countries. That regional study analyzes contraceptive procurement practices in eight Latin American countries (Bolivia, the Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua, Paraguay, Peru), in order to provide recommendations that can help to ensure that four critical elements are strengthened throughout the procurement process—— transparency, competitiveness, competitive prices, and quality. Objectives Contraceptive security is achieved when people have the ability to choose, obtain, and use contraceptive where and when needed. This primer provides tips to help facilitate the work of those responsible for contraceptive procurement within ministries of health and social security institutes. The primer aims to—— x Serve as a quick and accessible reference guide that provides practical advice to help maximize resources available for procurement. x Provide practical tips to help staff involved in contraceptive procurement improve their management practices and efficiency. Audience The audience is the staff in charge of one or all stages of the contraceptive procurement process within public institutions——for example, procurement managers, logistic directors, and technical staff responsible for carrying out or overseeing the procurement process within ministries of health and social security institutes. Primer Structure Each section of this hands-on, practical guide provides tips and useful suggestions for every step of the procurement cycle. This guide also provides specific examples of countries that have successfully selected and implemented procurement mechanisms and effectively managed the procurement process. For example, each of these short case studies presents the problem identified, the solution, and how the solution was implemented to improve their processes. Key Steps in the Procurement Process Selecting the critical path to carry out the Box 1. Basic Principles of Procurement contraceptive procurement process efficiently requires a series of complex steps. (See box 1 for a summary of basic principles to apply throughout the procurement process.) Figure 1 illustrates essential steps in the procurement process by drawing on multiple previous research and materials on the topic of procurement. Three stages are considered essential: Programmatic Planning B Procurement B Performance Monitoring (PATH 2009). Each stage includes specific steps undertaken to meet the objective and expected outcome, and move to the next stage. These steps are performed by procurement professionals and experts who have overcome challenges and improved processes and who work to achieve contraceptive security. The following section explains these stages. Procurement Carefully and efficiently manage the effectiveness procurement process, beginning by identifying technical specifications until supplies are delivered and used, ensuring quality from production to delivery to the final customer. Transparency Following guidelines and defined criteria to select the supplier in order to promote a rational and transparent decisionmaking process so these decisions can be clearly understood under external scrutiny. Competitive Select national or international sources prices and compare supply prices and delivery terms. Unified purchases are key to ensuring quality at a good price and economies of scale. Quality Effectively control quality of commodities to safeguard public safety and ensure procurement of effective and efficient contraceptives. The first step to quality assurance is to guarantee that purchased products are from suppliers prequalified by international agencies such as WHO, UNFPA, and FDA. 2 Figure 1. Key Steps in the Procurement Process Expected Outcome: Delivery of High Quality Products 3. Performance Monitoring 1. Programmatic Planning x Monitor the contract x Estimate needs x Review product delivery x Select products x Establish quality control processes x Define specifications x Analyze procurement options x Define the budget and ensure funding Expected Outcome: Expected Outcome: Signed Contract Secured Funding 2. Procurement x Plan the purchase x Define the tender x Develop documents and invite bidders x Select the supplier x Prepare the contract Note This graph is based on the Procurement Capacity Toolkit: Tools and Resources for Procurement of Reproductive Health Supplies (PATH 2009) and Procurement Strategies for Health Commodities: An Examination of Options and Mechanisms Within the Commodity Security Context (Rao et al. 2006). 