Moving from global advocacy to sustainable country-based change: how People that Deliver Initiative (PtD) is transforming human resources for health supply chain management at the country level

Human resources are a serious challenge to the successful operation of in-country health supply chains in resource-limited settings. This workshop will highlight unique approaches and tools to these challenges, as implemented by the People that Deliver Initiative (PtD), but also provide a space for conference participants to explore solutions to their own supply chain human resource needs and challenges.

From 2011 to 2015 PtD focused on creating global awareness of and engagement around the importance of the health supply chain workforce. It also applied, through PtD partner organizations, its tools and approaches in seven focus countries (Burkina Faso, Dominican Republic, Ethiopia, Indonesia, Liberia, Mozambique, and Namibia). Starting in 2016, PtD is focusing its efforts and partner resources directly at the country level as many other country supply chain programs have expressed desire and need for assistance in the human resources for supply chain management realm.

• Kevin Etter, UPS Loaned Executive, UPS / Gavi, The Vaccine Alliance
• Benjamin Ongeri, Senior Technical Manager, Management Sciences for Health
• Dominique Zwinkels, Executive Manager, UNICEF/People that Deliver Initiative (PtD)

Beyond Money and Drugs: Achieving Long-Term Impact with Public-Private Partnership

While humanitarian response coordination efforts have historically focused on response to natural disasters, the 2014 Ebola outbreak and the Syrian refugee crisis have highlighted the critical need for strong health and logistics coordination in disaster response – including epidemics and protracted conflicts or humanitarian crises. In addition, the increased role of the private, corporate sector in disaster response has created the need for additional coordination and the opportunity to leverage not just funding, but also the logistics expertise, product donations and other assets of the private sector to support a more robust response to communities in need.

In a workshop designed to improve the overall understanding of the opportunities and challenges present in making medical donations in the aftermath of an emergency, participants will be asked to identify the different constituencies in global health emergencies, and the ways those actors interact with each other to provide urgently-needed medication and supplies and support logistics capacity during a response. With a focus on the opportunities presented by public/private sector collaboration, at the end of the workshop, participants will have a better understanding of the logistics challenges present in the aftermath of a health or humanitarian crisis; requirements for product donations and best practices; and by exploring case studies and lessons learned from existing public/private partnerships, the opportunities for developing high-impact partnerships before a disaster strikes – helping deliver more effective care whenever and wherever it's needed most.

• Elizabeth Ashbourne, Executive Director, Partnership for Quality Medical Donations
• Julie Jenson, Director Social Investments, Corporate Responsibility, Pfizer, Inc.
• Ann Matz-Tirado, Program Manager, Corporate Responsibility, AbbVie
• Erica Tavares, Senior Director, Institutional Advancement, International Medical Corps

Impact from Anywhere: How technology can facilitate meaningful and productive humanitarian experiences across broad networks of volunteers

The collapse of road network segments is one of the most devastating consequences of a disaster. The affectation of the network diminishes the accessibility to affected areas, hindering the execution of relief tasks. In worst cases some areas become isolated and the attendance of victims is delayed until the network is enabled. Our research implements Operations Research principles for coordinating road network restoration tasks (debris removal, assembly of temporary bridges, dredging of accumulated water, others) with typical disaster relief operations such as massive evacuations and distribution of relief goods. The methodology developed here supports the decisions of: which affected segments of the network should be recovered, the route to be taken by recovery machines among restoration tasks, and which routes should the emergency response vehicles use, taking advantage of available segments after the completion of each road recovery task; and also, minimizing the social costs of the affected population that are caused by the lack of access to a good or service over each period of time.

• Jim McGowan, Director, Information Management & Situational Awareness, American Red Cross
• Karen Smilowitz, PhD, McCormick Professor of Teaching Excellence, Industrial Engineering and Management Sciences, Northwestern University

Collaboration and Segmentation – building blocks for an effective supply chain for neglected tropical diseases

1 in 7 of the world's inhabitants suffer from treatable or preventable Neglected Tropical Diseases (NTDs). However these diseases are not universally prioritized and many countries still lack the infrastructure to offer adequate treatment. National governments and public health organizations can struggle to address effective control of NTDs due to the sheer scale of the mass-prevention approach required to achieve elimination. We outline how a collaborative approach to NTDs has improved coverage of mass drug administrations and created effective and a sustainable NTD supply chain.

