Lois Privor-Dumm

By Lois Privor-Dumm. We’ve heard the anecdote that you can find Coke in just about any village in Africa, but not always essential medicines.  Is that really true?  Well, our team at the International Vaccine Access Center (IVAC) at Johns Hopkins set out to find out. 

It’s actually not as easy as you might think to test the hypothesis, as Hopkins PhD candidate Kyla Hayford found out.  We did, however, get enough data to say comfortably that the anecdote is true as you will find in our new IVAC report, Improving Access of Essential Medicines through Public-Private Partnerships.

Photo credit: Tielman Nieuwoudt

First, we found an astonishing lack of available data about stock outs, wastage and other measures that indicate whether essential medicines are available.  Our report compared this to measures of availability of consumer packaged goods – things like candy bars and cola and calling cards – which seem to be stocked in abundance throughout the developing world. 

Why are these indicators important?  The simple truth is that no one dies if there aren’t mobile phone cards at the local kiosk, but the stakes are high if an antibiotic is not available to treat a child with a deadly disease.  Why is it, then, that consumer goods companies have many means to effectively track distribution, while there are very few measures in place to track the availability of essential medicines throughout Africa?

We found that injectable ceftriaxone, for example – a life-saving antibiotic for those with severe infections – was available in Kenyan and Tanzanian hospitals less than half the time, while mobile phone cards were available 90% of the time. 

So what can be done?

First, we need to build and maintain better planning and tracking systems.  Recognizing areas where distribution mechanisms are in need of improvement is a first step in making progress to better distribution of essential medicines.  Those managing the supply chain process also need to have the skills necessary to interpret this information, and make modifications accordingly..

Second, we need to share knowledge on distribution practices.  Many for-profit companies have mastered the art of product distribution and have their systems down to a science.  This includes information tracking, training of personnel, network expansion strategies, flexible financing and incentives, and investment in analyses that lead to a reduction in the cost of distribution. 

Infrastructure for distribution is one area to consider leveraging and exploring potential partnerships.  If Coke can deliver to Timbuktu, why couldn’t they bundle some oral rehydration salts into that same load?  The packages are small and don’t add much weight.

This is happening already, but on a small scale. Exxon Mobil distributes malaria-preventing bed nets to pregnant women at gas stations across Ghana and Zambia, for example, and shipping company DHL provides warehouse space and distributes vaccines in remote Kenyan villages.  These efforts are commendable, and should serve as models for what is possible.

The challenge will be matching up programs with beneficiaries and working out kinks. We can think creatively and recognize that the value we bring is not always money.  For companies that have the infrastructure and know-how – let’s figure out how you can share that.  Post your comments.  I welcome your feedback.

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