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The unanswered questions of aid and health logistics

by Michael Keizer on March 22, 2009

'Small Talk' by xkcd

Some of the issues that I think should be in the forefront of aid and health logistics discussion:

  1. How should we ensure adequate logistics input in the planning phase of aid projects?
  2. Will medical professionals and health logisticians ever be able to talk each other’s language? Will non-logisticians ever feel that they own the process too?
  3. Are cold chains unbroken? Do we really vaccinate, or just administer useless stuff? (This is actually the subject of my thesis research project, so you can imagine that it is a question that is close to my heart.)
  4. What are reasonable goals when it comes to logistics efficiency in aid operations? Is it really possible to determine a minimum level of efficiency? And if not, how can we be accountable? And how about effectiveness? And the balance between the two?
  5. How much of health budgets in developing countries should be devoted to logistics? In developed countries it is often more than 80% (including procurement cost), but is that reasonable or necessary in a developing country?
  6. When should the supply chain stop being flexible (supply rubber bands?) and determine operational options instead of vice versa?
  7. Why does large-scale aid logistics seem to deliver so few economies of scale? How can we improve?
  8. How can we improve the level of logistics knowledge and skills in health systems in developing and middle-income countries? What are the determining factors for health logistics in these settings?
  9. Could health logistics be a determining factor in developing new drugs or techniques? E.g. less heat-sensitive vaccines, reagents with longer shelf lives, etcetera.
  10. Pull or push? And in which settings?
  11. Has the kit system had its time? Should we move on to less wastage-prone systems?
  12. How can we improve on training and mentoring of new health and (especially) aid logisticians? Isn’t it about time that we stop to just turn them out to swim or drown?
  13. Third-party logistics: a viable alternative in which contexts?
  14. Are logistics consultants actually worth what we pay them?
  15. Six sigma, lean, kaizen, SPC: what can we learn from them?
  16. Isn’t it time that we stop setting up parallel logistics systems for aid, instead using the ‘normal’ channels? Or is that just a pipe dream?
  17. Is it in any way possible to stop creating new patients by the environmental damage due to inefficiency of supply lines in developing countries?

Any other issues? What logistics issues keep you awake at night?

(With thanks to Alanna Shaikh for inspiring the form of this posting.)

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