A Humourless Lot

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  • The Zambian logistics pilot project (II)

    In this second interview in the series on the Zambian supply chain pilot, A Humourless Lot talks with Prashant Yadav, professor of supply chain management at the MIT-Zaragoza Logistics Program.

    AHL: Could you tell us a bit more about your role in the project?

    PY: I had conducted research on the medicines supply chain in Zambia in 2006 funded by the UK DFID which highlighted deficiencies in the system. After conducting the study to diagnose the supply chain problems, one of my specific mandates from DFID and the World Bank was to come up with four of five options that could possibly solve the issues that were identified in the earlier reports. A second task was to give input on measurement and the metrics to measure success vs. failure: what indicators to use and how to measure them in such a way that we could draw scientifically valid conclusions. We wanted to integrate monitoring and evaluation into the project from its earliest stages. (more…)

  • The Zambian logistics pilot project (I)

    The World Bank, The UK Department for International Development, and USAID recently released the results of a logistics pilot project in Zambia, in which the availability of various medical supplies was improved. This is the first of a three-part series in which I talk with two of the team members and finish with some personal reflections. In this first article in the series, I interview Monique Vledder, senior health specialist at the World Bank and supervisor of the project.

    AHL: Could you tell us a bit more about the background of this project? Why was it initiated?

    MV: We have been involved in supporting the government to implement malaria prevention programmes like bednet distribution in Zambia since 2005. However, over the course of our programmes we realised that, although the government was quite successful in preventing malaria, the people who still were infected could not get adequate treatment due to a lack of malaria treatment drugs at the rural health centres. Our analyses showed that those drugs were available at the central level and district level; but somehow they did not arrive at the health centres. Clearly, there was an issue with the supply lines between MSL (the central medical store), the districts, and the centres. We partnered with other major donors like the UK and US governments as well as JSI and Crown Agents as implementers, and with MIT to ensure academic support. Our joint analysis pointed towards placing commodity planners at the district level as the most promising option. When we discussed this with the Zambian government, we were given a strong commitment for for a pilot project to try this out. (more…)

  • The professional volunteer: impossible in aid? (And how about the salaried amateur?)

    Update July 4: Andrew points out a linguistic complication: in English, the adjective professional has a much wider meaning than the noun professional; in other words, one can be a professional without acting professionally. So please, read the article with this in mind and replace ‘a professional’ with ‘acting professionally’ where appropriate.

    The ever-excellent Linda Raftree recently wrote an article about amateurs, professionals, innovations and smart aid. In it, she sketches in its extreme form two diametrically opposed views of volunteers and professionals: on the one extreme, volunteers are seen as well-meaning but utterly useless do-gooders who potentially do more damage than good, while on the other hand professionals are seen as useless ballast who are in no way capable of doing what they claim to do and who weigh down agile, smart new initiatives from volunteers.

    I think that one of the big issues here is the conflation of amateur and volunteer, and of salaried aid worker and professional. In my view, being a volunteer does not automatically imply that you are an amateur, and some of the salaried aid workers out there are not professionals at all. I would say that there probably is a correlation between your contract status and your position on the amateur-professional continuum (although I have no evidence to back that up – just personal observation), but there is definitely no hard-wired link. (more…)

  • The ways and means that divide: parallel supply lines for medical supplies

    Kathleen McDonald asks for my views on INGOs who set up their own (parallel) supply lines for medical supplies, as opposed to using the country’s normal supply lines.

    Let me start with a truism: horses for courses. When deciding to use the local supply chain or set up your own, you will need to take into account your programme needs as well as your environment; and that means that it is impossible to make any sweeping statements about which way to go is better.

    Reasons to set up a parallel supply chain

    Some of the reasons that INGOs give for setting up a parallel supply chain:

    • Specific supplies are not locally available. Some programmes are so far ahead of what happens locally, that they use supplies that cannot be gotten through the national supply chain. This happened quite a lot in the early years of the international HIV response, when it was hardly ever possible to source antiretrovirals locally. It is still a consideration in some programmes.
    • Local supplies are of unproven quality. An INGO that takes its duty of care towards its patients seriously, will want to ensure that medications and other medical supplies qualitatively sufficient. This is not always easy: local producers and distributors are not always open to audits by customers, especially not if they cannot be guaranteed a certain minimum amount of custom. National regulatory agencies in ‘weak’ nations often lack the means to adequately ensure quality.
    • Local suppliers cannot scale up sufficiently. This can be a consideration in very large programmes or responses, especially in case of outbreaks/epidemics.
    • Local supply chains have broken down (temporarily). This will often be the case after large disasters or areas that are prone to violent conflict.
    • Local supplies are (much) more expensive than imported ones. It might be surprising, but in quite a number of cases imported supplies – even factoring in transport, taxes and import duties, clearing costs, and other incidental costs – can be cheaper than locally bought ones, sometimes by a large margin. This usually happens when only a small number of suppliers have a stranglehold on the market. (more…)

  • Humourless Links for June 13, 2010

    [Image: Liquid Links by Desirae; some rights reserved.]