• Julie Jenson, Director Social Investments, Corporate Responsibility, Pfizer, Inc.
• Carla Johnson, Supply Chain Manager, International Trachoma Initiative
• Tom Millar, Operations Director, Sightsavers
• Kehinde Onasanya, Team Leader, Northern Nigeria Integrated NTD (UNITED) Programme in Nigeria, Crown Agents

Public Health Supply Chains: Shifting focus from the commodities to the patient

Public Health Supply Chains currently focuses on ensuring that medicines, Lab reagents & consumables, rapid diagnostics test kits and other commodities are available at the facility for use. This practice dissociates itself from the patient and focuses on the availability of the commodities at the health facility; to this end, there is a need to design a more robust Public health logistics system with the patient as its central focus and this can be achieved by a new thinking in the way we define parameters in supply chain, implement interventions, monitor performance and use technology.

• Habibat Sheidu, LMIS Coordinator, United Nations Development Programme (UNDP)

Visibility and Analytics as an enabler to improve Public Health supply chain decision making.

To enable end to end oversight of supply chains to ensure availability of products requires visibility and workflow coordination at every stage of the supply chain. There are tangible interdependencies between country public health supply chains and global upstream vendor supply and freight movement organizations which can impact commodities availability. Silo’ed supply and demand functions with limited shared visibility impacts the management of the chain of custody of medicine. Analyzing service performance requires data integrity and visibility throughout the supply chain to establish robust performance management practices
Topics to be explored in the workshop include:

• Maintaining a holistic view of the supply chain, coupled with proactive transaction management, to enable all stakeholders to drive overall performance improvement
• Leveraging technology to embrace existing systems and enable collaborative operation and transaction management
• Providing visibility and analytics across complex global and local supply chain operations to improve decision making

• Chad Davenport, Chief Information Officer, Imperial Health/Partnership for Supply Chain Management (PfSCM)
• Clinton de Souza, Director of Public Health, Imperial Health Sciences
• Diane Reynolds, General Manager, Public Health, Imperial Health Sciences

Accelerating the professionalization of health and humanitarian supply chain managers in the development sector. Looking back then moving forward...

Objectives

• Understand the current human resource issues facing the humanitarian and health supply chain (HSCM) community.
• Explore the current focus of IAPHL, HLA and PtD as they seek to lead the professionalization of humanitarian and HSCM in the development sector.
• Contribute to a theory of change model being developed to accelerate current country progress.

Overview

The three facilitators will present an overview of the human resources issues facing humanitarian and public health supply chains in many developing countries and humanitarian contexts, noting that a lack of supply chain professionals is a critical factor.

IAPHL, PtD and HLA will be introduced as global open access organisations seeking to fill this professionalization gap.

IAPHL, a professional association for logisticians and HSCM with approximately 4000 members from 134 countries, supporting the professionalization of SCM and others working in the field of public health logistics, with particular focus on developing countries, equipping individuals to strengthen the health systems in which they work.

PtD a global initiative of more than 80 organisations seeking to professionalize human resources in health supply chains.

HLA, a professional association for humanitarian logisticians with approximately 2000 members, promotes and supports professional development initiatives within the global humanitarian logistics community of practice, acting as a neutral interface to leverage knowledge, information and capability across humanitarian organisations.

The current focus of these three associations will be presented and their current priorities and activities explored.

To accelerate change a theory of change model developed through consultation will be presented and participants given the opportunity to interact with the model providing suggestions on its relevance and identifying key points of activity. With the overall aim of strengthening humanitarian and health supply chains to ensure the delivery of essential life saving commodities.

• Becky Turner Martin, Emergency Management Specialist, Global Rapid Response Team, Centers for Disease Control and Prevention (CDC)
• Edward Wilson, IQC Manager, USAID | DELIVER PROJECT, John Snow, Inc. (JSI)
• Dominique Zwinkels, Executive Manager, UNICEF/People that Deliver Initiative (PtD)

Globalization and the future worker

Disaster risk management and humanitarian assistance are undergoing noteworthy changes, including a movement toward a globalized system. The world is becoming more interconnected and interdependent, transforming the systems we live and work in. Managing risk in this increasingly complex environment will require some new approaches. At the same time, local initiatives abound, raising the question of how global-local interfaces can be created and maintained. Such linkages have the potential for enhancing local capacity without the heavy investment otherwise required to develop those capacities in isolation. Exploiting the potential of these emerging changes requires a new type of worker.

