Information Sharing and Humanitarian Supply Chain Performance: Evidence from the Neglected Tropical Diseases Preventive Chemotherapy Supply Chain

Student thesis: Doctoral ThesisDoctor of Health (DHealth)

Abstract

More than two billion people globally are infected or at risk of infections by neglected tropical diseases (NTDs). NTDs are infectious diseases that have historically received limited focus from global governments and health organizations for decades and principally affect the world’s poorest people—causing disfigurement, disability, and blindness, which contribute to continuing the cycle of poverty. Preventive chemotherapy (PC) is one of primary NTD program strategies and entails the administration of medicines to entire at-risk populations to treat NTDs, with 1.144 billion people requiring PC treatment for at least one NTD in 2018. The World Health Organization (WHO) coordinates public-private partnerships programs that contribute billions of donated PC medicines annually through mass drug administration (MDA) campaigns, with large-scale medicine donations from major pharmaceutical companies. Between 2006 and 2018, over 1,300 shipments consisting of nearly 11.5 billion medicine donations were supplied to 108 recipient countries.

In addition to the considerable volumes involved, the supply chain to deliver donated PC medicines is complex due to the many stakeholders and partnerships participating, as well as challenging because the logistics are further complicated by delivery to remote destinations in developing countries. As MDA campaigns involve treating hundreds of thousands to millions of patients in endemic regions within entire countries over the course of days or weeks, close coordination and timing of medicine delivery is critical. Inefficiencies caused by fragmented data systems and limited transparency on supply chain performance further challenge the ability to identify shipment issues and explore the root cause of the issues. Prior to 2016, delivery was performing below standards, lagging as much as 40% below the WHO target of 80% on-time delivery. These delays result in wasted medicine donations, increased program costs, delayed MDAs, or sometimes even completely missed MDAs.

In September 2016, an online supply chain performance measurement system (SCPMS), “NTDeliver,” was launched by the NTD Supply Chain Forum (a public-private partnership focused on managing and improving the PC donation supply chain) to enhance supply chain performance and information transparency and thereby make it easier to identify and address performance issues. The intention of the system was to contribute to performance improvement in the supply chain metrics, but without a robust review of the performance after the SCPMS implementation, it would be unknown if the system successfully met its intention. The aim of this research was to empirically assess whether and how the SCPMS improved NTD supply chain performance, in particular on-time delivery to central medical stores. Secondary data was extracted from the SCPMS that covers over 1,300 shipments for four critical medicine donations delivered to over 100 countries. Statistical regression models were applied to assess impact on performance, comparing historical data before and after the implementation of the SCPMS.

The results suggest information sharing had a positive impact on three performance indicators: purchase order timeliness, arrival timeliness, and—most importantly—delivery timeliness. The analysis indicates purchase order timeliness and arrival timeliness were strong predictors of delivery timeliness and that the information sharing had a positive, moderating impact on these performance indicators. The analysis also suggests information sharing has more substantial positive impact on performance when the information is made publicly accessible and is focused towards country program managers. Three variables indicated such an increased positive impact when the data is publicly shared: shipment timeliness, arrival timeliness, and delivery timeliness. However, the information sharing appears to have a negative impact on upstream, country-driven performance indicators, with a negative impact on regional WHO clearance of medicine applications and a negative impact on forecasting variance.

The research findings confirm that a “private sector solution” such as information sharing through a SCPMS appears to have a positive impact even when applied to humanitarian logistics in a non-profit context, in which the product supplied has limited commercial value. While there are many studies on supply chain performance in the private sector, there is little empirical evidence on the impact of information sharing in humanitarian supply chains. The research reported here addresses this gap in knowledge while also contributing to practice by supporting the WHO, pharmaceutical companies, and implementing countries to manage the supply chain more effectively by increasing understanding of leveraging information to drive performance. The findings support that performance measurement coupled with information transparency leads to measurable supply chain improvements. Given the large scale of medicine volumes and the large number of people requiring these medicines, the research implications have the potential to provide incremental improvements to global health programs affecting the health of tens, if not hundreds, of millions of people. More broadly, the research supports investment in information sharing in humanitarian supply chains and data transparency with staff managing shipment logistics in-country.
Date of Award18 Nov 2020
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorChristos Vasilakis (Supervisor), Yufei Huang (Supervisor) & Bill Lin (Supervisor)

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