Roundtable on Strengthening Health Supply Chains to Improve Access to Quality Care

On Thursday, June 9, 2022, Corporate Council on Africa (CCA) held the “Roundtable on Strengthening Health Supply Chains to Improve Access to Quality Care.” The session featured Dr. Jeffrey Sturchio, Chairman, Corporate Council on Africa, Prashant Yadav, Academic Director, Africa Initiative, INSEAD, Ibnou Khadim Diaw, West Africa Regional Director, Africa Resource Centre (ARC), Laird Treber, Senior Advisor, Corporate Council on Africa, and Trip Allport, Managing Director, Africa Resource Centre (ARC). The roundtable on health supply chains allows CCA to showcase and advance its campaign titled “U.S.-Africa Health Security And Resilience Initiative” which establishes partnerships to promote U.S.-Africa trade and investment in Africa’s health sector.Opening remarks were provided by Dr. Jeffrey Sturchio, Chairman of the Corporate Council on Africa. Dr. Sturchio’s insights highlighted that the healthcare market in Africa will be worth an estimated $259 billion annually by 2030 as the African population will double in size by 2050 with 60% of that population being under 25. Therefore, there is an opportunity to build strong systems in Africa. There have been efforts around Continental Free Trade Agreement and Disease Control and Prevention where for example, 90% of Vaccines have been imported. With 90% of medicines, vaccines, and treatments being imported, the African Union has set a goal of achieving 60% of production by 2040. The Corporate Council on Africa has also led efforts through its U.S.-Africa Health Security and Resilience Initiative which relies on 3 pillars: Universal Health Coverage, Disease Control and Prevention, Health Sector Trade, and Investment.Moderated by Prashant Yadav, Academic Director, Africa Initiative, INSEAD, the session addressed the issues faced by African countries regarding supply chain management and accessibility in remote areas. This problem has been especially urged after Africa experienced major challenges in distributing the Covid Vaccines.On the topic of the pandemic, a representative from the Africa Resource Centre (ARC) agreed that the COVID-19 has pushed the government to think outside of the box. There is a need for policies around supply chain which has not yet been at the core of healthcare, but it is a relatively easy process. The private sector has equally complex supply chain issues but have been able to put in place an efficient process, and so should the public sector.Insights from Dr. Oumy Ndao, Director of Pharmaceutical Regulatory Agency, Senegal emphasized on the impact that the supply chain is having on Senegal. The country is facing institutional and political challenges including regulatory and distribution issues on the subregional, regional, and national levels. Dr. Ndao also agreed that COVID-19 has shifted the way African countries have been working with the health sector and has showed them the need of self-sufficiency and the urgency in reviewing pharmaceutical distribution. Senegal is currently working on the purchasing power of their purchasing units and is making efforts towards domestic policies to finance about 80% of the domestic activities.Dr. Zakarya Yabré stressed on the need to re-enforce the distribution channels at the corporate level. Dr. Yabré emphasized on Burkina Faso’s storage issues as their facilities are too old. Renovating these facilities to store the drugs is a crucial part of the initiative. In Burkina Faso, a pilot study has been carried where it could be possible for the purchasing unit to work on distributing to the very last mile, if not to the last yard. A private partner will bring the drugs from the distribution centers to the parties. This has validated the national strategy and will scale up our system. Now, the problem will be to scale it up using a mixed strategy. For the last 15 years, Burkina Faso has had security issues such as attacks in certain areas of the country. When there is a need to supply a particular health facility in an area facing these problems, planes and trucks are needed to carry out distribution which is challenging and expensive. The country also faces high employee turnover in some regions and constantly must renew the staff. Data can provide insights, IT systems and implementation of a database can help track and analyze all the data concerning storage and distribution to help us make better decisions.Aser Minoungo, also from Burkina Faso, stressed on the importance of purchasing units to support the facilities in Africa and come together to support the local level and make it possible to make drugs available to the people.Facilitated by Laird Treber, Senior Advisor, Corporate Council on Africa (CCA), the conversation surrounding the views from companies and associations highlighted some key points on the healthcare issue in Africa. Laird Treber noted seven areas to focus on namely, the trust between government and private sector, the importance of data, the quality of the data acquired, infrastructure, entry of drugs, incentivizing health care workers, and strengthening laboratories and ensuring the quality of samples.James Cordahi agreed on the fact that we are lacking trust and we have made efforts to establish a relationship of trust and the key thing is access to data. IT requires a step chain to share data and it is in everybody’s mutual interest and in the interest of the patient. Establishing public-private partnerships is key and mutually beneficial.Prashant Yadav also commented that if the government is seriously committed in attracting private capital, this will require creating predictability in the procurement process.The third conversation on the view from international organizations and donors was facilitated by Trip Allport, Managing Director at the Africa