RDT and ACT procurement and supply chain management
Procurement and supply chain management (PSM) is a multi-stage process that aims to ensure that products of the right quality, dosage and price – in this case malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapies (ACTs) – can be delivered to patients in the right quantities, at the right time and in the right place. Every stage in the supply chain is critical to ensuring that these objectives are achieved.
Malaria-endemic countries are responsible for ensuring that each of the five stages are completed in a timely manner to ensure that stock disruptions of life-saving medicines are avoided and that stock is available with adequate shelf-life remaining.
There are multiple activities to be undertaken within each of the stages, and bottlenecks often exist which impede effective supply chain management of RDTs and ACTs and result in either stock-outs or overstocking.
Most commonly observed bottlenecks in countries
- Delay in fund disbursement preventing timely procurement and product delivery
- Inadequate logistics management information systems which impede the ability to forecast, quantify, procure and ascertain ongoing stock levels at peripheral level
- Inadequate buffer stock
- Delays in customs clearance and product distribution from central to peripheral level
- Poor in-country infrastructure
- Inadequate storage facilities.
Main root causes of bottlenecks
- Weak policies and/or medicine regulation
- Inadequate country procurement capacity/systems
- Human resource attrition rates and lack of repeated training for staff
- Multiple stakeholders and weak coordination between them
- Workload involved in understanding multiple donor requirements
- Inability to implement procurement and supply chain management plans
- Weak oversight of grants
- Donor dependency and lack of country self-financing.