3 Stage I: Programmatic Planning Organizations can use their capacity to effectively plan and ensure that forecasts are correct and that sufficient funding is made available to ensure commodity security (see box 2 for a forecasting and quantification example) (PATH 2009 and Rao et al. 2006). Helpful Tips: 1. How can I improve forecasting and quantification? x Use reliable data sources. To more accurately Box 2: Forecasting and Quantification forecast contraceptive needs, the following logistics Country: El Salvador information should be collected and used: Institution: Ministry of Public Health and Social consumption data, stock on hand at all levels of the Assistance supply chain, length of time needed to resupply, Problem identified: Improve forecasting anddesired buffer stock levels, and information about quantification to ensure sufficient quantities to programmatic goals, such as educational campaigns to meet demand. better inform the population about family planning. Solution: Improved forecasting and quantification helped to achieve appropriate inventory levels. x Develop long-term projections. When the country Forecasting and quantification estimates included a faces transition conditions (e.g., changes in more accurate calculation of safety stock levels government, suppliers, or products, and donor phase- needed to cover increasing demand for out or health sector reform), potential disruptions in contraceptives, family planning program plans to help reduce unmet need, and gradual reduction of procurement or distribution should be anticipated. USAID donations.Through careful budget preparation, forecasts, How was this solution implemented? Byprocurement processes, and distribution schedules, coordinating among the family planning program, logistics staff should be able to anticipate and prevent central medical stores, procurement and planning these disruptions from resulting in stock outs at the units, and regional level representatives, family service delivery point. This applies even when the planning staff members worked with the logistics public budget is calculated annually. staff to collect periodic data of quantities needed from the regional level. Annual meetings provided x Carefully integrate contraceptive forecasting and an opportunity to negotiate amounts for all quantification into the procurement process for medications and agree on methodology for essential medications. Even when working in an calculating family planning needs at the central level. integrated system, it is important to use maximum and What tools or methods were used? Since 2002, PipeLine software has been used at the minimum levels that make sense for each supplier and central level to aggregate and prepare these each product’’s characteristics (consumption, stock forecasts. Regional staffs have also been using this levels, expiration dates, etc.). These forecasts should tool for forecasts since 2008. consider resupply periods for each product. x Integrate contraceptive forecasts into the Ministry of Health’’s annual operating plan. This will guarantee its inclusion in the draft budget so the calculations reflect actual demand. x Coordinate forecasting and quantification among the procurement unit, central medical stores and those responsible for the family planning program at different system levels. This type of coordination and joint effort facilitates procurement of an adequate quantity of high-quality contraceptive commodities. Family planning programs generate logistics information not always reviewed or analyzed by procurement and central medical stores at the time of forecasting and quantification. Therefore, timely information sharing at all levels of the system is important. In a decentralized system, regions and provinces estimate and consolidate needs before sending them to higher levels. This information feeds centralized procurement even amid a decentralized system. Box 3 below shows useful tools for improving forecasting and quantification. 4 Box 3: Useful Tools Estimation of needs x Centers for Disease Control and Prevention. n.d. Contraceptive Forecast and Cost Estimate Spreadsheet (CastCost). Forthcoming at or email x Engender Health/The ACQUIRE Project. 2007. Reality Check: Family Planning Forecasting Tool User’s Guide. New York, NY: Engender Health (revision forthcoming). x Family Planning Logistics Management (FPLM). 2000. Contraceptive Forecasting Handbook for Family Planning and HIV/AIDS Prevention Programs. Arlington, Va.: FPLM/John Snow, Inc., for the U.S. Agency for International Development (revision forthcoming). Spanish: English: x PATH and the World Health Organization (WHO). 2008. Procurement Capacity Toolkit: Tools and Resources for Procurement of Reproductive Health Supplies. Chapter 1. Defining Reproductive Health Supply Requirements. x U.S. Agency for International Development (USAID). 2009. Getting the Numbers Right: A Guide to USAID-Developed Contraceptive Forecasting Tools. Washington, DC: USAID. x USAID | DELIVER PROJECT, Task Order 1. 2009. Quantification of Health Commodities: A Guide to Forecasting and Supply Planning for Procurement. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 1. x USAID | DELIVER PROJECT, Task Order 1. 2011. PipeLine 5.1 Software Tool. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 1. 