The question of integrating supply systems has been raised a few times already, and was on the agenda of the Copenhagen TechNet Meeting, which took place - in 2003, if I remember correctly. At that time I presented a paper (please see attached copy). Now Umit correctly points out that, often, there is a certain resistance or fear of "handing over the cold chain" by Immunization Programme Managers. This concern was already voiced in 2003, and I coined it in my presentation at the TechNet Meeing, "Who is taking over who?".
Another point is that integration of supply systems, in many cases, is already partially done, because ordering/tendering is done by the Medical Stores; and storage at the central and regional level is handled by medical stores, leaving distribution from regional stores to district stores and health center stores to be done by the immunization programme. This is explained with details in my paper. The role performed by the Medical Stores brings me to present another argument for integrating the supply systems. The Medical Stores, particularly in Africa, are managed by professionals, i.e. by pharmacists, called Technical Officers with 3-4 years of education in pharmacy. I have extensive experience of cooperating with these people from working in essential drugs programmes in Zimbabwe, Zambia, and Mozambique. The pharma techs are indeed very good in logistics, having to handle a substantial number of supply items in the Essential Drugs Programmes that can amount to 500-600 items for regional hospitals and district hospitals, and 150 for health centers, i.e. 4-5 times more items than the number found in an immunization programme. The logistics of the essential drugs programmes are dealt with in the "Yellow Bible" edited by Management Sciences for Health, Boston, and more up- to- date by the excellent software programme mSupply, available free of charge for non-comercial users. The manual of the mSupply describes very clearly the problems in a supply system and how to handle them.