Resource Centre (ARC). Trip provided some remarks on the dedicated budget lines from donors and how private investments should be encouraged. He noted that this discussion can focus on private investments in Africa and budgeting efficiently.Carter Wilbur, Economic Officer, Office of Multilateral Trade Affairs, U.S Department of State gave some points on how the United States through US Department of State is working on improving health security and working with African CDC and stakeholders. Biden hosted a global COVID-19 Summit which focused on the goal of vaccinating the world and building back better. The Department is working on immediate needs and how that looks like moving forward. Mr. Wilbur went on to also explain that he is working on ‘Line of Effort 2’: Bolstering supply chain resilience and focus on mechanisms to get supplies needed to end the pandemic phase of covid. As mentioned previously, Mr. Wilbur also went over the need to capture data and ensure a steady supply of products.Eric Takang, a supply chain technical expert from the US Department of State provided some observations: “The government is the sole owner of the supply chain, and it is recommended that the government enables the environment where stakeholders are brought to the table and participate in joined discussions and strengthen collaboration and share responsibility to create sustainability and create transparency.”Scott Dubin from The Global Fund explained that their goal was to understand how do use business processes that would put the government in a good position. He also said that The government should communicate when it is necessary to outsource and articulate their need to the private sector.Uyigue Omoma Idahosa, Senior Investment Officer, International Finance Corporation (IFC) joined the conversation and provided insights on the importance to focus on key health resilience initiatives and on how to scale up the availability of health services, how to support the govt to scale up and how to boost local manufacturing and combine analytical study to see what the best course of actions would be. Applying the upstream approach; Nigeria is working with Fidson and the private sector on the expansion of KPI capabilities that would work.Sharing the risk capital with the private sector in case of risks of scaling health initiatives.In the public sector, aggregation is key, and we need to be methodical about aggregating. Procurement processes are price driven; the lowest dollar is a key factor, and we need to flip that statistic where we have scalable procurement practices to incentivize the products to be manufactured locally.Prashant Yadav moderated the last topic of the roundtable focused on the aspects of solutions. Prashant addressed the session by giving three areas of focus; create a patient-centric model to get more patients by using new models, reimagine procurement and supply chain financing strategies, and create governance structures to improve coordination.Eric Takang added that if there is no information on what private sector resources or expertise are available, one key activity that would help is the regional mapping of supply chain and the logistics or resources to develop a regional directory of supply chain resources and have private sector companies identify their areas of expertise. A second key solution is to support a country in identifying their logistic professionals and recruit people in the community and do basic training on supply chain management.This discussion provided a variety of solutions from different sectors. For instance, Regional economic communities such as the ministries of health can investigate regional industries and access facilities because there is a lack of knowledge of these facilities and ability to use connections. Laird Treber added that creating a system where we build a connection od data would heavily contribute to our goals. There is an opportunity to develop a trusted third-party model that opens innovation and new hacks for procurement and if we understand the scope of the problem and what the patient needs, then we can develop reality-based local production. If the private sector has that information, they will deploy and provide the need. There is a need to establish the concept of creating a sustainable market structure and setting up the market correctly where private sector will participate in the market directly.Another issue raised during this discussion was intellectual propriety. Carter Wilbur stressed on the importance of transparency and balance a company’s legitimate propriety concerns. Prashant Yadav added that intellectual property issues are the reason why it is hard to share some information outside of the ministry of health. The government needs to find ways to establish greater trust to make it work. James Cordahi provided insights on the intellectual property concerns raised. He added that accessing the data by a password could or automated interface between medical stool systems and multi-country center base where the supplies are accessed would improve the trust between both sectors could be a potential solution.Prashant Yadav provided closing remarks emphasizing on the set of challenges from the private sector and international donors to address the downstream of supply chain and manufacturing to increase supply chain resilience. The government must therefore create a structure to coordinate across which could lead to the question of whether the government should focus on providing a blueprint at a national and regional and presumably at the global level.Dr. Jeffrey Sturchio also provided some closing remarks on behalf of the Corporate Council on Africa and noted that it is crucial to establish trust between the private and public sectors. Trust must be earned through roundtables exemplified by this dialogue.