  • Latest job opportunities (June 11, 2010)

    [Image: Job opportunities by Coffeechica. Some rights reserved.]

  • Tell me what you want, what you really really want

    Ì have been posting for a while now, and I think it’s time that I start to listen instead of blathering on. So, here are some questions for you, my readers.

    1. Should I expand the series on push versus pull supply lines? Almost all my points have already been pre-empted by Dennis Bours’ comments on the first posting in the series, so there it might not be much use to just rehash what’s already there. On the other hand, the comments might be a bit cryptic for non-insiders. So, it’s up to you: expand and explain, or go on to the next subject?
    2. Are there any specific subjects that you would like me to write about? No, don’t worry, I have definitely not run out of ideas for future posts, but I might very well have overlooked some issue or idea that is very much alive amongst you.
    3. Any other ways in which I can improve the blog and make it more helpful or interesting to you, or more attractive to new readers? E.g., I have been toying with the idea to introduce the occasional podcast or video – would that be a good idea, or definitely not? Other ideas?

    So, this is your turn. Let me know what you think. The ball is in your court.

    [Image: Tennis ball by Michal Ufniak]

  • Diversion/rant: T-shirts, child trafficking, and how to lose friends & alienate people

    The 1 million T-shirts saga goes on.

    I really, really would wish that we could all just say that the T-shirt guys learned from what happened and we could move on to more rewarding issues. In fact, I thought exactly that had happened, and hadn’t spent even the shortest tweet on it for several weeks – and then they posted this blog post. Go and read. And cry.

    Yes, that is right. They want to support what is probably the most badly conceived anti-child-trafficking initiative ever. I am not going to tire you here with why it is such a bad idea (others have done an admirable job on that, e.g. this post by Amanda Kloer, which was written well before the T-shirts ever came up). What I do want to draw attention to is that, evidently, Jason still has not learnt that it might be a good idea to stop and think before jumping off –  and preferably only do so while being informed by best practice and evidence.

    Obviously, he was taken aback a bit by the criticisms and quickly took the post down, tweeting that he did so for ‘due diligence’. Perhaps it should be pointed out here that ‘due diligence’ is normally understood as something done before the proverbial shit hits the proverbial fan. If you do this afterwards, it is more properly known as ‘negligent laziness’. (more…)

  • Struggle with the knot: push and pull systems

    Ordering systems come in two basic flavours: push and pull, plus any number of hybrid systems. All have pros and cons, and each is most appropriate for a specific situation. In this first article in a miniseries on push and pull systems, I will discuss the basics: what exactly are pull and push systems and when would you use either.

    Push versus pull

    In the push model, “higher”, central levels decide on supply allocation for “lower”, local levels; these decisions are typically based on supply at hand and in the pipeline, and on calculated expected consumption – the latter often approximated, based on (in the case of medical supplies) patient numbers or population data. In the pull model, “lower” levels decide on the necessary supplies for the next supply period, which are then either procured independently or obtained/ordered from the “higher” level.

    The basic difference between the two models is the responsibility for timely, complete, and accurate initiation of distribution: in the push model this is the “higher” level, in the pull model the “lower” level. (more…)

  • Blood will flow: fragility and robustness of supply lines

    You have designed and implemented a pretty good logistics system and are proud of how effective and efficient your aupply line provides your programmes with any materials they need. Transport and administration cost are now at their minimum, fulfilment rates are close to 100%, and you process and fill almost every order within set timeframes. You feel pretty good about yourself (and not without reason), and are ready to hand over the system to your successor with justifiable pride.

    And then the ministry of trade announces that as of tomorrow, clearing rules will be changed, adding three weeks to the current four to five days it takes you to clear your goods. Suddenly things look a lot less optimistic: your carefully balanced and trimmed-down supply chain is strained to the snapping point, and you are looking at having some of your key operations suspended. Even worse: one of those is a treatment programme for TB patients, and suspension of treatment might cause resistance to the drugs involved – making a bad situation suddenly look catastrophic. (more…)