How to save lives by improving supply chains

“There’s a reason scientists study fruit flies rather than
tortoises.”
You wouldn’t normally expect to hear that phrase at a workshop
on improving supply chain performance. The statement was
made during a recent panel discussion where leading private-
sector experts from Proctor and Gamble, UPS , One Network,
Imperial Health Services and Accenture were sharing their
thoughts on how to improve supply chains.
Held in Istanbul, Turkey, the workshop was the latest in a series
of meetings funded by the Bill & Melinda Gates Foundation to
bring such experts together with their counterparts in the public
health sector. The workshop examined how supply chain control
towers—or visibility and analytics networks (VANs)—can help
improve the availability of life-saving commodities. Increasingly,
this approach is being adopted by leading private-sector
companies to ensure they are meeting client needs by securing
availability of the right product at the right price, in the right
quantity and quality, at the right time and in the right place.
VANs pull data from different areas of a company’s supply chain
to analyze trends and provide early detection of possible issues.
They also help companies remain a step ahead through the use
of predictive analytics, which can recognize possible demand
signals before they happen and ensure their products are being
procured and distributed in sufficient quantity. Thanks to this
approach, companies have the ability to avoid stock outs. A VAN
can also be used to identify districts that may be in danger of
running out of key commodities as well as those that may have
excess stock, which could be transferred elsewhere as
emergency supplies.
During the recent workshop in Istanbul, private-sector panelists
shared a number of important lessons from their experience
implementing VAN projects. Their experiences echoed those
from a previous private sector panel and underscored that while
technology is important, success requires finding the right
people to understand current processes and provide strong
leadership before deploying a VAN.
Private-sector panelists encouraged attendees to “think big but
start small,” focusing at first on a small set of attainable and
desired improvements, and moving from there to create a new
set of goals with a slightly larger scope.
So, why fruit flies? Scientists chose to study fruit flies rather
than tortoises because their life cycles are so short. This allows
scientists to study many generations over a relatively short
period of time and assess the effects of experimentation more
rapidly. Small, rapid experiments can also help identify what
works and what doesn’t work when looking to improve supply
chain performance. However, implementing better data visibility
and use will happen over time, not overnight.
The panellists noted that incentives can help spur the adoption of
VANs, but that those incentives need not necessarily be
financial. Instead, the key is to make people’s jobs easier and
not create additional burdens. Health care professionals are not
typically supply chain experts and—as identified by People that
Deliver —we need to create new roles and responsibilities that
professionalize public health supply chains and introduce new
systems with adequate training and support.
Dr. Dafrossa Lyimo from the Ministry of Health in Tanzania
stressed this, pointing out that we should avoid introducing new
tools that only add to the workload of already overworked health
facility staff struggling to deal with burdens caused by
fragmentation in government oversight and policy
implementation.
The CDC faced similar issues in 2010 when it rolled out its
Vtrack vaccine management system in the United States. Part of
their approach was to maintain existing data entry systems but
streamline how information flowed to managers, which allowed
the CDC to eliminate redundant systems. This increased data
visibility while minimizing disruption to front-line health workers.
Unfortunately, budget uncertainty and insufficient resources
meant that even more efficient ways of doing business were
required.
For the CDC , centralizing supply chain management
responsibility, outsourcing warehousing and distribution, and
improving data visibility were all necessary for improving
vaccine delivery efficiency. The CDC now boasts 99.6 percent
order fulfillment accuracy with just one to four days delivery
from the time an order is placed by one of the 40,000 primary
health care providers across the U.S. As a follow-on to these
improvements, the CDC plans to use analytics to track vaccine
consumption and usage.
While not all countries can emulate the CDC’s approach
immediately, they can replicate aspects of it. For example, the
Nigeria National Primary Health Care Development Agency
(NPHCDA) has developed data dashboards to increase visibility
of stock levels at the state and local government area (LGA)
levels. This has helped Nigeria increase vaccine availability
nationwide, with over 80 percent of LGAs now reporting
adequate stocks of all antigens, up from 34 percent when the
dashboard was first implemented. The next step in Nigeria is to
introduce more regular deliveries to the LGA and some state
facilities based on analysis of consumption and actual
population needs.
We have seen many examples, both public and private, of how
improving supply chain performance is important to decreasing
stock outs and increasing access to life-saving commodities.
The Bill & Melinda Gates Foundation continues to work with
multiple implementing partners in different geographies to
improve supply chain visibility and analytics networks, and will
continue to explore different approaches to improving public
health supply chain commodity availability at scale.