Always Cola, Rarely Essential Medicines: Comparing Medicine and Consumer Product Supply Chains in the Developing World (original) (raw)
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The World Health Organization estimates that almost a third of the world's population still lacks access to essential medicines. The distribution network for medicines is ineffective and inefficient in many developing countries. Discussions often centre on why the supply chain for non-alcoholic beverages (soft drinks) is not replicated by that for medicines. There is little understanding of the similarities and differences between the two supply chains. This article compares these two supply chains in developing countries from a structural and incentive perspective. It illustrates the complexity of medicine supply chains, and highlights the important differences between these and soft drink supply chains. In doing so, it identifies areas that negatively impact on patient access to medicine.
SSRN Electronic Journal, 2000
Despite increased investments in health commodity procurement, the availability of essential medicines at health facilities remains very low in many low and middle income countries. The lack of a wellfunctioning supply chain for essential medicines is often the cause of this poor availability. Using a randomized experiment conducted in over 400 health facilities and 24 districts in Zambia, this study helps understand the optimal supply chain structure for essential medicines distribution in the public sector in low income countries. It focuses on the availability of 15 essential medicines at the health facility level and compares between a cross-dock based two-tier distribution network and a three-tier network. The study shows that a two-tier "cross-dock" like system outperforms a traditional three-tier drug distribution system due to better information flow and better management accountability even though stock is positioned closer to the health facilities in the three-tier system. Results from the study advance existing knowledge in the area of public sector distribution system design in general and drug distribution systems in developing countries in particular.
Health Systems & Reform, 2015
Well-functioning supply chains to deliver medicines, vaccines, and other health products form the backbone of the health system. Health product supply chains in developing countries are fraught with many problems. Ineffective supply chains weaken the overall health system's ability to respond to the healthcare needs of the population and put treatment programs at risk. This article provides an overview of the structure of health product supply chains in developing countries and outlines the main challenges and their root causes. It aims to identify key areas of reform to ensure that supply chains enable-or at least do not impede-achieving the targeted health outcomes from the increased investments in global health.
Medicine adherence levels remain frustratingly static at 50% or lower (Sabaté, 2003). We believe that supply chains can contribute improvements by making appealing and acceptable medicines available to consumers. We use Service-Dominant Logic (Vargo & Lusch, 2004; Vargo & Lusch, 2008) to investigate consumption – the “last yard” of the supply chain – and empirical research performed in India, Uganda and Nigeria to assess how different populations view the formulation and packaging of Oral Rehydration Salts. The results and analysis provide new and actionable insights into medicine appeal and acceptance in the developing world.
His research interest is in the area of integrating developing countries into the global public procurement framework. Kambaza Stephen Faculty of education is a lecturer in Kyambogo University in the Fcaulity of Psychology(psychometry) His interests are Psychometric assessment: Values, beliefs, attitude measurement, Influence of values and beliefs on life perceptions and orientation, Development of materialism, consumer psychology. ABSTRACT. Recent empirical studies point to structural supply chain constraints in the supply of essential drugs in developing countries, hence calling for interventions and policy direction. Despite Uganda's commitment to improve drug access and availability, actual realization remains low and structural bottlenecks in the chain have not been identified and documented. A cross sectional survey was conducted on 240 respondents in four malaria prone districts. Structural bottlenecks at each stage of the supply chain have been systematically identified and documented as a starting point. Findings indicated hospitals were mainly affected by lack of credible and accessible drug consumption information, poor planning, forecasting and logistics. Health centre IVs mainly faced inadequate procurement skills and consumption information. Health centre IIIs encountered poor procurement practices and logistics. Health centre IIs faced poor procurement practices, collaborative linkages and logistics. These findings add to the literature of the increasingly complex drugs supply chains in developing countries. The paper concluded that access and availability of essential drugs remains sub-optimal. Recommendations are drawn towards policy interventions aimed at strengthening programmes at local governments, investing resources in collaborative services, training staff in procurement best practices, and logistical management.
