Access to medicine matters. Safe, effective medicines and health products need to reliably reach the people who need them—when they need them. Yet health systems, particularly in resource-limited settings, often fail to adequately respond to this demand.
According to the World Health Organization, a third of the world lacks access to essential medicines and diagnostics—and in the poorest regions, half of the population struggles to access the medicine it needs.* This has significant implications for both the timely initiation of treatment as well as treatment adherence, and the effect on health outcomes can be staggering.
For people living with noncommunicable diseases (PLWNCDs), a regular, reliable supply of quality, affordable medicines is especially essential, as the chronic nature of NCDs like hypertension and diabetes requires lifelong care and treatment.
A collaborative approach to addressing supply chain challenges
As the incidence of NCDs around the world continues to skyrocket, a large part of the response by Access Accelerated is our collaboration with partners to address supply chain challenges in low- and middle-income countries—from issues with capacity and resources, to governance, accountability and data collection.
Building on previous NCD supply security initiatives, PATH partnered with Access Accelerated to map the NCD supply chain in Ghana, Kenya and Vietnam. PATH recently published findings of the comprehensive end-to-end NCD supply chain assessment in Vietnam, The Journey of the Pill, which you can read in full here.
“Understanding the unique inefficiencies and bottlenecks along the NCD supply chain is a critical step in improving access to affordable NCD medicines and health products,” explains PATH Global NCD Program Leader Helen McGuire. ”The Journey of the Pill assessment is part of a multicountry effort by PATH, in partnership with ministries of health and with the support of Access Accelerated, to design targeted, local solutions towards a consistent supply of NCD commodities.”
Supporting Vietnam to achieve ambitious NCD targets
Vietnam is confronting a growing NCD crisis. In 2016, NCDs accounted for almost 80% of total deaths in the country. In response to this urgent threat, the Vietnamese government launched two policy initiatives: the national NCD strategy (2015-2022) and the national plan for the prevention and control of NCDs and mental health (2022-2025). Both outline ambitious targets, including the goal to provide all primary healthcare facilities and half of workplace health facilities with access to essential NCD equipment and drugs.
“This robust analysis of Vietnam’s NCD supply chain provides crucial insight into its strengths and weaknesses at every level, including at the primary care level,” says Mara Nakagawa-Harwood, Associate Director of Implementation and Partnerships at Access Accelerated. “Importantly, the findings will inform concrete actions to close identified gaps and foster greater efficiencies to help achieve the country’s targets and meet its NCD priorities.”
Turning findings into a roadmap
The six-month assessment, conducted in partnership with Vietnam’s leaders and stakeholders, maps the NCD supply chain relating to hypertension and diabetes. In addition, it provides a detailed understanding of the product flow to the consumer (including the time it takes) and an evaluation of the availability of specific drugs, while illuminating the process barriers and challenges that threaten supply security.
The assessment highlights a number of key challenges, including a complex and protracted bidding process—which can take up to eight months—along with less-than-optimal practices in storage and temperature management and outdated manual inventory management processes at the primary care level.
“One common practice we learned was that health facilities in Vietnam are forced to procure multiple brands of the same medicine from different vendors in order to ensure sufficient supply,” says McGuire. “This supply patchwork means that people living with NCDs often must switch from brand to brand, resulting in reduced confidence in treatment, higher costs and a greater risk for side effects or varied treatment response.”
To overcome the identified challenges, the assessment lays out specific recommendations that include revising procurement regulation and processes, adjusting finance practices—such as piloting agile payment and reimbursement models to address supplier stockouts and debts to suppliers—as well as strengthening supply management at the facility level.
“The roadmaps resulting from the Journey of the Pill assessments have led to concrete improvements in NCD supply security in Ghana and Kenya. We are confident that tailored solutions will yield similar results in Vietnam,” says Nakagawa-Harwood.
Access to medicine is a matter of life and death. Medicines can save and transform lives by improving a patient’s condition, preventing complications and ultimately contributing to a better quality of life.
The partnership between PATH and Access Accelerated, alongside ministries of health, is dedicated to strengthening health systems so that safe, affordable, high-quality medicines are consistently accessible for every person living with NCDs.
Learn more about the ways Access Accelerated and PATH are working to strengthen supply chains in low- and middle-income countries here.