Governments, NGOs, and civil society organizations are examples of entities that have made significant investments in reaching the United Nations Sustainable Development Goal of “[achieving] universal health coverage, including financial risk protection, access to quality essential health-care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all.” Even with these investments, there are still gaps in stakeholders’ willingness, ability, and funding to ensure healthy lives and promote well-being. Traditionally, governments or parastatal agencies, with the support of donors, have managed public health supply chains in LMICs. This support has mostly focused on strengthening health supply chain operational capabilities such as forecasting and supply planning, procurement, and storage and distribution. Recently, however, donors are increasingly envisioning the private sector as an important advisor, executor, innovator, and financier for governments, donors, and implementing partners to achieve sustainable health outcomes.
Embracing Stewardship in Health Supply Chains
Countries such as Nigeria and Zambia are testing and scaling private sector-led supply chain solutions to improve their health supply chain performance and health outcomes. In Nigeria, to ensure adherence to treatment, the Chemonics-implemented USAID Nigeria SHARP program partnered with 55 community pharmacies for antiretroviral therapy and reproductive health commodity distribution. In Zambia, we implemented an innovative health commodity distribution system in the Medical Stores Limited (MSL) for the USAID Global Health Supply Chain Program-Procurement and Supply Management project, using a third-party logistics (3PL) service model. The tripartite subcontract allowed easy information exchange among parties, as well as for MSL training in managing a 3PL contract. The 3PL subcontractor, Lechwe Express Zambia, provides fleets for distribution and uses a comprehensive live-tracking system to track shipments. In both cases, national governments have assumed a stewardship role, managing and monitoring private sector-run supply chain operations with support from donors and implementing partners.