Here's an idea that's easy to like: Set up a warehouse in Johannesburg stocked with AIDS drugs that can be shipped on an emergency basis to virtually any country in Africa when treatment program runs out of supplies. That's what the non-profit Dutch group, IDA Solutions, has just received a license to do -- and they can do so without having to deal with the registration and patent restrictions that would be in effect for drugs intended for use in South Africa, so they can bring in relatively low cost generics.
This is indeed a good, short-term solution to deal with problems in the global supply chain for drugs. But far more is needed to respond to the challenge of getting life-saving and life-extending products to those who need them. With the large amounts of new money aimed at purchasing health products -- from the Global Fund to UNITAID to PEPFAR and more -- the conversation has to shift from one about getting more money to one about using that money as effectively as possible, given a realistic assessment of health system weaknesses that will take long-term support and political will to address.
Programs run out of drugs because the capacity to forecast demand, manage inventory and conduct procurement activities is extremely limited in many countries -- and because donor funding can be erratic and difficult to access in a timely manner. These are problems that need to be diagnosed well, and then systematically solved by thinking beyond the AIDS programs alone, and identifying ways in which both donor funding and public health programs can be oriented to provide a reliable supply of many different kinds of health products, from vaccines to anti-malarials to bednets.
Finding a way to provide drugs when stock-outs occur is a good first step. Now we need to prevent those stock-outs in the first place.
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise.
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