Abstract: There are structural supply chain constraints in the supply of essential drugs in India hence calling for interventions and policy direction. Government’s effort to improve drug access and availability has been too late and too little. A cross sectional survey is planned on 195 respondents in four districts of eastern U.P. Structural bottlenecks at each stage of the supply chain is planned to be identified. The sampling method used for the research is convenience and method used is factor analysis. Result can help us in identifying bottleneck in supply chain of medicine in primary health centres. Recommendations will provide guidelines for policy interventions aimed at strengthening programmes at local governments, investing resources in collaborative services, training staff in procurement best practices, and logistical management. Keywords: logistic management, supply chain, forecasting, bottleneck
BMC Health Services Research, 2020
Background Global health priority setting increasingly focuses on understanding the functioning of health systems and on how they can be strengthened. Beyond vertical programs, health systems research should examine system-wide delivery platforms (e.g. health facilities) and operational elements (e.g. supply chains) as primary units of study and evaluation. Methods We use dynamical system methods to develop a simple analytical model for the supply chain of a low-income country’s health system. In doing so, we emphasize the dynamic links that integrate the supply chain within other elements of the health system; and we examine how the evolution over time of such connections would affect drug delivery, following the implementation of selected interventions (e.g. enhancing road networks, expanding workforce). We also test feedback loops and forecasts to study the potential impact of setting up a digital system for tracking drug delivery to prevent drug stockout and expiration. Results ...
Journal of Pharmaceutical Policy and Practice, 2023
Background Insurances in high-income countries (HIC) often contract with private community pharmacies to dispense medicines to outpatients. In contrast, dispensing of medicines in low-and middle-income countries (LMICs) often lacks such contractual arrangements. Furthermore, many LMICs lack sufficient investment in supply chains and financial and human resources to guarantee stock levels and services at public medicine-dispensing institutions. Countries striving to achieve universal health coverage (UHC) can, in principle, incorporate retail pharmacies into their supply chains to expand access to essential medicines (EMs). The objectives of this paper are (a) to identify and analyze key considerations, opportunities and challenges for public payers when contracting out the supply and dispensing of medicines to retail pharmacies and (b) to provide examples of strategies and policies to address these challenges. Methods A targeted literature strategy was used to conduct this scoping review. We created an analytical framework of key dimensions: (1) governance (including medicine and pharmacy regulation); (2) contracting (3) reimbursement; (4) medicine affordability (5) equitable access; and (6) quality of care (including 'patient-centered' pharmaceutical care). Using this framework, we selected a mix of three HIC and four LMIC case studies and analyzed the opportunities and challenges encountered when contracting retail pharmacies. Results From this analysis, we identified a set of opportunities and challenges that should be considered by public payers considering public-private contracting: (1) balancing business viability with medicine affordability; (2) incentivizing equitable access to medicines; (3) ensuring quality of care and delivery of services; (4) ensuring product quality; (5) task-sharing from primary care providers to pharmacies and (6) securing human resources and related capacity constraints to ensure sustainability of the contract. Conclusion Public-private partnerships offer opportunities to improve access to EMs. Nonetheless, managing these agreements is complex and is influenced by a variety of factors. For effective contractual partnerships, a systems approach is needed in which business, industry and regulatory contexts are considered in tandem with the health
Malaria …, 2010
Background: In many low-income countries, the retail sector plays an important role in the treatment of malaria and is increasingly being considered as a channel for improving medicine availability. Retailers are the last link in a distribution chain and their supply sources are likely to have an important influence on the availability, quality and price of malaria treatment. This article presents the findings of a systematic literature review on the retail sector distribution chain for malaria treatment in low and middle-income countries. Methods: Publication databases were searched using key terms relevant to the distribution chain serving all types of anti-malarial retailers. Organizations involved in malaria treatment and distribution chain related activities were contacted to identify unpublished studies.