David Jamieson, deputy project director, health supply chains, Crown Agents, Washington DC, United States, @crownagents

Multi-sector partnerships bring together unique qualities and boost project's capacities: Governments and donors need to work together with the private sector to develop capacity and reliability. Governments can direct and set standards, donors support improve quality and the newly empowered private sector has the incentive to maintain the service standards to keep the contract. The US president's emergency plan for Aids relief's supply chain management system has done this in several countries, including Mozambique for the supply and delivery of lab commodities.

Resources:

This UNAids report sets out the economic impact of health improvements.

This piece on the Crown Agents Guardian partner zone explains our partnership with the Zambian government-established distributor Medical Stores Limited.

Tamsin Chislett, partnerships manager, Living Goods, Kampala, Uganda @TamsinChislett



Make logistics technology easy to use for consumers and healthcare workers: Often, building the delivery systems isn't the hard part, it's getting people to use them. At Living Goods we built a system that collects treatment data in real time and delivers health messages and promotions to our community health workers and their clients. We thought it was a clever way of increasing accuracy of data collection at a much lower cost, but our community health workers thought it was hard work.

Andreas Seiter, senior health specialist, World Bank, Washington DC, United States



Create new drug payment systems that ensure against corruption: In resource poor settings health workers divert some of the drugs that are supposed to be free and sell them to the patients that can't afford them. The motive may not be personal greed, but a desperate need for cash to pay for diesel to keep their generator going, or to drive to the next town and get supplies. The only way out of this problem would be a system that empowers the patient by ensuring that payment to the provider flows only once the drug has been given to the patient.

Simon Berry, founder and chief executive, ColaLife, Lusaka, Zambia @colalife



Partnerships with governments should run down to the community level: Based on our experience at ColaLife, working with micro-retailers in remote rural areas, having the public sector on board is really important. We have found it crucial to have a partnership with the ministry of health, right down to the community level. After all, rural health centres can kill private sector work and products stone dead if they are not supportive of them.

Rose Reis, communications officer, Centre for Health Market Innovations, Washington, DC, United States @CHMInnovations



Emerging pharmacy chains lead to cheaper, better drugs: The benefits of the growing number of pharmacy chains and franchises are often overlooked. According to research from a University of Chicago economist that isn't yet published, the growing Hyderabad-based chain MedPlus not only improved the quality and lowered the price of drugs for its customers, but it also improved the quality of the markets the chain entered. Another significant new chain includes Vine Pharmacy in Uganda, which just got a significant investment from the Africa health fund, via the Abraaj group, to double in size and go national.

Don't overlook informal healthcare providers: A significant amount of medications are sold by informal healthcare providers. In parts of India they go door-to-door on bicycles, ringing their bell, much like milk or vegetable sellers. Governments often ignore these providers, but it may be time to better harness them and their community inroads.

Resources:

In the Philippines, the Generics Pharmacy has thousands of tiny storefronts in its popular franchise network. Rich and poor alike buy drugs here because they are so convenient and ever present.

With 97 outlets, global health organisation PSI's BulshoKaab franchise is improving the quality and availability of drugs in Somaliland.

Private firms Sproxil, mPedigree, and PharmaSecure are all using mobile phones to help consumers verify the authenticity of medications at the point of purchase.

Mandy Sugrue, community manager, mHealth Alliance, Washington DC, @mHealthAlliance



Work at the community level: Key to improving access to essential medicines is working at the community level. This means engaging with the community, particularly empowering them to hold their health systems to account for service delivery. This is being demonstrated in Kenya with the national rollout of the Kemsa supply management system that uses mobile phones for the ordering of essential medicines. However, the second feature of the system is a short code for the public to use their mobile phones to make complaints about problems in accessing or in the quality of their medicines.

Resources:

HealthUnbound is an online community run knowledge sharing platform, that can be used as a resource library and community networking forum for medicine delivery logistics.

George Jagoe, head of access, Medicines for Malaria Venture, Geneva, Switzerland, @MedsforMalaria



New technologies should be adapted to fit broader needs: Current technologies such as SMS for life should be adapted to let frontline health workers track and report on all of the basic essential medicines that they need to keep stocked. After all, the health workers who keep these platforms fed with data need to see that these technologies are not just useful for tracking a single medicine or indicators for a single disease.

Resources:

The VidaGas project by Villagereach is a good example of a hybrid model that focuses on both for-profit and public sector product delivery.

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