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Responsibility

Supply Chain Challenges and Structures

Supply chain challenges exist around the globe.  Many facets of the pharmaceutical industry continue to diversify.  In an ever changing global society, there are consistent monitors to help maintain, control, and identify secure supply chains.  Although millions of dollars are spent, thousands of human resource hours are spent, and innovative ways of securing pharmaceuticals are created daily, there are those instances when sub-standard or counterfeit medicines make their way into the health care market. Tanzania is no exception to this situation, and working as a Supply Chain Fellow in Dar es Salaam has helped understand the struggle from a broader perspective.  Working in Incoming/Purchased Materials Quality for the past 12 years at the Kalamazoo site has provided a diverse view of the supply chain from a supplier perspective. Regardless of where a product is manufactured, regulatory requirements require a minimum of criteria to be achieved prior to processing.  Cost and complexity of importation of manufacturing goods plays a large role in the procurement of raw materials, active ingredients, and packaging materials.  Validation of suppliers, audit inspections, quality testing and release, and shipping are handled with strict policies and procedures to ensure that there is no gaps in the supply chain, the documentation, and the control of every product.  In Tanzania, approximately 80% of their products are imported and this creates a strong need to regulate.  Tanzania’s advantage over some of the inland countries of Africa is the coast of the Indian Ocean.  They are capable of receiving large shipments of supplies through ports located in Dar es Salaam, Tanga, and Mtwara.  Their inland counterparts do not have this luxury, as well as the western portion of Tanzania. The travel inland creates a complex arrangement of transportation to get critical supplies to remote villages.  With the struggles of any supply chain, unique challenges arise in a country such as Tanzania.  Weather is a big concern as the rainy season can make transportation to a village completely inaccessible.  Road conditions are poor in all areas of the country, so larger vehicles have a difficult time maneuvering the terrain.  Maintaining the cold chain supply (both in transport and in facilities) become difficult as refrigeration is not readily available where there are frequent power outages or no power at all.  A struggling country in respect to information technology, the challenge to maintain a strong chain of custody for pharmaceuticals becomes cumbersome and a burden for many rural communities.   While creating a stronger supply chain is possible, it is these challenges that must be addressed. This is what I am working on in respect to the facilities housed under programs supplied through PharmAccess International.  PharmAccess has made great strides in accomplishing commitment to quality care and quality medicines for the patients in the facilities they work with.  This commitment is the basis of creating functioning systems of quality care.  Consistent training and innovative delivery of quality are ways that this NGO is providing community service to the citizens of Tanzania.  The hope is that this fellowship will bring forth some new knowledge and expertise in the maintenance and strengthening of the supply chain.  With seven weeks left in my fellowship period, significant progress has been made in understanding the gaps of the supply chain systems, the quality assurance weaknesses, and recommendations on closing those gaps are in process.  The knowledge gained from years of experience is gladly handed down in hopes that a real change can be made.  This is the footprint I wish to leave behind.