2. How can I select products that meet these key procurement elements: competitive price, quality, transparency, and competitiveness? x Ensure availability of reliable suppliers for selected products. The procurement unit can identify viable sources of supply and prepare a list of manufacturers and distributors who offer contraceptive supplies. With this information, the unit will determine which suppliers have the capacity to guarantee delivery of supplies under the best conditions of quality, price, and performance. The unit can then advocate with decision makers so the list of qualified suppliers becomes the official list and is widely disseminated to all parties involved in procurement. x Verify that products are prequalified by international agencies. These include the World Health Organization (WHO), which prequalifies hormonal contraceptives; the United Nations Population Fund (UNFPA), which prequalifies condoms and intrauterine devices (IUDs); the U.S. Food and Drug Administration (FDA); and the European Medicines Agency (EMEA), counterpart of the FDA. This advice is relevant for international and national procurements. Asking the supplier for a prequalification certificate from these agencies makes it easier for governments to authorize entry of these commodities. x Promote availability of a sustainable and cost-effective basic package of contraceptive supplies. This should include at least one injectable, one oral, one IUD, one barrier contraceptive, and surgical methods. The product range can be very broad and justifiable, but there must be at least this basic package, as defined in most essential medicines lists. 3. How can I define technical specifications that help guarantee procurement of quality supplies? x Describe technical specifications as precisely as possible. Include this information: generic name, presentation, concentration and amount per container, product color and size, and regulatory 5 requirements, i.e., license certification, good manufacturing practice compliance certification, raw materials quality certification, product prequalification by international agencies, and product shelf life. x Ensure quality. Require documentation such as analysis certificates provided by the supplier, promoting the buyer’’s right to inspect products according to generally accepted international standards, and by clarifying standard procedures for inspecting a sample if requested by the buyer. x Define requirements for packaging and shipping. For example, cases in the shipping container should have visible labels that list product name, lot number, expiration and manufacture dates, name and address of the supplier, content and quantity, chemical composition of products, registration number, country of origin, etc. The container can also include educational information about the product for personnel dispensing the product. x Use existing examples of technical specifications for contraceptive supplies provided by the WHO and PATH (see box 8 for useful tools in this document) (PATH 2009 and Rao et al. 2006). 4. How can I identify and analyze my procurement options? x Verify and monitor qualifications of potential Box 4: What Is Reverse Auction?suppliers. Monitor whether suppliers demonstrate It’s a selection method in which the supplier of production capacity, delivery timeliness, financial a common good is chosen based on the best solvency, recognized commercial trajectory, ability to price offered (below a ceiling price) and not on delivery at various levels (central or regional), the technical characteristics of the good, competitive prices, and international quality standards including quality. These characteristics are according to the International Organization for predefined and applied as a minimum standard Standardization (ISO). This monitoring can also include for participating in the auction. requesting certificates of registry by registration Advantages: authorities in the supplier’’s country of origin. x Permits the buyer to obtain better prices x Provides greater incentive for x Continue bidding for contraceptives on the local manufacturers to participate market through reverse auction. This process can be x Leads to cost savings in managing the performed alternatively or simultaneously with other procurement process existing procurement mechanisms, which will also help x Allows the government to standardize to update the list of potential suppliers offering quality goods and services products and competitive prices. Testing the market will x Facilitates monitoring processes encourage participation and competition among x Allows more favorable conditions for the available suppliers and government openness to new buyer regarding procurements and suppliers. Use of reverse auction (see box 4) is suggested contracts. to ensure that offered prices are equal to or lower than those obtained at international reference prices. x Request that providers quote prices for delivering the product at different geographic distribution levels, making one offer with delivery to the central warehouse and the other with delivery to regions. Comparing both options will help to determine whether an economic benefit exists between choosing the existing procurement mechanism or a new alternative that delivers products to regions. In this type of analysis, comparing the cost of managing the supply chain according to these different options is possible. (See box 5 for an example of this type of comparison.) 