IAPHL are debating the agenda for their next Webinar. Some are suggesting a focus on aspects of logistics integration for CD and NCD programs. For me, this is the 'Elephant-in-the-room' of future distribution strategy for country health pogrammes. Incorporating the distribution of vaccines and the fast-growing category of medicines that require cooling (i.e. insulin) and CT storage would have much to discuss, including the following three strategic issues:
1. Defining and achieving high efficiency distribution by:
- requiring that every national list of medicines contains the secondary packed volume of each generic and name-brand medicine so that cooled storage capacity can be correctly anticipated at time of tender;
- requiring that every medicine procured declares storage conditions (temperature range, humidity, sensitivity to light radiation) to ensure availability of required conditions of transport and storage;
- assessing in the country context whether the stages of transport in distribution can be more efficiently handled by active-refrigerated vehicles or passive-cooled insulated cold boxes/packaging;
- employing back-loading practices to bring sealed sharps boxes containing used syringes to central disposal hubs.
2. Optimizing the distribution network by:
- minimizing the number of stages of transport and storage at which products are handled and repacked for onward distribution;
- exploiting the current state-of-the-art energy management technologies in the design of new warehousing and for transport. As autonomy of electric vehicles now reaches 400 kms, take advantage of greater efficiency of electric vehicles, lower maintenance and cost reduction by solar-grid linked electricity management;
- using IT applications to maximise efficiency of supply trips and vehicle loading and also to provide GPS tracking and temperature monitoring with remote alarms.
3. Calm the fears of 'silo' programme logistics officials and support them by:
- using IT and communications technologies to maintain the control functions (distributing specific groups of vaccines or medicines) entirely in their hands via computer applications;
- offering freedom of access to vehicles and warehousing for PH officials to ‘control quality’ by inspection and routine review meetings with the distribution central management;
- as plans are laid for transition to integrated distribution, build time and progressive implementation stage by stage to allow time to build confidence. If outsourcing is introduced or expanded, allow for contract supervision and quality monitoring.
Join the IAPHL debate and add your thoughts to theirs?
26 Novmber 2017