The Next Generation Core Competencies are the product of a recent FEMA-sponsored focus group addressing future demands on disaster risk managers. Oriented toward future needs, the next generation core competencies are built on the current disaster risk management competencies and a disciplinary purview, a review of related competencies and global risk trends, a Delphi Study, and wider consultations.

The Next Generation Core Competencies fall under four groupings. Competencies of Broad Knowledge Base include: 1) Scientific Literacy, 2) Geographic Literacy, 3) Sociocultural Literacy, 4) Technological Literacy. The second set comprises competencies of Organizational Acumen: 5) Understanding Complex Systems, 6) Risk Governance. The third set is one that engenders Problem Solvers: 7) Critical Thinking, 8) Professional Ethics, 9) Continual Learners. Finally, competencies of Emergency Management Leadership include: 10) Operate within the Emergency Management Framework and Principles, 11) Facilitate Community Risk Understanding and Ownership, and 12) Community Leadership, Team Building, and Resource Management.

This workshop will explore the implications of globalization, demands for a new type of worker, and the opportunities to shape anew workforce.

• Michael Brown, PhD, President, One World One Way, Inc.
• Steven Jensen, PhD, Member, Preparedness and Disaster Health Subcouncil, Scientific Advisory Council , American Red Cross

Using modeling and analysis to drive better strategic supply chain decision making

The global health community has historically lacked a robust body of evidence and tools to inform strategic supply chain design decisions. This is due in part to the high cost of collecting supply chain data, as well as the program-based silos that hinder broader analysis & sharing of insights. Faced with this evidence gap, governments have increasingly invested in pilot studies, electronic logistics management information (eLMIS) systems and other mechanisms for improving data infrastructure. While these investments have undoubtedly improved our understanding of current supply chain performance, they alone can only solve part of the problem. Too often key future design decisions are still made based on concepts and anecdotes rather than rigorous modeling or data analysis. To truly resolve this evidence gap, the health supply chain community needs a critical mass of practitioners and tools to build upon existing data infrastructure, generating insightful analyses and incorporating those insights into strategic design decisions.

This session will be structured as an interactive workshop, and will highlight a growing body of strategies and analytical models that facilitate different aspects of supply chain design decisions: 1) incorporating a more holistic approach to analyzing and modeling supply chain cost-effectiveness, 2) understanding approaches to decision-making with minimal or proxy data, and 3) using analytical modeling as an ongoing tool to align long-term investments and continuously re-evaluate supply chain design. As global health supply chains continue to evolve towards more diffuse and country-driven supply chain design decisions, this ability to rigorously understand and challenge existing models will be critical to ensuring long-term performance improvement.

• Neelima Ramaraju, Director, Global Impact Initiatives, LLamasoft
• Olivier Defawe, PhD, Senior Manager, Health Systems, Village Reach
• Wendy Prosser, Senior Manager- Health Systems, VillageReach
• Michael Krautmann, Senior Research Associate, William Davidson Institute

Drones in Rwanda; How Zipline, Gavi and UPS are Changing the Conversation on How Critical Medical Supplies are Delivered

Rwanda is "the Land of a Thousand Hills". Unfortunately, the roads that traverse these hills often make delivery of critical medical supplies difficult and time consuming.

Later this year, Zipline, a California based drone operator, will begin transporting emergency blood supplies to hard to reach areas by drone. As the network builds, other emergency medical supplies like rabies vaccines will be included.

The operation is co-funded by the Rwandan government and a public private partnership between the UPS Foundation and Gavi, The Vaccine Alliance.

This panel discussion will highlight the innovative and operational aspects of the initiative as well as provide background on a unique public private partnership funding strategy.

