This document brings together best practices for emergency supply chain preparedness so that countries can respond quickly and effectively to epidemic and pandemic threats. The emergency supply chain recommendations in this document are intended to be part of a broader national emergency preparedness program. This document specifically focuses on supply chain preparedness for the range of infectious disease and zoonotic threats commonly faced by developing countries.
Local and international actors have developed a range of materials to support emergency supply chain preparedness and response. Clearly identifying who has authority and responsibility for the overall emergency supply chain and key sub-components within it will help countries mobilize quickly and effectively in the event of a disease outbreak. In addition, the identification of potential partners in each of the components of the emergency supply chain and the opening of sustainable channels of.
This document is organized into four sections: (1) Landscape assessment; (2) Governance, financing and personnel; (3) Emergency Protocols; and (4) Emergency Procurement and Supply Chain. The best practices in this document were gathered from a review of existing literature in the fields of supply chain management and emergency response, as well as from interviews with interdisciplinary experts.
Landscape assessment
Map the local and international players in a country's Emergency Supply Chain (ESC) to understand their roles, responsibilities and capabilities in an emergency. Accurate identification of the capabilities each stakeholder will bring to the emergency supply chain allows for coordination and planning ahead of time. Some of these organizations (probably the international organizations, NGOs and functional sectors) will have a local supply chain or logistics director.2.
Assess the current state of supply chain readiness to understand baseline capacity and identify potential pain points. Are roles and structures identified in the plan to manage the emergency supply chain. This existing data should be reviewed and expanded or updated in areas relevant to the emergency supply chain.
Failure to adequately learn from previous outbreaks in identifying strengths and weaknesses in the emergency supply chain. Assuming that routine supply chain capabilities will be sufficient to implement supply chain contingency plans in the event of an emergency.
Governance, financing, and personnel
A clearly defined organizational structure for an emergency supply chain is essential to ensure effective execution in a high-intensity, time-critical situation. National emergency supply chain manager for health and the Ministry of Health's organizational structure for emergency supply chains. A single position should be designated as the government's primary responsibility for the emergency supply chain in the event of an epidemic.
The emergency supply chain manager must be able to request additional resources from the routine supply chain during an emergency. The emergency supply chain should have a reporting structure that extends from the national to the local level. The same capabilities as above should be required for emergency supply chain focal points at every level of the supply chain.
The Health Emergency Supply Chain Manager reports to the National Emergency Operations Center (EOC) Logistics Manager. The MoH should use input from their stakeholder mapping to determine how best to coordinate the many partners involved in the emergency supply chain. Determine how the ongoing maintenance and response functions of the emergency supply chain will be funded.
These costs should be incorporated into routine supply chain strategic planning, product forecasting, allocation and procurement processes. The final budget for ongoing emergency supply chain maintenance should be derived from the priorities outlined in the state's Emergency Preparedness and Response Plan (ERP). This incremental cost should be calculated as a weekly budget to operate a nationwide emergency supply chain.
Sierra Leone's response to the Ebola epidemic demonstrates the importance of proper documentation in emergency supply chain financing. Simulations should be used by country officials to identify which vulnerabilities could affect the effectiveness of its supply chain in an emergency. In the past decade, Nigeria has effectively used staff training to improve supply chain preparedness for influenza epidemics.
Emergency protocols
Establish protocols in advance for what types of alerts trigger ESC activation to minimize decision-making difficulties. The activation of the ESC means that the country will switch from using routine protocols to following its emergency protocols. Once an emergency protocol is initiated, the ESC should become as self-contained as possible and be managed by a different individual as a routine supply chain.
By clearly separating emergency and routine supply chains and defining their interaction, governments will be able to better prioritize the maintenance and functionality of the ESC in response to an emergency. There are concerns that merging emergency and routine supply chains would lead to a reallocation of resources from the ESC to potentially under-supplied routine supply chains, which should be avoided. Successful operation of the ESC in a crisis situation depends on several levels of priority.
During an outbreak, ESC operations must take precedence over routine supply chain operations. In addition to prioritizing ESC over the routine supply chain, prioritization should take place within the routine supply chain itself during an outbreak. In this way, if a reassignment from routine supply chain to ESC must occur, lower priority efforts can be shifted to support ESC.
In this way, the most important parts of the routine supply chain(s) can be preserved even while prioritizing the ESC. Additionally, this partial preservation of the routine supply chain should seek to minimize wastage of non-essential commodities wherever possible. Another point of interaction may be in the last mile, where in practice the ESC can leverage aspects of routine supply chains.
These funds helped ensure that the emergency supply chain did not jeopardize the operation of the routine supply chain. Countries should track indicators to continuously monitor the current state of preparedness as part of ESC performance management. Response Quick Guide", where ESC teams can document their essential ESC protocols for emergency preparedness across each element of ESC (e.g. transport, waste management).
Emergency procurement and supply chain
A predetermined and well-defined list of goods provides countries with key information for planning throughout the supply chain. In the early stages of an emergency response, ESC can use pre-configured power kits to speed up supply chain operations. Although Botswana's experience with supply chain reform does not specifically focus on ESC, it highlights the benefits of improved supply chain planning and management.
Bottlenecks for essential goods can hamper emergency response even when other areas of the supply chain are operating efficiently. International procurement and partnerships with non-governmental organizations have also played an important role in the supply chain, allowing Liberia to attract international suppliers to meet unmet needs. The revamped Liberian supply chain procured and delivered over 70 metric tons of supplies in twelve weeks.
Demand considerations: Likelihood of use, substitutability (can another product or method be used to the same effect?), consumption patterns, existing stock levels in routine supply chain. If stocks are kept locally, the raw materials should be purchased and stored separately, and the country should develop a system to rotate the supply through routine supply chain while regularly replenishing emergency stocks to prevent run-out. 67 “Emergency Response Supply Chain Assessment,” Australian Council for International Development's Humanitarian Reference Group (2007) 68 CDC Website: https://www.cdc.gov/phpr/stockpile/index.htm.
The ESC team can work with routine storage and warehouse personnel in the supply chain to identify strategic locations where temporary storage can be set up (e.g. lots near airports/seaports, centrally located locations). The Logistics Chain of Emergency Supplies in Disasters,” University of Athens: School of Medicine (2012) 75 Pandemic Supply Chain Network: “Project Report,” (2017). 76 Logistics cluster website: http://dlca.logcluster.org/display/public/DLCA/LCA+Homepage 77 Pandemic supply chain network.
By keeping these separated, the possibility of further contamination is reduced, thereby easing the burden on the overall supply chain by minimizing the total amount of contaminated waste to be transported80. When used well, LMISs track the correct and timely delivery of all elements of the supply chain and enable data-driven decision-making about supply chain management. LMISs serve both as a check on the supply chain (to ensure that goods actually arrive at the expected destination in the quantity and frequency they were planned for) and a tool to improve the supply chain (identifying gaps or inefficiencies).
Countries should assess the existing LMIS for their routine supply chain for its viability. As a result, data accuracy and access have improved, helping to drive well-informed decision-making throughout the supply chain.
