COVID-19 has highlighted vulnerabilities in the medical product supply chain worldwide. With a decline in international transport capacity, new border controls and export restrictions, and national stockpiling of medicines involved in COVID-19 care, supply chains have been severely disrupted.

 

 

For many healthcare systems, the focus has been on coronavirus patients and the risks to intensive care units. Yet disruptions in the supply chain are having a big effect on those in low-income countries living with non-communicable diseases (NCDs) such as cancer and diabetes. These diseases cause around 70% of all deaths globally. A regular regimen of treatment is often essential for patients, so any disruption to supply can be devastating.

A WHO rapid assessment in May 2020 found half of low-income countries experienced COVID-19-related disruptions to services for cardiovascular emergencies. More than half had seen cancer treatment disrupted (comparable figures were 17% and 26% for high-income countries). Unavailability or stock outs of essential medicines were causing disruptions to NCD services in one in five countries, with transport a major factor for low-income countries.

 

Dealing with closed borders

In 2020, we sent a total of 63 shipments to our NGO partners in 36 countries. These comprised more than 5.8 million treatments for those in need. During the pandemic, we have been working hard to counter supply chain issues exacerbated by COVID-19. Colleen Harrisson-Dodds, our director of logistics, spells out some of the challenges.

“Early in 2020, flights started to dry up. A lot of our shipments go on passenger flights and as countries shut borders, options for airfreight diminished. We couldn’t get anything into Sierra Leone or Liberia, for example.” The challenge of finding routes has been compounded by lack of sea freight. “Temperature-control containers are in short supply because of pandemic supply chain disruption, Brexit and other factors. From a one- to two-week wait, on certain routes it is now five or six weeks.”

To overcome challenges, we are continuing to adapt our processes. “If freight has to stop in five or six places, there are implications for cost and risk, as goods are in transit for longer. Normally we would pack, book, and go, but we’ve rejigged. In this challenging environment, lateral thinking is important. We brought on a new carrier to give ourselves extra options, and are in regular contact with carriers to check routes.” 

A shipment we sent to Panzi Hospital in the Democratic Republic of Congo (DRC) shows this adaptation in action. The hospital caters for a population of 500,000 people and treats everything from broken bones to heart failure. A recent shipment we sent contained more than 15,000 treatments of essential medicines (such as antibiotics and analgesics) and was to be airfreighted via Ethiopia to Kigali, Rwanda, then trucked to Bukavu, DRC.

With no flights to Kigali available before the end of 2020, we booked a space on one leaving on January 10. Our in-country partner, with extensive experience of importing and handling medicines, helped to expedite delays at the Rwanda/DRC border, and the shipment arrived safely on January 20. Medicines were distributed to help 12,500 people, including those with NCDs such as hypertension, diabetes mellitus and cardiac pathologies.

Colleen says our success lies in talking regularly to partners. “Tight communication channels and transparency are key. We are quick to act: what’s available one minute might not be the next.”

 

 

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