Once there is a treatment for a disease, manufacturing it, sending it, and distributing it to those who need it seems like the easy part. But in reality, the complexities of supply chain logistics and management can prevent people from receiving treatment just as much as if there were no treatment at all.
For neglected tropical diseases (NTDs), five NTDs – intestinal worms, lymphatic filariasis, river blindness, schistosomiasis, and trachoma – can be controlled and eliminated with preventive chemotherapy treatments that are distributed to at-risk populations during mass drug administrations (MDAs). However, supply chain challenges result in recipient countries’ unnecessarily spending scarce resources on port storage, missing MDA timelines due to the drugs not reaching the communities, or ending up with unusable, expired medicine; in the end, these roadblocks slow the progress of the main goal – preventing people from getting these diseases.
To help ensure the timely delivery of the appropriate type and number of drugs to endemic countries around the world, volunteers from the NTD community came together to form the NTD Supply Chain Forum in 2012. A key driver of the Forum is to help streamline and address the logistical challenges of moving medicines from the doors of the manufacturing facility to the doors of individuals in remote villages around the world.
This infographic shows the NTD supply chain that medicines must travel along before reaching those who need them. Courtesy of GSK.
The Forum is made up of the World Health Organization (WHO), the Bill & Melinda Gates Foundation, seven pharma donors, a logistics partner, and nongovernmental organizations, including four of The Task Force for Global Health’s NTD programs, – Children Without Worms (CWW), International Trachoma Initiative (ITI), Neglected Tropical Diseases Support Center (NTD-SC, and Mectizan® Donation Program (MDP).
This volunteer group has blossomed into a key tool for the elimination of NTDs, focusing “on the delivery of NTD donations from the manufacturer to the country central medical stores (First Mile), and responding to potential in-country supply chain management and distribution areas where further support may be required (Last Mile)” (NTD Supply Chain Forum).
“I think the most impressive thing about this group is that it is all volunteers,” said Cassandra Holloway, facilitator for the Forum and Project Specialist at CWW. “All of these experts who make up the Forum are paying their own way to meetings and dedicating time above and beyond their full time careers all because they understand how important a strong supply chain is to the global fight to beat NTDs.”
The Task Force’s CWW program has been involved in the Forum since its inception and has facilitated it since 2015, organizing the recurring meetings, managing the Forum’s online database, engaging new partners, and providing basic structure for the Forum to address any supply chain challenges recipient countries are having.
Recently, the Forum’s online database, NTDeliver – a one stop shop for all data around NTD donations – went live to the public. The data collected through NTDeliver helps inform the NTD community’s Impact Dashboards to track progress and provides recipient countries with the opportunity to track their treatments from the second they leave the manufacturing facility’s door until it reaches community health centers for distribution.
The Forum has established standard operating procedures and intermediate process monitoring alerts that allow for a detailed management of the supply chain process from production to delivery.
A sophisticated system like this where countries can monitor and report back on medicine they are receiving and distributing to at-risk populations has revolutionized the NTD community’s ability to efficiently and safely produce and distribute treatment.
Additionally, during the coronavirus pandemic, expected staff shortages and social distancing lockdowns are causing unprecedented challenges for NTD programs by interrupting drug production, shipment, and distribution. To address these issues, the Forum hosted two crisis teleconferences – one in March and the other in April – with over 50 participants to discuss how to manage delays in delivery and meet key MDA timelines.
Being able to virtually bring together these partners during a global health emergency is a testament to how NTD programs and countries rely on the Forum as a source of supply chain expertise everyday and during times of crisis.
Thanks to the dedication of volunteers, the Forum is an essential component of reaching the WHO’s NTD elimination goals in the next decade and ultimately relieving populations from the clutches of these disfiguring diseases.
Watch this video to learn more about the Forum’s work. Video credits: GSK
Header photo caption: Medicines arrive at a mass drug administration from a community health center in Cameroon, reaching the end of the medicines’ journey from manufacturing facilities in places like Europe.