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Supply chain improvements could decrease under 5 malaria mortality by 37%

Started by Prashant Yadav on 24 Apr 2010
Last edited by Robert Szypko on 29 Jul 2011

A study that I have been very closely involved in the last 2 years (together with my colleagues Monique Vledder, Jed Friedman, Mirja Sjoblom and Tom Brown at the World Bank and Jeremie Gallien at MIT) has shown that simple structural and information flow changes to the government run system for essential medicines and malaria drugs distribution in Zambia can lead to remarkable improvements in the availablity of drugs. The 12 month quasi-randomized experiment (first of its kind for supply chains and health product distribution) shows that simple changes can improve the availability of drugs at health clinics by up to 30% (almost eliminating stock outs in some cases). This translates into over 27,000 lives saved for children under 5, almost 37% reduction in U5 mortality due to malaria.

The results are exciting and novel because they show that clever technical improvements rooted in the principles of supply chain management combined with good understanding of the political economics of the health system could in fact make the public sector system for essential medicines work in sub Saharan Africa.

More info is available at
http://web.worldbank.org/WBSITE/EXTERNAL/NEWS/0,,contentMDK:22548646~pagePK:6...

Keywords: Diagnostics & Treatment  malaria  Operations & Logistics  Supply Chain  supply chain management  Zambia 

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Timothy Archampong

Its amazing how improved structural efficiency translates into better delivery of essential medicines to the periphery. If the political will is there, issues like this can be disseminated widely in sub-saharan africa.

9:58 AM, 30 Apr 2010 | Permalink

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Kileken ole-MoiYoi

Two recent articles published in the Malaria Journal raised some concerns regarding access to artemisinin-based combination therapy (ACT) in the private sector in Tanzania. In 2007, Tanzania changed its first line treatment from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (AL). The AL combination was made available in the public sector and selectively in the private sector and its introduction was preceded by a social marketing campaign.

Between 2004 and 2008, there was a 22% increase in the understanding of the causes of malaria to 84%. Additionally, there was a 25% increase in health facility attendance as a first treatment option to 52%, a 10% increase in treatment coverage to 96%, and an increase of roughly 15% in people treated within 24 hrs of a fever to 95%. However, following the policy change, the AL combination was not readily available in the private sector resulting in a roughly 30% decrease in the proportion of patients taking the new first-line treatment to 53%.

The findings indicate a potential implementation lag time in the private sector that could be relevant to programs such as the AMFm (http://www.theglobalfund.org/en/amfm/) which is expanding the availability of subsidized ACTs to the private sectors in ...

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4:37 PM, 22 Jun 2010 | Permalink