• Kevin Etter, UPS Loaned Executive, UPS / Gavi, The Vaccine Alliance
• Brittany Hume Charm, Business Development, Zipline International

Public Private Partnerships and The Last Mile

Public Private Partnerships (PPP) are considered one of the most plausible solutions for sustainable supply chain development in countries receiving extensive donor funding for ARV medications and vaccines. In theory, technical supply chain expertise combined with the financial motivation of private industry can foster long-term solutions that, to date, have been elusive. In most supply chain models, last mile delivery is the most expensive and complex due to lower population density, limited infrastructure and harsher physical conditions to new rural points of care.

To explore the concept of PPP and pilot a potentially sustainable integrated healthcare distribution model for the last mile, Village Reach and Medecins Sans Frontieres (MSF) began collaboration in 2015. The concept was to pilot an outsourced distribution model for the Ministry of Health which covers the Tete Province of Mozambique for ARVs together with vaccines.

Workshop Overview
1) Contextual Trends in the Development World:

1. The growing commercial sector in sub-Saharan Africa
2. Key considerations for outsourcing: benefits and risks
3. Optimal private sector conditions to engage with the public sector

2) Key Pillars of the Outsourcing Agreement 

1. a. Stakeholders and partnerships
2. Scope and strategy

3) Operational Successes and Challenges

1. Creating habits and expectations
2. Performance Review and KPI's

4) Future Concerns and Potential challenges:

1. How will outsourcing impact local market in the long term?
2. Variability of Transport Needs
3. Financial sustainability under the MoH

Final Discussion Point

Given the concerns, implications, and contextual factors involved in the application of the PPP model in Tete, Mozambique, to what extent can we justify using donor money in terms of the exceedingly positive humanitarian impact of the project?

Is the "humanitarian spirit" getting lost by donor fatigue and ambitious demands for sustainability?

• John Beale, Director, Private Sector Engagement, VillageReach
• Mark McCaul, Supply Chain Head, Medecins Sans Frontieres (MSF)
• Prashant Yadav, PhD, Visiting Scholar, Harvard Medical School

Bridging the gap: Development of an integrated digital platform that links health, last mile logistics and other humanitarian services.

One of the biggest challenges faced by humanitarian agencies is the lack of evidence of the effectiveness of programs and substantial impact on making a difference in the lives of affected people. The few tools and systems that are in place to measure these indicators are not usually focused on the entirety of the project, rather subsets such as beneficiary assessments and targeting. There is widespread agreement among donors and other stakeholders on the need to answer the 3 fundamental questions of:-

1. Did we reach the right people?
2. Did the assistance get there and how do we know?
3. Did it make a difference?

Against this backdrop, this workshop will outline how an integrated digital technology platform will consolidate and analyze data from a number of different but related logistics, health and humanitarian systems. These systems include assessment and targeting tools, health tracking and monitoring tools as well as last mile logistics and Business Intelligence systems. The concept, model, and methodology will be discussed by a number of subject matter experts from academia, humanitarian, government and the private sector as we work towards the goal of greater interoperability, better coordination leading to a clearer and holistic picture of the program and contributing to the improvements in the measurement of reach, effectiveness and impact at the last mile of humanitarian programming.

• Keith Chibafa, Business Development lead for Last Mile Mobile Solutions (LMMS), World Vision International
• Alexandre Liege, VP, International Development, Mastercard
• Mirjam Wit, Commodity Tracking System Consultant, CARE USA

Preparing for the future of global health supply chains

In emerging markets, investors in global health have become increasingly cognizant of the importance of supply chains in successful health outcomes. Significant attention and investments have been made in health supply chain improvement, from market shaping at the global level to investments in warehousing and information systems at a country level. However, additional effort is needed to ensure that emerging market populations have universal access to affordable, high-quality health commodities. Investors in global health supply chain could benefit from a new paradigm, a model to move investment focus from tactical and ad-hoc toward visionary and strategic over a long time horizon, such as 20 years. This workshop will discuss potential scenarios of future-state health supply chain needs and capabilities in order to better orient short-term global health supply chain investment decisions with long-term priorities.

• Steven Harsono, Senior Advisor, Healthcare Supply Chain, William Davidson Institute at the University of Michigan
• Maeve Magner, SCM Advisor, Independent Consultant
• Prashant Yadav, PhD, Visiting Scholar, Harvard Medical School