Procuring medicines does not make them available to clients at the last mile; functioning and fully funded public health supply chains are essential to delivering health supplies for all. An international cost analysis has shown that, on average, an additional 12–25 percent over and above the cost of essential medicines is needed to deliver them to the last mile. The cost of the public health supply chain is an essential consideration for health planning and results-based budgeting.
Like many Eastern European countries in the early 1990s, Romania had a history of low contraception use and a high rate of abortion. Starting in 1999, progress accelerated dramatically thanks to a number of critical and complementary interventions; a national health insurance scheme, the privatization of health providers, extensive policy change, training to enable more providers to offer family planning services, and a heavy focus on rural access.
We need to look at whether people have the right mix of incentives to avoid unhealthy lifestyle choices, and to access preventive health, such as vaccinating their children, using contraceptives for birth spacing or to avoid pregnancy, using condoms for disease prevention, and sleeping under bed nets in malarial zones. But just as importantly, we need to ensure that health care providers, both individual and institutional, have the right alignment of incentives to deliver high quality, affordable health services and pharmaceuticals.
Do we have anything to learn from the Cola supply chain? Certainly. Governments and others working to distribute health commodities can learn a lot from the private sector, which excels at finding innovative ways to reduce cost, improve efficiencies, plan effectively, create incentives, and motivate people.
Countries and development partners have made progress in strengthening data collection and deploying technologies to move data up the health system for monitoring and evaluating performance. But to realize the transformative power of information, it is the frontline healthcare workers—the doctors, nurses, community health workers, etc.—who require information to make informed, intelligent decisions.
A recent Lancet editorial invokes the concept of ‘contraceptive security’ to argue the case for strengthened health workforces. However, Chris Wright points out that the editorial neglects to mention the role of strong supply chains in achieving contraceptive security.
Today is Innovation Day during World Immunization Week, and there are a lot of innovative ideas out there to reach every child. But innovation doesn’t always require radical new ideas. Sometimes it simply means challenging traditional approaches based on current information. For immunization supply chains, that means changing over 40 years of custom to embrace state-of-the-art commercial best practices.
World Malaria Day 2016 reminds us that robust financial investment, political will, and innovation are essential to ensure continued success in ending malaria for good. Prevention and treatment are equally important in the fight against malaria, and both depend on accurate and timely diagnosis. Nowhere is the need greater than in Nigeria, which has the highest mortality and morbidity due to malaria infections in the world. Malaria accounts for about 30% of all under-5 pediatric deaths each year and is the single biggest driver of demand for health services, accounting for 60% of all outpatient visits annually.
JSI’s Chris Wright looks ahead to the scenarios that will require new approaches to health supply chains in low and middle income countries.
More than 800 political leaders, technical experts and advocates attended the first Ministerial Conference on Immunization in Africa, sponsored by WHO/AFRO and the African Union in Addis Ababa, 24-25 February 2016.