ENSURING SUSTAINABILITY OF PUBLIC PHARMACEUTICALS SUPPLY CHAIN SYSTEMS IN EAST AFRICA: A CASE OF ETHIOPIA
Abstract
Sustainability of Pharmaceuticals Supply chain Management systems is found to be a prime importance as the governments are, at least, in the contemporary world, particularly in developing horizons are expected to provide public goods to their citizens.
To this effect, states are struggling to set up health sector delivery systems to deliver their mandate as duty bearers to their citizens. However, the business continuity of these service delivery organs of several governments are at stake due to their undeterminable future at the bare face of everchanging business environment, sky-rocketing prices due to inflations and fiscal, macro & micro economic policies, tense world trade and global conflicts and the like. Not only providing services but also ensuring their continuity for an unforeseeable future remains a challenge.
Therefore, this study is dedicated to exploring the possibilities for sustainability of pharmaceuticals supply chain system in developing countries with specific reference to Ethiopia. To facilitate the process, the study delved into the sustainability of supply chain systems and financial sustainability as its cause and effect.
To gather input for the study of PSM & Financial Sustainability of service delivery entities, several assessments and analyses had been conducted through survey observations, field visits, key informant interviews, and extensive document reviews. The areas selected for observation were purposefully chosen based on their stakeholder relationships, levels of interaction, and intentions to enhance future collaboration. Notable visits included the Afar Regional Health Bureau, Dubti General Hospital, EPSS Samera Hub in the northeast, Arbaminch Hub of EPSS, Arbaminch General Hospital, and the Gamo Zonal Health Department in southern Ethiopia. In Addis Ababa, we contacted ALERT Hospital, Lebu Health Centre, and the AA #1 Hub of EPSS, engaging all functions and directorates within the EPSS Hub. During these visits, key informants were interviewed using pre-designed questions, and warehouses were inspected to observe processes.
Furthermore, the consultant conducted a SWOT analysis based on the collected information, as well as a review of reports, policies, financial statements, and audit opinions. A validation session was also facilitated. This process identified additional performance metrics to measure financial sustainability, assess the current situation, identify potential gaps, and establish goals within these metrics. This strategic approach will enable the institution to make progress toward financial sustainability while considering future financial needs, mandated service levels, and best practices from peer countries.
The SWOT analysis highlighted the need for improvements in logistics coordination, cost minimization, productivity enhancement, risk management, and asset utilization, while also revealing significant growth potential and opportunities.
Considering perceived strengths and opportunities around, supported by evidence obtained by application of various financial modelling and trend analyses, to address perceived weaknesses and identified gaps, we recommend strategies focused on revenue diversification, cost minimization, productivity enhancement, and overall performance improvement. Proposed initiatives include skill development programs, on-the-job coaching, the development of manuals and standard operating procedures (SOPs), revisions to policies and procedures, process improvements, and investments in upgrading and utilizing fixed assets, liberalizing the organ to develop and implement research-based business models and exercise autonomy to design robust workforce acquisition, retention and development systems including salary scale decisions. To ensure the continuous supply system, financial sustainability must be ensured by taking all available opportunities around, including partnerships and short-term subsidies with observed political will, and use competitive advantage of existing huge strength and momentum.
To facilitate the implementation of these proposed strategies and detail activities, a detailed multi-year operational and financial sustainability plans need to be developed, and realized accordingly.
