On 5 and 6 February 2020, representatives from PEPFAR, USAID, The Global Fund and The Bill & Melinda Gates Foundation convened the Africa Supply Chain Roundtable in Kampala, Uganda.
The roundtable was prompted by recent changes to the public health supply chain landscape, including the ever-increasing importance of modernising these. The event was designed to provide opportunities to share country lessons and private sector content alongside bilateral agreements between all donors and individual countries.
Ministries of health from Burkina Faso, Ethiopia, Kenya, Mozambique, Nigeria and Uganda, as well as representatives from the private sector and other stakeholders were invited to share their expertise and learn from one another on strengthening supply chains for medicines and health commodities.
The Africa Resource Centre (ARC) led various sessions with the objective of helping delegates to identify fresh solutions, develop new partnerships and establish a joint commitment to accelerating the change and transformation of supply chains in Africa.
ROUNDTABLE FORMAT AND THEMES
Each day of the supply chain roundtable commenced with three supply chain tracks. Participants in each session were invited to share their experiences, challenges and solutions for patient-centred supply chains that focus on building integrated systems across public and private sectors.
- Day 1: segmentation, route-to-market design, last-mile distribution
- Day 2: policy and advocacy, multi-month dispensing, visibility and analytics.
From the discussions, it was clear that all governments face similar challenges when it comes to transitioning to patient-centred supply chains. Additionally, some common themes emerged:
- Every country has similar challenges, and every country can learn from each other. Through sharing innovations, participants had a chance to consider how elements of that approach might fit into their context and solve similar problems that require government-led reform processes.
- One of the biggest hurdles to modernising supply chain design is making the investment case. Building a case for a patient-centred supply chain is not an easy task – there are alignments to be built, ‘hard’ and ‘soft’ benefits to be considered and a link to the overall public health policy and strategy reforms to be made.
- Translating learnings from country to country remains a challenge across sectors. Each ministry prefers to see an example that works in their context. Finding a way to share learnings across countries is vital to accelerate the rate of change and to move faster towards patient-centred supply chains.
- There is a need to describe how to transition to patient-centred supply chains. This applies to how patients’ needs are segmented, how route-to-markets are designed and how last-mile distribution options are implemented. The ways in which elements of visibility and analytics are implemented across varying country structures also need to be explained to inform policy and strategy reforms to establish and implement the supply chain.
Key points that were communicated over the two days included:
- Supply chain innovations are not one-size-fits-all. Every ministry will have different needs, context and desired outcomes for their supply chain strategy. Instead of needing to apply a whole innovation, it is possible to apply only specific elements.
- Modernised supply chains are patient-centric and orientated around impact. Throughout the supply chain, patients must be considered to ensure that the design is delivering positive health impacts. In addition, countries with donors need to be clearer on defining how investments return impact in the supply chain space.
- Supply chain design is not just about antiretrovirals; it affects all medicines delivered by the ministries of health. Supply chain design needs to consider therapeutic areas beyond medications for HIV/Aids, malaria, tuberculosis and non-communicable diseases. This approach by ministries of health would require all vertically funded programmes to be brought on board and would need to include all major donors.
- Increased country-based knowledge sharing between government and private sector is needed. The relationships between governments and private sector are often based on application of laws and related regulations. A forum between ministries of health and the private sector could create opportunities for sharing of knowledge and capabilities to inform considerations related to developing supply chain related policies and strategies.
The roundtable discussions, tracks and activities enabled attendees to share their unique supply chain challenges and think about innovations and how to apply aspects of these within their own contexts. By showcasing the diversity of innovations and the shift from product-focused supply chains to patient-centred supply chains, the Africa Supply Chain Roundtable helped to start a multi-sectoral discussion that can advance the pace of change and transformation of public health supply chains in Africa.
The outcomes of this roundtable will inform the forthcoming grant-planning processes, such as COP20 and The Global Fund Grants. Additional support from the Bill & Melinda Gates Foundation, and the response by advisory services such as ARC at country level, will be offered to each participating country.