Pharmaceutical supply chains are vital to the delivery of health services by ensuring access to affordable, quality medicines, vaccines and other medical products to everyone who needs them. But most countries in sub-Saharan Africa—and Nigeria especially—struggle to set up effective medicine value chains, a reason why they also have weak health systems.
Nigeria faces several challenges in its pharmaceutical supply chain system, ranging from frequent stock outs of medicines, falsified or substandard drugs flowing through the market, and public mistrust in medicines because of safety concerns. These challenges render the health system unable to deliver on its promise of preventing suffering, saving lives, and improving quality of life for the citizens of our country. Most, if not all, of these challenges are the consequence of supply chain policy and management issues, which stem from poor coordination in sourcing, storage, distribution and logistics management of pharmaceutical products—all the way from the manufacturers to the end users.
While there is merit in the argument that better infrastructures, such as reliable electricity and supply chain software, could improve supply chains, evidence from the work of various development partners has shown that that alone is not enough. Rather, what would prove most effective and sustainable in the long run is for a country like Nigeria to implement sound pharmaceutical supply chain policies and regulations to establish a robust and efficient system for procurement, storage, distribution, quality assurance, and monitoring of side effects of medicines.
The organization I work for, Management Sciences for Health (MSH), in over a decade working in Nigeria to support the government in strengthening its health system, recognised this gap and with funding support from the Global Fund under the Resilient and Sustainable Systems for Health project began working with the country’s government to develop new—or update existing—guidelines to improve the management of the pharmaceutical supply chain system.
Evidence from the pilot of our work shows that well thought out plans and guidelines can improve coordination between Nigeria and its local and international partners in the supply chain ecosystem. This is especially so because those guidelines are in line with globally recognised standards. Continuous implementation of these guidelines will address once and for all the challenges of governance and coordination and the associated problems of delays in delivering medicines to people and the problem of medicine stock outs and expiry in health facilities.
Tied to the challenge of creating an efficient supply chain system is the issue of assuring the quality of medicines. With the right mechanisms in place, medicine manufacturers can take all necessary actions to ensure their products are safe and effective. The World Health Organization has specified that countries should invest in an independent quality control laboratory. While building this critical infrastructure has helped Nigeria, there are still challenges in coming up with appropriate guidance that accounts for our unique national context. MSH’s work in developing policy guidelines for supply chain management included developing a quality assurance protocol with the Nigerian government that outlines testing schedules for medicines. This is especially pressing given the presence of so many national and international organizations working toward strengthening our country’s public health infrastructure. Early results from this work indicate that coordination in the supply chain system has significantly improved, while also laying the foundation for identifying counterfeit medicines flowing through the system.
To build people’s trust in medicines, we also updated the existing national pharmacovigilance policy—the system to monitor and report side effects and unintended drug reactions. Building on the expertise of key stakeholders in the sector, we worked with the national government to address gaps in the document and make it reflect the most current global best practices. Mitigating the risks associated with medicine use will go a long way in building trust in medicines, vaccines, and technologies among the Nigerian people. This work is especially important as COVID-19 vaccines have been introduced and will need to be closely monitored.
But for all these critical efforts to make a real, long-lasting difference, it is of utmost importance that the Nigerian government put in place mechanisms for regular monitoring of adherence to these guidelines. When properly implemented, they will enhance the availability of quality health products whenever and wherever they are needed now and for generations to come.
Otohabru is director of supply chain with Management Sciences for Health (MSH)
