2022 U.S.-Africa Business Summit – Health Supply Chains in Africa
INSEAD’s Africa Program Director Prashant Yadav moderated a session that looked at health supply chains in Africa. This session looked at lessons learned from the pandemic and disruptions in global supply chains, as well as opportunities to re-imagine how supply chains work, getting to a more patient-centric approach that works across the health sector as part of a broader effort to strengthen health systems. Speakers included Dr. Ahmed Ogwell Ouma, the Director A.i. of the Africa CDC, Bronwyn Timm, Strategy and Partnerships Lead of the Africa Resource Centre, Kwabena Ayirebi, Director Banking Operations at Afreximbank, Christina Struller, Vice President, Public Affairs, Indian Subcontinent, Middle East and Africa at UPS, and Jo Tierens, Senior Director, Global Health Supply Chains, Johnson & Johnson.
Dr. Ouma began the session by noting that bigger changes are coming out of the discussion over the last two years about access to vaccines. One of the specific themes that has emerged is the need to develop cold chain as a profession in Africa as part of an effort to get equipment that is appropriate to Africa in the right places in Africa. He noted there are often mismatches between the large modern equipment available at airports in the capitol, and what is available in villages. These challenges also present opportunities, including the potential to manufacture equipment on the continent, and training professionals to repair and maintain this equipment. Africa has ignored this as a profession and needs to develop it.
Companies provided some real world examples of innovations that are expanding capacity and stretching resources. Bronwyn Timm noted ARC works on health system strengthening in 10 countries in west, east and southern Africa in two pillars. First, how do you build ownership and leadership in the Ministries of Health as well as accountability. Second, how to re-imagine the supply chain to bring in imagination and innovation with companies. It is important to build supply chain strategies that are costed, and a roadmap for government frameworks of accountability. They are reimagining what it could look like working with the private sector at the global and local level. This leads to differentiated channel distribution, and central planning awareness tools in South Africa, Namibia and Senegal. They are also working on an outsourcing tool that explains to governments why to outsource, how to issue an RFP, how to put in the right incentives, and how to follow through on implementation of contracts. They are working with JNJ on warehousing, where they have good and bad examples. They have several FMCG partners which use differentiated channels to create a patient-centric last mile delivery option. This involves figuring out where are your patients, and how to engage with them. In Uganda, they are working on a global idea of differentiated chain, which they are working to incorporate into Uganda with IDI, and academic institution. Jo Tiernens noted that JNJ has a lab to last mile approach that focuses on African diseases; they have done some deep dives on TB and other diseases with big impacts in Africa, like Ebola, Denge and Leprosy. They did a survey and identified 1500 facilities in different countries, from which they are working on repair, energy, maintenance and the frequency of delivery. This has shown that they need leaders that are thinking transformationaly. JNJ has partnered with Arc and UPS to train 50 leaders a year, and working with INSEAD on a community of practice with a curriculum for front line workers. They are also developing planning and forecasting tools with ARC. Christina Struller from UPS noted that they have delivered more than 1.5 billion Covid doses worldwide, including through a number of innovative partnerships in a number of countries on the continent, including with Zipline, UNICEF, Pfizer and CARE, piloting new delivery methods that radically cut delivery time from hours to minutes in Rwanda, and expanding soon to Malawi, Kenya and Nigeria. The UPS foundation has brought in cold chain and freezers into 25 ports, and have trained transporters in Ethiopia, Kenya, Ghana and Malawi on the ground.
ARC noted that funding is an important issue, and often comes through donors and governments. The long-term goal is to change how funds are deployed, into systems not programs. Applying private sector methods to public sector procurement can save significant sums and improve delivery performance -but require governments to change how they think. Kwabena Ayirebi from Afreximbank noted that there have been improvements in AMSP and AVAT that include supply chain funding. He noted that, as Africa pushes into implementing the Partnership for African Vaccine Manufacturing (PAVM), Afreximbank will look at new paradigms of working with the private sector, including through blended finance. Afreximbank can work with donors to be more sustainable to unlock resources that are not longer dependent on the whims of donors. Kwabena noted they are looking to support the development of pharmaceutical parks. This would include logistics, storage, and they believe that localized in one area will reduce costs. Senegal is an example. They are talking to the government about expanding manufacturing to also include a pharma park with cold chains.
Click here to view the session.