Frequent, recurring stock-outs of essential drugs and medical supplies as well as stock expiration and waste continue to challenge the health system performance in Sierra Leone. Some of the underlying and systemic causes include:
disconnect between demand management and quantification,
procurement planning and timing of distribution,
the continued ‘push’ system,
poor storage facilities at all levels,
transportation challenges,
poor monitoring systems and lack of supply chain performance metrics,
and bottlenecks related to timely clearance at the port.
Existence of parallel supply chain systems for different commodity groups (largely based on their funding sources and supporting organization) has further complicated the Procurement and Supply Chain Management (PSM) landscape in Sierra Leone. In the public sector, some efforts have been made to integrate supply chains, but integration to date has been limited to integrating distribution mechanisms. In the private sector, organizations and other entities independently run their supply chain system with their efficiency some-how questionable. Moreover, in both public and private sectors, availability of supply chain performance metrics and data for the management of supply chains are lacking, making it difficult to quantify the impact of such interventions.
The weak, parallel and uncoordinated supply chain system has been a main bottleneck in improving the effectiveness of health programmes and the entire health sector, and therefore any effort to strengthen it has transformative effects. With its major focus on quantification, procurement, warehousing, transportation, and distribution of medical commodities, Pharma Twenty20 will provide an alternative that has a strong comparative advantage to make positive difference at system level beyond day-to-day operation (i.e., actual procurement and distribution). This could help build stronger supply systems for organizations and entities.
Yet, the above mentioned components of the health supply chain system remains weak, and longer-term system strengthening efforts are much needed. The timing to intervene is opportune, as the procurement and supply chain function of the health sector in Sierra Leone is undergoing constant challenges, with epidemic outbreaks and increased demands for medications and related supplies nationwide. There is also an acute need for capacity building support in a wide range of supply chain areas such as commodity quantification, forecasting, and budgeting/financing, and information management.
The continuous supply of quality, safe, effective and affordable medicines and vaccines is one of the building blocks of every well-functioning health system. Sierra Leone faces a high imbalance in the nationwide distribution of staff, services and medicines, with urban settings having more attention than rural settings. A good healthcare and supply system will ensure that quality products are available at all levels of the health system. While there may be some achievement in the supply and distribution of essential health commodities in urban settings, the frequent stockouts and uncoordinated efforts continue to be a challenge and needs improvement. Rural settings continue to be at risk of poor healthcare services as a result of constant stockout, most times, of needed medications.
Pharma Twenty20 has the capacity and capability to develop a supply chain design that will ensure equitable access to medicines and supplies nationwide (i.e., urban and rural settings).
Opportunity cost and long administrative waiting times due to administrative bureaucracies continues to be a growing challenge for private pharmaceutical business owners with respect to product and premise registration. This has led to growing dissatisfaction among business owners with the regulatory authority. With the growing number of new businesses seeking registration with the regulatory authority, in addition to the already existing business, this could not be easier anytime soon. With the responsibility to manage both professionals and premises registration, this could not become easier either. With this in mind, Pharma Twenty20 is well-placed professionally to alleviate the inconveniences of opportunity cost and long waiting times and improving collaboration between pharmacy business owners and the regulatory authority.
Technology and innovation have made so much contribution to improving services in many sectors globally. The health sector has an opportunity to use this to its advantage. In Sierra Leone, the private sector seems to be operating in silo such that private pharmacies and medical specialists are offering products and services that are most times missed by clients. The rate at which caregivers, health workers and patients enquire about products, medical services and specialist health facilities location is high. This signifies the need to harmonize this information across service providers and collate on a platform powered by technology and innovation. Such a platform can be updated to meet the needs of the targeted clients. Pharma Twenty20 will focus in this area and develop a platform that will provide the much-needed services in this area.
