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Cardinal chains level 541/8/2024 ![]() Much of the technical literature on supply chain management was designed for use by commercial firms so when applied to public organizations it presupposes motivated well-intentioned bureaucrats, honest politicians, and separation between politics and management. Such information is key to the development of remedial interventions that can improve access to medicines and strengthen health systems. Given that public sector, private sector and NGO supply chains are inextricably linked with multiple points of interface, it is important to understand this for the system as a whole. Understanding the root causes of underperformance in healthcare supply chains represents an important gap in knowledge. ![]() 5,21,22Īlthough GHIs, national governments, academics, consultants and experts in philanthropic foundations have recognized the importance of investments in healthcare supply chains, a deeper and structured understanding of supply chain issues is lacking. 20 There is also an increasing skepticism around the conventional supply chain models used in developing countries and pressure to learn from the private commercial sector. ![]() Risks of poor product quality and counterfeiting are further reinforcing the demands to strengthen supply chains. 28 Many middle- and lower-middle-income countries that are facing a significant demographic, epidemiological and economic transition are also realizing the value of investments in improving their healthcare supply chains making. In addition to greater interest from GHIs and bilateral agencies, pharmaceutical companies are also putting additional focus on developing their supply chains in low- and middle-income countries. International recognition of the role of supply chains as one of the key bottlenecks in health systems strengthening has been growing over the past decade. This increase in product volume has started putting more pressure on the hitherto inadequately resourced supply chains. 19 GHIs have contributed to large increases in drugs, vaccines, bednets, and diagnostic and laboratory materials flowing through country supply chains. 18 Despite the large investments, the availability of medicines remains very poor in public health facilities. 3,16ĭuring the last decade, significant sums of money have been invested into global health initiatives (GHIs) aimed at addressing global health issues such as HIV/AIDS, malaria, and TB in developing countries. As a result supply chains that serve patients in low-income countries remain weak and ineffective, 3 putting treatment programs at risk 15,17 and weakening the overall health system's ability to respond to the healthcare needs of the population. 7 Supply chain management is a well-developed scientific discipline, 8–14 but has not been fully utilized in improving public health supply chains in developing countries. Supply chains play a role in each of the categories identified for health system performance improvement: payment, organization, regulation, and also behavioral aspects of the health system. Supply chains not only deliver medicines and health products to the population, they also return critical information regarding need, demand, and consumption to health system planners. 4–6 Although some envision a supply chain to be a set of warehouses, trucks and carton boxes, a supply chain is in fact the ecosystem of organizations, people, technology, activities, information, and resources that have to come together to ensure the delivery of the product from the point where it is manufactured to the end-patient in a cost-effective way. 1–4 Any good health system necessitates supply chains that can guarantee consistent availability of affordable, high-quality medicines, vaccines and health products at all health service delivery points. Well-functioning supply chains to deliver medicines, vaccines and other health products are critical to the provision of health services.
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