- This diagram dramatically illustrates the complex network of parallel channels through which Kenya's essential medicines make their way from donor to user. Kenya is typical of many low- to middle-income countries in the complexity of its distribution system. Click on the image to enlarge.
Weak systems amidst an increasingly complex supply environment
The shift towards greater country ownership of the development process brings with it tremendous responsibilities. With fewer donors taking an active role in addressing reproductive health (RH) supply needs, that responsibility has now increasingly shifted to the countries themselves. This requires the presence of functional, effective systems for forecasting, procuring, warehousing, distributing, and managing information.
Confronting this new environment is a challenge. The legacy of vertical assistance programmes have left many countries ill equipped to bear the new responsibilities placed on them. It has, in many cases, left them with tools and systems that are duplicative, wasteful, and counterproductive to the development of national health systems.
The environment countries face is itself becoming more complex. The number and types of organizations involved in procuring and distributing RH supplies has grown dramatically over the last 15 years. In the early 1990s only about three donors were involved in procuring contraceptives, now there are more than ten, each with different procurement rules and supply sources. Added to this is a proliferation in the number of manufacturers, including generic manufacturers, emerging throughout the developing world. Managing this new environment requires efficient, effective systems that allow countries to procure high-quality supplies and deliver them efficiently in a timely manner.
Finally, the last few decades have seen considerable divergence with respect to the development process. Some countries have matured to a more developed status, while others are still struggling with key systems issues. And cutting across all are areas affected by conflict, natural disasters, and other crises. The level of RH commodity security among these different categories of countries varies, and responses must be tailored accordingly and by donors and agencies charged with responding to emergencies.
Look at our Strategic Plan to find out what we are doing.
