Health Logistics: A Vital Issue

The 2005 WHO report Health and the Millennium Development Goals highlighted the challenges in the field of health logistics: "Much of the burden of disease can be prevented or cured with known and affordable technologies. The problem is in getting staff, medicines, vaccines, and information – on time, reliably, and in sufficient, sustained and affordable quantities – to those who need them " [1] .

Weak logistics systems can be an obstacle to the success of health initiatives as a whole, whether in terms of immunization or distribution of drugs and health products. Deficiencies in the supply chain are especially problematic when introducing new vaccines (e.g. vaccines against pneumonia and diarrheal diseases), which require sophisticated health systems and skilled personnel to guarantee (among other things) proper conditions for storage, transport and delivery to the site of use.

Enhancing the efficiency of health systems and their capacity to integrate new products (vaccines, medicines, etc.) requires a functional, large-scale logistics system, with top-down coordination from central level to the periphery. For such a system to run smoothly, it is essential that the actors in the logistics chain are properly trained and motivated, as well as recognized and supported by the Ministry of Health.

To this end, the Benin LOGIVAC Center runs diploma and certificate courses to improve the skills of health logisticians.

The major challenges of new vaccines

Quantification, storage and distribution

A wider range of health products is available today, improving the prevention and care of debilitating and fatal diseases. However, the share of the costs of these products in health budgets is growing,  placing a significant burden on countries with limited resources. Moreover, the availability of products globally is sometimes uncertain. As a result, quantifying products over the medium and long term is a critical exercise for ensuring that requisite and sufficient quantities are available in a country.

The storage of health products must meet standardized norms to preserve their quality and assure their safety. Finally, the methods for distributing products must be safe and efficient so that they are available where they are required, i.e. as close as possible to health system users.

Maintenance

Biomedical equipment must be properly maintained and replaced on schedule for a safer and longer lifespan and to improve reliability, with a direct impact on the quality of vaccines in relation to cold chain facilities. Efficient systems must be devised and employed for managing and maintaining equipment, with controlled interventions by private sector providers.

Shortage of skilled health logisticians

A lack of dedicated and qualified staff often forces pharmacists and nurses to take on logistical functions in developing countries, even though they have not received any specific training in logistics and it is crucial that are effectively employed elsewhere in the health system.

The way forward

The provision of new health products and innovative strategies for fighting disease, together with growing distribution and storage costs at different levels of the health pyramid, requires a long-term effort to improve supply chain management in the health sector.

Success hinges on working with the private sector to transfer best practices and new technologies. In addition, some tasks need to be delegated under satisfactory quality and cost-control conditions.

Supply chain managers must capable of ensuring that health products are delivered to the right place at the right time; in adequate quantities and in the best conditions; and at a lower cost.