Improving availability of medical supplies through public health logistics

In many health projects in low-resource settings, medical supply is a problem. Stock shortages (whether from inadequate order quantities, delayed arrival, changes in program goals or treatment guidelines) can result in substandard treatment; overstocks become expensive mistakes if they expire and must be destroyed. Accurately quantifying medical supply continues to be a challenge despite the prevalence of computers and mobile data collection options. This presentation argues that there is no “one-size fits all” calculation for medical supply forecasting due to variations in usage patterns of medicines and medical supplies, disease incidence and program goals. The presentation discusses a medical supply monitoring and forecasting methodology that combines and triangulates medical morbidity, logistical consumption and service statistic data to better model medical supply need. This methodology is derived from work done in Peru, DR Congo and Haiti in health projects focusing on MDR-TB, HIV/AIDS & STDs and an obstetrics project, respectively. It is also motivated by analyses of public, private and mission sector supply chains in ten other countries. Finally, I outline possible ways to extend the methodology to the country level. The key is to place public health logisticians at the project, regional and central levels of the health system who liaise between the medical and logistics teams and relay medical logistical information up and down the supply chain. I suggest that the approach, while requiring a small team of public health logisticians, can improve availability and reduce wastage enough to be cost effective.