Medical supply chain not in good health

THE government’s medicine store in Lae is in urgent need of a standby generator and another walk-in refrigerator to keep vaccines and supplies at the required temperature.
A health worker says when the power goes off, she goes into the store to put icepacks in the chest freezer and transfers the vaccines there to keep them from being spoilt.
Towards the end of last year, they had one walk-in refrigerator installed to store all the vaccines. Before that they had been using chest freezers.
That medical store in Lae is where all the medicines and vaccines for the province of Morobe are stored.
Apart from that, there are also communication problems with the company contracted to deliver the medical supplies, resulting in late delivery. Someone has to be responsible and that person should hang his or her head in shame for failing to do a good job.
That is for Lae. What about the other government medical stores in other centres? Imagine if they are experiencing the same difficulties with supplies, logistics and reporting?
According to a Medical Supply Reform Impact Evaluation in 2013 conducted by the Burnet Institute, the national procurement of medical supplies remains hampered by major information gaps which constrain the effective quantification of needs across different procurement and supply chains.
A new process of multi-year planning for medical supplies procurement started in 2012, supported by increasing budget allocations, but remains hampered by weaknesses in quantification, a critical lack of data on medicines usage and needs, and difficulties in coordinating procurement across pull, vertical and push systems. National stockouts and an associated need for emergency procurements persist.
Recent reviews and stakeholder interviews acknowledge the difficulties in procurement governance, with processes that still do not guarantee transparency and avoidance of conflict of interest.
Current reforms are aiming to strengthen NDOH inhouse systems for procurement and tendering, although there remains a mix of opinions as to whether out-sourcing procurement authorities would be of greater benefit. Efforts to improve the quality of service through training, supervision, innovation or partnership are almost nonsensical if a basic input such as medical supplies is not in place.
A brief by the Development Policy Centre at the Australian National University on medical supplies reform in Papua New Guinea says medical supply is a system with many parts: Forecasting, tendering, payment, currency exchange, receipt, transport, storage, ordering, distribution, dispensing; monitoring and quality assurance.
In PNG, various reviews have identified significant problems at nearly every stage of this system.
We already have the help and support of various stakeholders to build stronger health systems and increase access to a reliable supply of medical supplies.
All efforts should be on a coordinated approach from everyone – from the national, to provincial and district level – to ensure there are sufficient supplies available at the stores, the request or ordering process and the dispatching including facilities to store the supplies.
Medical supplies (drugs, dressings and equipment) are essential to an effective health service, regardless of how the service is provided or by whom.