Stronger Drug Supply Chains Can Save Thousands of Children in Zambia and Beyond
WASHINGTON, April 21, 2010–A pilot project in Zambia has shown that strategic improvements in the supply chain for lifesaving drugs can have an immediate and dramatic impact on child mortality. Pediatric malaria drugs—so essential to save children’s lives—are now available in 88 percent of public health centers in trial districts, nearly double the 51 percent availability rate in control districts.
Scaled up nationwide, simple but smart steps, such as hiring a district-level planner to ensure smooth delivery of drugs to rural public health centers, could save as many as 27,000 children in Zambia between now and 2015. In fact, child mortality due to malaria could be cut by up to 37 percent with these changes.
The 16-district pilot project, which was evaluated using state-of-the-art methodology, takes on extraordinarily urgent significance in a context where only 7 percent of children in rural areas receive these medicines within 24 hours of developing fever (Zambia National Malaria Indicator Survey, 2008). Malaria is a leading cause of child mortality in Zambia, and access to effective treatment is a major challenge.
“The Zambian government has done very well with mass malaria prevention measures such as distributing treated bed nets and spraying houses, but malaria remains endemic and progress on access to treatment has been slower,” said Eva Jarawan, Sector Manager, Health, Nutrition and Population for the World Bank’s Africa Region. “We have found that strengthening drug supply chains can make a significant contribution toward extending treatment access and reaching the health MDGs.”
The potential benefits of stronger supply chains—in which orders based on actual needs pass quickly through district stores instead of lying there for weeks—extend well beyond pediatric malaria drugs. The same chains carry malaria preventives for pregnant women, antibiotics, and other critical supplies.
“Working with the Zambian government and our partners USAID and DfID, we have been able to get drugs off the shelves in district warehouses and into the villages, where their availability is often the difference between life and death,” said Monique Vledder, who oversaw the project for the World Bank. “I hope that our findings will help strengthen the public sector’s ability to provide lifesaving drugs to people—not only in Zambia, but also in other places across Africa.”
This supply chain project—called the Zambia Access to Artemisinin-Based Combination Therapy (ACT) Initiative—was jointly funded by the World Bank, USAID and the UK’s Department for International Development. The project was implemented by the Ministry of Health in Zambia with support from John Snow, Inc., and Crown Agents. The Massachusetts Institute of Technology (MIT) and the MIT-Zaragoza Logistics Program provided technical support to the des