Comprehensive supply chain engagement and the exit challenge

UNICEF Supply | 15 June 2013 | 0 comments

© UNICEF/Supply

Programme Area: HIV
Supply Chain Segment: All
Country: Malawi
Organization: UNICEF

UNICEF engagement with governments to improve supply chains is often initiated when local supply chains break down and delivery systems fail. When this happens, the immediate priority for the country and for UNICEF is to identify which essential supplies are not getting through – and to procure and deliver these as fast as possible to where they are needed. UNICEF’s longer term capacity development goals related to supply chain strengthening, and the eventual handover to governments, are often more challenging than meeting the immediate supply needs.

In 2003, an estimated one million people in Malawi were living with HIV, a prevalence of 14 per cent, and the country had a weak health supply chain infrastructure. As an interim measure, and with funding from the Global Fund, the Ministry of Health asked UNICEF to provide and distribute lifesaving anti-retrovirals (ARVs) and other HIV supplies.

In parallel, efforts to build the capacity of the national system in line with standards defined as part of the country’s health sector-wide approach strategy were given priority. The areas identified for capacity development included the redesign of systems and the training of Government counterparts in sourcing, procurement, quality assurance and distribution.

An independent evaluation recently concluded that after eight years of engagement, UNICEF and partners had established a cost effective supply chain for HIV related commodities in Malawi. This has contributed to the steady decrease in HIV related deaths in the country from 80,000 in 2005 to less than 45,000 in 2011.

In 2012, UNICEF handed over the procurement of HIV related supplies to the Voluntary Pooled Procurement mechanism established by GFATM. The evaluation highlighted that the intended capacity development had been less effective than anticipated, resulting in delays in the handover of supply chain functions to the Government.

UNICEF’s engagement in Malawi is a reminder that effective and sustainable capacity development in health supply chains requires a comprehensive approach that operates at the individual and organizational levels, and relies on an enabling environment and a strong legislative framework. It requires government leadership, transparency, accountability and partner coordination.

Joint efforts on the part of all stakeholders can address the complex and interrelated capacity development components, and garner the necessary long term investment and political commitment to bring about sustainable results – even after the immediate supply chain challenges have been tackled.

It is these lessons and experiences that UNICEF draws on when engaging in comprehensive supply chain strengthening programmes, such as the Free Health Care Initiative in Sierra Leone and the Essential Medicines Logistics Implementation Programme in Zambia.

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