We need funding and investments in the supply chains that get nets to communities, diagnostics tools to practitioners, entomology supplies to researchers, insecticides and equipment to spray programs, and medicines to clients, wherever and whenever they are needed. Investments in supply chain strengthening contribute to greater product availability, preventing, diagnosing, and treating malaria, and ultimately in malaria case outcomes. Supply chain strengthening remains a critical component of the global malaria agenda.
Blockchain is the hot new technology topic in the financial world, the health sector, and the supply chain industry. It has a variety of applications in health, not least of which are medicine traceability and patient data management. This is just as true for the US domestic health sector as it is for health systems in low- and middle-income countries.
Having deployed OpenLMIS in three countries, JSI has experienced first-hand how dynamic the environment is. A more modular version with plug and play features will provide much needed flexibility to meet the evolving demands of tomorrow’s health supply chains.
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.
Procuring medicines is not enough to make them available to the last mile. When functioning and fully funded public health supply chains are in place, the population, especially the most vulnerable, will receive the medicines when and where they need them.
When we first started this work (in Ethiopia) about seven years ago, when customers came to a warehouse in search of their medicines, the pharmacist had to run down to the warehouse to check if they had an item (it took too long to find the stock card). Now they can access the data the same way as my Walgreens pharmacist can. And they can look to see if the stock is available at any of the other warehouses (even if the nearest location might be a day away).
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.
Providing and maintaining continuous access to health products for the most difficult-to-reach populations necessitates the development of agile supply chains that rely on a multiplicity of partners and strategies to improve service delivery.