Making Traceability Work In Developing Countries Health Supply Chains

In the recent past, the global health sector applied technology in health commodity supply chains. Despite its widespread use in western-world, not many African countries have embraced it.

It is proven that in most of the developing countries, particularly, African counties, with the highest disease burdens, the health supply chain function poorly which results in stockouts and a high prevalence of substandard and falsified medications.

The reason for the poor functionality of the health supply chain in LMICs is because of their complexity in nature.

Unlike in developed countries where health supply chains are managed almost entirely by the private sector, in LMICs public, private and nongovernmental Organisations coexist as channels of distribution of medicines with various interconnected flows between the three channels. Of the three, the public sector-that is, developing country governments-takes the lead. Whereas these governments have varying health models, the most common one is Central Medical Store (CMS) which operates alongside other donor-established vertical supply chains. These tend to overlap and cause a lot of complexities that create inefficiencies and ineffective monitoring processes. It is these inefficiencies that weaken the supply chains and make them vulnerable to corruption, product diversion, theft of medicines in the case where the medicines change to many hands-on the path between a CMS and a local health centre.

Thus, these problems tend to escalate the stock-outs in developing countries and also raise the use of substandard medicines entering the health system as wrongdoers try to cover their activities.

Thanks to the Global Health Initiative that has been taking into account these concerns. Efforts have been stepped up to improve the health supply chain management in developing countries.

The global health community has worked to expand the use of traceability in developing countries’ health systems by encouraging the use of GS1 standards by their suppliers and working with their governments to establish the foundation required for adopting serialization.

As part of the work done so far, is USAID taking the lead to work with governments such as Ethiopia, Ghana, Lesotho, Malawi, Uganda, Tanzania, and Pakistan.

Advocacy efforts that have made a huge difference have transpired and trickled the interest of most developing country governments in traceability technologies. Much of this interest was displayed during the first African GS1 Healthcare conference held in Addis Abba, Ethiopia in May 2018 which was attended by representatives from 38 countries, 45 regulatory bodies, and 23 Humanitarian organizations.

What steps have these developing countries taken to implement traceability technology?

In Ethiopia for instance, The Pharmaceuticals Fund and Supply Agency (PFSA)- a division of the Federal Ministry of health-with support from USAID successfully piloted the GS1 barcode technology to enhance their health commodity supply chain.

Utilizing GTIN’s that include serialization gave PFSA the ability to track and trace the distribution of each product, down to the individual package. This degree of traceability can assist in many critical ways, from implementing product recalls to reducing counterfeiting.

more accurate data and fewer redundancies,
Other benefits PFSA highlights include the ability to capture information in a timelier manner, more accurate data, and fewer redundancies. Lastly, technology-enabled PFSA staff view and track the product and transaction information at each stage in the supply chain on a customized web platform.

Uganda another country among those USAID plans to work with does not have a clear policy on product serialization and to make matters worse, the country doesn’t have a country-specific barcoding system. Products originating from Uganda use Kenya barcoding System (616 series).

This, however, has not deterred some healthcare sector players in Uganda from looking outside for the solution.

One such healthcare player is Cipla Quality Chemical Industries Limited (CiplaQCIL), an affiliate to CIPLA Ltd India, a global pharmaceutical manufacturing and distribution company.

According to Mr. Kamili John, a Regulatory Affairs Senior Manager, some of CIPLA’s biggest customers are USAID and Global Fund based in the USA and Europe. These institutions comply with their respective country serialization road map.

Thus, CIPLA had to implement GS1 Serialization through Global Data Synchronization Network (GDSN) in order to be able to supply to these in being one of the suppliers for these institutions

Mr. Kamili proudly acknowledges how this has greatly contributed to CIPLA’s increased business with international customers. The company is rolling out serialization for all its product for all markets, and signed-up customers can track their products through the GDSN platform to trace the status in the supply chain.

While traceability in health supply chains holds realistic solutions and great promise, implementation is faced with serious challenges including the huge endeavour to investment to in setting up systems needed. Perhaps this could one huge reason among the many Traceability has not picked in developing countries.