6 Box 5: Analyzing Procurement Options Country: Peru Problem identified: Limited range of suppliers. Solution: Procuring at the local level (rather than through UNFPA) at slightly higher prices but with the benefit of product delivery at the regional level. How was this solution implemented? Local competitive tendering promoted wider supplier participation and secured a local supplier (Pfizer) to deliver to the regional level. The procurement unit performed a cost-benefit analysis of central level vs. regional delivery. What tools or methods were used? A comparative market analysis of UNFPA prices and national competitive tenders by using reverse auction. This process invited a larger number of suppliers that offered lower prices for a minimum predefined quality standard and delivered products to the regional level. 5. How can I define the budget, identify gaps and secure funding? a. Calculating the budget based on different situations x Have price and costs information associated with the purchase to calculate the required budget. This information can be used for this exercise: � amounts and price paid for the last procurement Box 6: Securing Financing � price lists published by bidders Countries: Nicaragua and El Salvador � price list of international procurement agents Problem identified: Investment need of public health institutions for contraceptive � associated costs: freight duties on each delivery procurement. mode, inspection and quality testing costs, shipment Solution: by air and sea, and taxes. El Salvador: Funding increase. In 2008, 75 percent of the contraceptive needs were x Define the budget based on needs, not on the covered; in 2009, it reached 84 percent. historical budget. Needs may vary from year to year, Nicaragua. Funding increase. In 2009, it reached 70 percent and it is expected that by especially as the logistics system and availability of 2012, public funds will cover 100 percent of contraceptive supplies improve. Both improvements the investment needs. lead to higher demand for contraceptive supplies in How was this solution implemented? health care facilities. Thus, updating consumption data El Salvador. Advocacy, negotiation and regularly to serve as the basis for forecasting and requests to government institutions that quantification is essential. (See box 6 for an example of provide funding, based on a justification of resource mobilization in two countries). cost-effective purchases at lower prices through UNFPA as an international x Develop different scenarios based on these factors: procurement agent. type of procurement mechanism (national or Nicaragua. Advocacy plan through the CS international tender, use of a procurement agent, local committee to ensure government funding for procurement), supplier, products, transport system (air, direct and protected contraceptive sea, land), taxes, customs clearance, customs broker and procurements. supplier administrative costs, place of delivery, and What tools or methods were used? Documentation of comparative costs, buffer stock levels at year’’s end. For example, at year’’s preparation of financial scenarios (by supplier), end, you need more financial resources to procure and financial gap analysis based on the selected enough supplies to allow buffer stock for 12 months supplier and advocacy presentations with than for eight months. Preparing several scenarios decision makers from the Ministry of Health. combining the above factors allows the procurement (central medical stores, finance and planning process to adapt to budgetary constraints and maximize units). use of scarce resources. 7 x Reconcile the forecasting and quantification process with the approval and budget allocation process. Experience in other countries has shown that preparation of contraceptive forecasts is not always completed in time to include in the government's annual budget exercise. Strengthening coordination between the family planning program and strategic planning and budget offices is important so funding for annual and multi-annual procurement of contraceptives is included. b. Identifying the gap x Estimate necessary financial requirements. To document the resources requirement, it is important to develop an analysis of the total cost of products while considering the procurement mechanism and/or suppliers. x Compare ideal financing and historic budgets to determine gaps and anticipate actions to achieve full funding. Gaps may be identified using tools such as Spectrum or PipeLine. c. Advocating for sufficient funding x Carry out advocacy efforts to secure sufficient resources to meet total demand. In this process, advocacy arguments are developed to show possible unmet demand and its adverse effects on maternal and child health. As noted earlier, gaps can be reduced by negotiating government budget adjustments, which are usually allowed by ministries of treasury or finance, as in the case of El Salvador during 2007 to 2009. Box 7: Enhancing the Procurement x Permanently monitor changes in demand and Process available budget. Closely monitor inventory levels and Country: Paraguay check for additional resources, anticipating that future Problem identified: Restrictive regulatory framework that does not allow forward budgets will be insufficient to cover increasing demand. funding to international agencies such as An alternative is to strengthen coordination between the planning program and strategic planning and Solution: A direct contracting mechanism was budget offices to include funding for annual and multi- discovered within the procurement law that annual purchase of