Strengthening the pharmaceutical supply chain in resource limited low- and middle-income countries: A look into pharmaceutical companies’ contributions to making antimicrobial supply chains more resilient

Karrar Karrar, Cardiff University

Supply chains in healthcare settings are inherently complex and highly interdependent. They involve a multitude of stakeholders, processes and resources that facilitate the transformation of raw materials and components into finished products, which are subsequently delivered to the patient. In any healthcare system, a functioning supply chain should provide patients with the right medicine, at the right time, in the right place, at the right quantity and at the right cost.  

However, the major functions leading to an efficient supply chain are significantly compromised in resource limited low- and middle-income countries. Challenges such as poor infrastructure and immature governance mechanisms pose significant risks in ensuring access to medicines. While national governments shoulder the responsibility for solving major issues in their healthcare supply chain – pharmaceutical companies also have a unique role to play.  

Global constraints on government spending and competing demands on the public purse have resulted in minimal funding for strengthening healthcare system infrastructure. These constraints are aggravated by the global epidemic of communicable and non-communicable diseases (NCDs). These constraints have shown increasing impact on health status in populations with disproportionally higher rates in developing countries, where the health systems are least equipped to face the growing challenges.  

Low- and middle-income countries continue to bear the brunt of communicable diseases such as HIV/AIDs, tuberculosis (TB), malaria, acute respiratory infections and diarrheal diseases, coupled with a rapid increase in the prevalence of NCDs such as cardiovascular diseases, cancer and diabetes.  Additionally, neglected tropical diseases prevalence is almost exclusive to low- and middle-income countries, and includes diseases such as lymphatic filariasis, leishmaniasis, schistosomiasis, cholera, sleeping sickness, chagas, dengue and many others.  

To treat many of these diseases, healthcare systems depend on the appropriate and timely access to antimicrobial medicines such as antibacterials, antivirals, antiprotozoal, anthelminthic, antifungals. However, millions of people cannot access the antimicrobial medicines they need, despite having curable infections.  This lack of access is particularly acute in low- and middle-income countries, where weaknesses in healthcare delivery systems can limit access to these vital treatments. While national governments shoulder the main responsibility for improving supply chain processes, pharmaceutical companies also have a unique role to play. 

This study aims to develop a framework of emerging themes of supply chain strengthening activities that companies are carrying out in these settings with respect to antimicrobial medicines.  This framework may act as a blueprint to which companies can look to strengthen their supply chains for antimicrobials medicines. The themes pulled out will form a framework that takes into account the caveats specific to company type or products lines e.g. vaccines and cold chain. 

This project ran from January 2018 to January 2019.