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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. So why not to set up a parallel supply chain? And what is best in the end? Click to read on…
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Humourless Links for June 13, 2010

by Michael Keizer on June 13, 2010

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Latest job opportunities (June 11, 2010)

by Michael Keizer on June 11, 2010

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Struggle with the knot: push and pull systems

by Michael Keizer on May 26, 2010

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. Click here to read more about push and pull systems

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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. What went wrong? Click to read on.

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Latest job opportunities (May 12, 2010)

by Michael Keizer on May 12, 2010

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Scenario 1: a house in your town catches fire, killing one person and making 5 people homeless. As the logistics officer of your town’s emergency services, you are in charge of the logistics support for the initial response as well as for the physical support of the newly homeless people.

Scenario 2: you are still that town’s logistics officer, but now a gas explosion rips through an entire block. Ten people are killed instantly, tens are seriously wounded, and scores are made homeless.

Scenario 3: you did well in the previous two cases, and have been promoted to your state emergency services’ logistics position. Three days after you start your new job, a number of bush fires break out under very hot, dry, and windy conditions, and converge on your state’s capital. More than a hundred people are killed in the next three days, several hundreds are seriously wounded (swamping the hospitals’ emergency, IC, and surgical departments), and almost a thousand people are now without homes.

Scenario 4: as emergency logistics coordinator at your country’s ministry of internal affairs, you are confronted with a devastating earthquake that destroys large parts of the capital and trashes the main harbour and the two airports. First reports indicate over a thousand casualties, untold numbers of wounded, and up to a million people who are living in the streets under improvised shelters.

The impact of these four scenarios more or less follows a logarithmic scale: each is about ten times as big as the previous one. Does that mean that the logistics for each is ten times as difficult as the scenario that precedes it? Nothing like it: organising the logistics for scenario 2 will take considerably less resources than ten times scenario 1; but scenario 4 will take considerably more than 1000 times as much to respond to at the same level – and organising its response logistics is probably several thousands of times as difficult. In fact, it becomes a practical impossibility to offer the same level of response: there is no way that we can give all those casualties dignified burials, all those wounded top-notch medical care, get everyone who is made homeless under a solid roof within the day; even if we would have the resources to do so. Why does it become so difficult? Click here to read on.

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Humourless links for May 8, 2010

by Michael Keizer on May 8, 2010

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

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  1. Tenacity. No, I did not put it there because I have been looking for an opportunity to use that word for as long as I can remember (although that is true): a lot of what we do in logistics needs long-term, relentless attention – you will need to follow through what you start in the long term.
  2. Patience. Hardly anything will happen as quickly as you might want to. The flip side of the tenacity is that you will need the patience to wait things out – which sometimes can take quite a while.
  3. Numeracy and maths skills. A lot of what we do requires a feel for numbers and some basic mathematical skills. You don’t have to be an operations research whizz (although a basic understanding might help), but you have no business working as a logistician if you don’t understand the sawtooth graph and its mathematical underpinnings, how it affects what we do, and how our decisions affect it in turn.
  4. A flair for administration and communication. Information management is immensely important for what we do. Without a certain facility with the underlying paperwork and with communicating the information, you will be less effective than you could be.
  5. Time management. As logisticians, we will always need to juggle several balls: it is rare that we can concentrate on one issue. If you don’t manage your time well, you are sure to drop one or more of those balls.
  6. The ability to delegate. You cannot do everything yourself. If you don’t know how to delegate (without abrogating your responsibilities), you will probably do more harm than good.
  7. The ability to ‘switch off’. People who cannot stop mulling over the daily problems and challenges when they go to bed are prime candidates for a burn-out. This is true for most aid professions, but especially for logisticians because logistics is usually a 24/7 process. I put in long hours, but most people I work with have learnt to respect that I prefer not to discuss work when I’m off.
  8. Language skills. You will hardly ever work in a country where everyone (or even a sizable majority) will speak your native language. Speaking more than one language helps, but what is even more important is a facility to quickly pick up the rudiments of a new language. Click here for more skills
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Latest job opportunities (May 4, 2010)

by Michael Keizer on May 4, 2010

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