contraceptives. permits direct procurement through UNFPA using an “exception route,” Stage II: Procurement Process How was this solution implemented? The direct procurement exception route was Institutions can effectively carry out a range of activities justified on grounds of lower prices. Through including procurement planning, definition of bidding terms, advocacy and financial arguments, family supplier selection, and preparation of the contract, all of planning staff members were able to justify which are essential to guarantee an efficient and transparent forward funding to UNFPA. These staff members coordinate with the UNFPA procurement process. (See box 7 for an example of how to procurement area to closely monitor orders, improve the procurement process.) reduce delivery time, and legalize advance of Helpful Tips: funds more quickly. What tools or methods were used? Family planning staff members applied advocacy 6. How can I plan an efficient procurement processes based on comparative and cost- process? benefit information to sign a new agreement Several decisions are made between financing and signing and implement the direct procurement the contract. This phase is defined as the procurement exception route to forward funds to international organizations. In addition, the period. Ministry of Health advocated for adjustment of x Establish standards for delivery date, time of payment, regulatory framework before the National Congress to allow use of advance payments to and basic rules to monitor the process. such agencies in the future. x Involve the proper people in decision-making. If the procurement mechanism is a local tender, responsible 8 parties must coordinate with the family planning program and procurement unit managers. For example, procurement committees must include a representative of the family planning program and jointly establish steps and responsibilities of those involved in the bidding process. x Minimize bottlenecks during various stages of the process. Develop a critical path or process map that illustrates various steps in the process. This critical path can be documented in a standard operating procedures manual. This will prevent duplication of activities and unnecessary steps and will eventually improve management competencies of the procurement unit staff. x Ensure that the amount on the pro-forma invoice exactly matches funds available. If the mechanism used is through a procurement agent, it is necessary to have exact prices, record them on a spreadsheet, reach consensus with the procurement agent, and submit final numbers and specifications to issue the final pro-forma invoice. The family planning program of the Ministry of Health in El Salvador is a good example of this practice. x Designate a point person from the family planning program to lead and monitor each stage of the procurement process, with the procurement committee and unit. This point person will be responsible for coordinating with the procurement unit, establishing relationships with the supplier (international purchasing agent or local provider), identifying bottlenecks in a timely manner, and updating databases regarding lead times and supplier compliance. Using software tools such as PipeLine can make this task easier and expeditious. Stage III: Performance Monitoring During this stage, compliance with contract terms is monitored, including terms that must be met before delivery, such as product inspection, customs clearance, and delivery to designated warehouses. 7. How can I monitor the contract and ensure that the supplier is delivering the correct product? x Develop a checklist that includes all contract conditions and agreements. For example, process duration from request to delivery, quality verification based on ISO 9000 standards, and review of shipping documents for compliance contract clauses. x Monitor product quality during shipment deliveries. Use a simple quality assurance system activated only if boxes display visible damage. If none is observed, sporadic visual inspections should be performed following storage standards for each product. Product technical specifications help to monitor product quality. x Consider air or sea ports of entry to compare cost benefits of both. In some cases, the tax exemption is not recognized when supplies arrive by sea (e.g., the presidential tax exemption in El Salvador). 8. How can I establish effective quality control? x Regulate quality control for contraceptives during stages of the procurement process. When product arrives at customs or the central warehouse, review certificates issued by vendors or procurement agents. After receipt, verify integrity of supplies with a random lot check. For example, condoms do not require quality verification procedures in laboratory tests unless obvious product damage is observed. If this is the case, a random quality test by a certified laboratory is recommended. If necessary, one option is to contract Family Health International (FHI), a USAID- supported organization, to perform quality assurance on products. 9 Box 8: Useful Tools Selecting products x USAID | DELIVER PROJECT, Task Order 1. 2009. Public Health Procurement Guide and Product Catalog 2010. