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.

This article is published in collaboration with Impatient Optimists. Publication does not imply endorsement of views by the World Economic Forum.

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Author: David Sarley is a Senior Program Officer at the Bill and Melinda Gates Foundation and is managing collaboration with Coca-Cola, GHS and ADP. 

Image: A woman with a baby on her back looks on at an informal settlement in the capital Luanda, August 30, 2012. REUTERS/Siphiwe Sibeko.