Improving access to essential medicines through public-private partnerships

Focusing on the distribution stage in the EHP supply chain, the report examines the causes of bottlenecks at this stage. Distributors of consumer packaged goods (CPGs), such as food, beverages, tobacco, and mobile phone refill cards, have been more successful at reaching remote locations under difficult conditions than distributors of essential medicines. In the most remote villages of Africa, a person is more likely to find a kiosk with mobile phone cards in stock than a clinic with the basic antibiotics in stock.

"Global efforts to improve access to essential medicines and vaccines have often focused on procurement and financing but not enough on distribution, especially to 'last-mile' populations," said Orin Levine, Executive Director of IVAC. "By capturing best practices from the private sector, we think we can improve distribution systems and enhance access while saving both lives and money."

In 2007, 151 million vaccine doses were wasted in developing countries due to improper refrigeration. A study by the GAVI Alliance suggested that 25-50 million doses of pentavalent DTP-HepB-Hib vaccine, valued at $80-160 million, could be saved in developing countries by eliminating unnecessary wastage from heat damage, freeze damage or disposal of unused portions of multidose vials.

"Companies selling soda and mobile phone cards work in the same hard-to-reach markets in Sub-Saharan Africa as essential medicine distributors, but they have been far more successful at modifying their systems and aligning incentives to overcome distribution barriers," said Kyla Hayford, a PhD Candidate in the Department of International Health at Johns Hopkins Bloomberg School of Public Health and an author of the report. Public-private partnerships between the global health community and private sector can leverage the strengths of CPG companies to improve availability of essential medicines via knowledge exchange, shared infrastructure, generating appropriate performance monitoring metrics, and investing in product innovation.

In Sub-Saharan Africa, 30-50% of the population lacks access to essential medicines. "The stakes for getting distribution of essential medicines right in the developing world are huge," said Lois Privor-Dumm, Director of Alliances & Information at the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health. "There appears to be a lot we can learn from both the formal and informal structures of consumer packaged goods companies that could ultimately save lives and prevent unnecessary suffering."