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 1. Defining specifications x PATH and the World Health Organization (WHO). 2009. Procurement Capacity Toolkit: Tools and Resources for Procurement of Reproductive Health Supplies. Chapter 2. Specifications. x WHO. 2004. The male latex condom: specification and guidelines for condom procurement 2003. Geneva, Switzerland: WHO (revision forthcoming). Analyzing purchase options x UNFPA. 2011. General terms and conditions for contracts: Provision of goods and/or services. Accessed May 3, 2011 at Securing funding x Futures Institute. 2011. SPECTRUM Software (a suite of easy-to-use policy models that provide policymakers with an analytical tool to support the decision-making process). Glastonbury, Ct.: Futures Institute. x USAID | DELIVER PROJECT, Task Order 1. 2011. PipeLine 5.1 Monitoring and Procurement Planning System. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 1. Monitoring performance x USAID | DELIVER PROJECT, Task Order 1. 2011. PipeLine 5.1 Monitoring and Procurement Planning System. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 1. Ensuring quality x FHI. 2008. The Latex Condom: Recent Advances, Future Directions. Chapter 5. Durham, NC: FHI. x USAID | DELIVER PROJECT, Task Order 1. 2010. Assessment Tool for Laboratory Services (ATLAS). Arlington, Va.: USAID | DELIVER PROJECT, Task Order 1. x World Health Organization, WHO Expert Committee on Specifications for Pharmaceutical Preparations. 2007. Quality assurance of pharmaceuticals: Meeting a major public health challenge. Geneva, Switzerland: WHO. Experiences in procurement alternatives x See the studies cited in— Sarley, David, Varuni Dayaratna, Wendy Abramson, Jay Gribble, Nora Quesada, Nadia Olson, and Verónica Siman Betancourt. 2006. Options for Contraceptive Procurement: Lessons Learned from Latin America and the Caribbean. Arlington, Va.: DELIVER, and Washington, DC: USAID | Health Policy Initiative, for the U.S. Agency for International Development. x Ensure that quality-control laboratories promote quality test standards according to ISO standards. This will prevent discrepancies between the acceptable quality level (AQL) defined by manufacturers and the AQL used by local laboratories, which should be the same. These discrepancies may delay entry of shipments and cause stock outs. x Consider that condoms have additional quality-control issues such as temperature and taking care that the wrapping has no lubricant leaks. 10 x Promote technical leadership of highly qualified and trained staff in ISO standards to design a quality management system in-country so the system adheres strictly to international standards——WHO, UNFPA, ISO, and good manufacturing practice. One of the most important standards is the definition of the AQL. x Avoid routine quality testing of supplies donated by USAID unless damage is observed on shipment boxes. If product quality at time of registration in-country and on arrival does not vary, rely on quality assurance methods used by manufacturers. A Final Thought The contraceptive procurement process is based on basic principles that help efficient product delivery to users. Among these principles are effective procurement management, transparency, competitive prices, and product quality assurance. Procurement staffs perform based on these principles that guide stages of the procurement process——planning, procurement, monitoring and supervision, and evaluation of the procurement process. Such staffs aim to clearly define technical specifications, to ensure an efficient quality monitoring system, and to select suppliers that meet ISO standards. It is also recommended that countries bid with prequalified suppliers according to international standards (WHO, UNFPA, OPS, FDA, and EMEA). A highlight of this primer is to consider implementing the bidding mechanism called reverse auction. This procurement mechanism has been used in several countries, and part of its process includes market research that periodically monitors availability of suppliers while guaranteeing quality and lower prices. References PATH. 2009. Procurement Capacity Toolkit: Tools and Resources for Procurement of Reproductive Health Supplies. version 1. Seattle: PATH. Olson, Nadia, Anabella Sánchez, Ángel Reynoso and Nora Quesada. 2010. The Procurement of Contraceptives in Latin America and the Caribbean——An Analysis of Current and Future Options in Eight Countries. Arlington, Va.: USAID | DELIVER PROJECT, Task Order 1. Rao, Raja, Peter Mellon, David Sarley. 2006. Procurement Strategies for Health Commodities: An Examination of Options and Mechanisms within the Commodity Security Context. Arlington, Va.: DELIVER, for the U.S. Agency for International Development. Websites Peru: —— Reverse Auction For more information, please contact Nadia Olson, Nora Quesada and Anabella Sánchez 11 The authors´ views expressed in this publication do not necessarily reflect the views of the U.S. Agency for International Development or the U.S. Government. USAID | DELIVER PROYECT John Snow, Inc. 1616 Fort Myer Drive, 11th Floor Arlington, VA 22209 USA Telephone: 703-528-7474 Fax: 703-528-7480 Email: Internet:

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