Burkina Faso is a landlocked country that has experienced challenges due to climate change and increased security threats caused by terrorism in the region. Additionally, Burkina Faso has a high dependency on imported pharmaceutical products to meet the needs of its population of over 20 million people. The Essential Generic Drugs and Medical Supplies Purchasing Centre (CAMEG), the main supplier of the public health sector, supplies six university hospital centres, nine regional hospital centres and 70 district warehouse dispatchers. In addition, the district warehouse dispatchers supply over 2000 public essential generic medicine warehouses. CAMEG’s storage and distribution capacities adhere to the sector’s best practices. However, many district warehouse dispatchers and essential generic medicine warehouses do not maintain the necessary pharmaceutical conditions. In addition, underqualified and disempowered staff manage many of the warehouses.
The Ministry of Health (MoH) and its partners have been working to increase the availability of medicines to the last mile. It approached the Africa Resource Centre (ARC) to support it by evaluating two last mile distribution pilots and contributing to its health products strengthening plan.
Two last mile distribution pilots are underway in Burkina Faso, and ARC is supporting the MoH by evaluating both pilots. Based on the evaluation, the MoH will select the model that will then be scaled up. ARC will also develop a transition plan for the broader implementation of the chosen model.
The evaluation work began in August 2020 and will continue in 2021 and 2022. As part of its evaluation plan, ARC has submitted a budget to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) to recruit consultants and for operational activities to support the evaluation. Due to ARC’s operating model of brokering and advocating for resources and funding for technical support and operational costs, the funding relationship remains between the donor and the consultants or MoH directly. However, an enabler from ARC will support the government financial and technical partners to ensure a coordinated approach to supply chain transformation.
ARC has also supported the MoH by creating a roadmap and strategy for governance for its health products supply chain strengthening plan. As part of this work, ARC developed a concept note and brought together several supply chain stakeholders to understand and advocate for collaboration in achieving the plan’s aims. The MoH has also engaged ARC to contribute to developing a new health products supply chain strengthening plan from 2022 to 2024.
With support from the Global Fund, ARC is also developing a concept note and proposal for pilot projects around differentiated channel delivery (DCD) in Burkina Faso. ARC’s expertise and experience in conceptualising and supporting the implementation of DCD projects in other African countries will provide robust, proficient insights for the MoH as it seeks to increase the availability of chronic and other essential medicines.
OUTCOMES AND IMPACT
ARC’s support to ministries of health focuses on strengthening six supply chain elements. The work with the MoH and CAMEG strengthened four of these six areas: strategy, improvement roadmap, governance and solutions proposals.
STRENGTHENING SUPPLY CHAIN ROADMAP AND CONTINUOUS IMPROVEMENT PLAN
Key elements: strategy and improvement roadmap
ARC has supported the development of the public health supply chain consolidation plan, strategic emergency supply plan, directory of private carriers, standard operating procedure for suppliers and CAMEG’s continuous improvement plan.
IMPACT: The MoH has a robust roadmap for the implementation of supply chain solutions going forward.
ALIGNING STAKEHOLDERS ACROSS THE SUPPLY CHAIN
Key element: governance
ARC has worked to increase the alignment of partners in the implementation of activities in Burkina Faso, with strong leadership at the level of the Minister of Health’s office and the Health Products Access Directorate, especially in the Health Products Access General Directorate.
IMPACT: Increased alignment will support health product strengthening and last mile delivery.
APPLYING LEARNINGS FROM OTHER COUNTRIES
Key element: solutions proposals
ARC is leveraging its expertise in differentiated service delivery models in other African countries to support developing a model that will work effectively in Burkina Faso.
IMPACT: Differentiated channel delivery solutions will increase the availability of medicines to the last mile.