Shaping the Future of Global Health Supply Chains

 What transitions are needed to unlock new ways of financing global supply chains, especially for LMICs?

The transition requires a shift from donor-dominated funding models to more diversified, sustainable financing mechanisms—blending domestic resources, regional initiatives, and private sector investment to align better with national priorities.

What key interventions would you prioritize to strengthen supply chains and reach last-mile and underserved communities?

We need a mindset shift: instead of focusing solely on delivering products to facilities, we must understand where patients prefer and are able to access services. Designing patient-centric supply chains that leverage diverse delivery channels ensures products are available when and where they’re most needed.

Without donor funding and technical assistance: (1) what is the life expectancy of the CMS model, and (2) how should governments prepare for change?

The CMS model will continue in some form, though its structure may vary by region. Some countries moved away from CMS but returned during emergencies like COVID-19. A balanced approach involving both public and private sector channels is essential. Governments should invest in adaptive capacity to manage transitions effectively.

Did the research explore how trade and non-tariff barriers affect supply chains and patient access?

Yes. In LMICs, trade barriers—such as tariffs, export bans, customs delays, and complex regulations—can significantly disrupt the supply of essential health products. These barriers drive up costs, delay deliveries, and limit patient access. As seen during COVID-19, such restrictions also weaken global health security by undermining collective preparedness and response.

 What alternatives exist to replace traditional donor funding, especially as donors withdraw?

In the short term, programs like Unlock Aid can bridge funding gaps. Long-term solutions include support from institutions like the African Export-Import Bank, the African Epidemic Fund, and development banks. Governments and private sector actors are expected to play a larger role, particularly in emergency preparedness and procurement.

What are the pros and cons of current global procurement mechanisms, and how should they evolve?

While mechanisms like GF, Gavi, and UNICEF have improved access and reduced costs, they have underinvested in building local and regional procurement capacity. Future roles should focus on emergency responses and introducing innovative technologies, possibly through regional aggregators rather than global ones.

In private sector outsourcing, what guarantees exist for timely payments and cost recovery?

Guarantees vary across programs. Innovative models like those used by MedAccess could help, especially if tailored to regional buyers. More structured financial mechanisms and risk-sharing tools are needed to assure private partners.

What would you change in the paper, considering today’s health financing environment?

The paper anticipated many of today’s changes. It’s more important now than ever to move from talking about transitions to actively planning them. We must assess risks, prioritize patient centricity, and define exit strategies for global actors.

There’s a strong focus on product regulation—what about regulation of people and premises?

Regulation of pharmacists and premises often falls under broader health systems governance and may not directly intersect with PSM.

How can we operationalize cross-sectoral planning, tech adoption, and integration in PSM?

Donor-driven silos remain a challenge. National governments must lead integration efforts internally and advocate for donor alignment around unified strategies, enabling systems that are interoperable and future-ready.

Are we ready for the next global health emergency?

Not fully. The shift of donor funds away from global health is already disrupting supply chains. Scenario planning, local capacity development, and agile systems are vital to respond quickly to future shocks.

Why are there so few WHO-prequalified manufacturers in Africa?

African manufacturers face several challenges in achieving WHO prequalification, including complex regulatory processes, high production costs, limited infrastructure, and fragmented demand. Many lack access to capital and reliable utilities, while competition from more established manufacturers in Asia further limits their market share. Additionally, a shortage of specialized technical expertise and unpredictable procurement volumes makes it difficult to justify the long-term investments needed for prequalification.

 What’s the key to transitioning from a singular supply chain to dynamic supply networks?

One lever is shifting Incoterms to empower manufacturers. Building flexible, interconnected networks allows for more responsive, decentralized supply systems.

Which countries exemplify strong supply chain management with private sector collaboration?

Several LMICs in Asia and the Pacific have successfully integrated private-sector partnerships to strengthen health supply chains. In the Philippines, the government contracts private logistics firms for last-mile distribution of medicines. Malaysia’s Ministry of Health collaborates with Pharmaniaga for nationwide procurement and delivery, achieving high fulfilment rates. In Bangladesh, the Social Marketing Company (SMC) works through private retail channels to distribute affordable health products, now covering about one-third of modern contraceptive use nationwide. These models show how public-private collaboration can enhance efficiency and expand access.

What’s needed to ensure cost-effective supply chains and sustainable manufacturing strategies?

Ensuring consolidated, sustainable, and consistent demand is key. As global health donors evolve their roles, new collaborative approaches are needed—such as innovative and blended financing, regional joint procurement, and manufacturing coordination. Digital forecasting tools and public-private partnerships can strengthen planning and delivery, while robust governance and regulatory alignment ensure long-term resilience in an increasingly fragmented funding landscape.

Can PSM drive patient centricity and system transformation without addressing healthcare delivery?

Not entirely. PSM must be integrated with service delivery to ensure that supply systems align with how and where care is provided. Transformation requires holistic, systems-level change.

Public supply chains often focus on stock availability and on-time delivery—what about appropriate use by health workers and patients?

While avoiding stockouts is essential, inappropriate use—such as poor prescribing, patient non-adherence, and compromised products—can lead to treatment failures, antimicrobial resistance, and wasted resources. It also distorts demand signals, making forecasting and planning harder. Addressing this requires more than logistics; PSM experts must be part of broader health planning to ensure supply chains truly support better health outcomes.

What’s the difference between risk sharing and risk outsourcing in public-private models?

Risk sharing involves both parties jointly absorbing potential losses, while risk outsourcing shifts responsibility entirely to one side. Successful models often involve a balanced approach with aligned incentives.