Why Distribution Is Key
Supply chain inadequacies remain a persistent problem across public and private health sectors. There are a myriad of problems in securing access to health across sub-Saharan Africa from a regulatory, capacity and infrastructure perspective.
However, distribution is particularly highlighted as an issue due to the often out-of-pocket funded healthcare systems where the implication of high medicine prices is acutely felt by those least able to afford it.
According to research by the group Health Action International (HAI) the sub-Saharan African region has some of the highest drug prices in the world at the point of care for both branded and generic medicines.
Fragmentation and Competition
Many of the issues of the health commodity distribution system for countries in Anglophone Africa stem from excessive levels of fragmentation in the market and an inadequate competition.
With often hundreds of pharmaceutical sub-wholesalers in the market there is undoubtedly competition. However, the competition is imperfect due to a lack of transparency on medicines prices, stock levels, long payment cycles and the cost of credit.
High Tech and Low Tech Solutions
There is a temptation when looking at last mile solutions for optimizing health commodity distribution to focus on high tech solutions that use computers and centralized control. Often how practical this is will depend on the context and often a lower tech solution can be just as effective if deployed correctly.
Ultimately what you need is to fully understand the needs and incentives of the various stakeholders involved in the project, and redesign a system that is still inclusive, sustainable and brings benefits across the supply chain rather than attempting to only pressure the margins of your distribution partners.
In the longer term higher tech solutions are likely to be the end point, in order to create better end-to-end visibility, but as with all things it is a gradual process.