Ethiopia: Q & A with Andualem Mohammed, Advisor for the Supply Chain Management System in Ethiopia

[Andualem Mohammed, SCMS advisor. Photo Credit: Margaret Hartley.]Andualem Mohammed, SCMS advisor. Photo Credit: Margaret Hartley.MSH: Please tell me about your background and how you became interested in public health.
I am from Ethiopia, and I joined Management Sciences for Health (MSH) as an employee seconded to a Missionaries of Charity orphanage for HIV-positive children, where I became the head of the pharmacy. But I wanted an opportunity to help millions of people instead of hundreds, so I joined the Supply Chain Management System (SCMS) Project as Quantification and Supply Planning Advisor.

MSH: What is your role at MSH?
With other teams, my team coordinates and supports activities so that commodities for HIV & AIDS (such as antiretroviral medicines, medicines for opportunistic infections, laboratory reagents, and supplies) are procured and delivered. We work closely with government officials to maintain efficient pharmaceutical supply throughout Ethiopia.

MSH: What are the major health issues Ethiopians face?
The major issues are infectious diseases (such as HIV, malaria, and tuberculosis), issues related to maternal and newborn health, and malnutrition. Our project supports essential medicines programs, and our experiences have been so good that our work with HIV & AIDS can be used as a model for other infectious diseases.

MSH: What are the challenges in providing care for people with these health issues?
The main challenge is poverty. The social, economic, and political circumstances of the Ethiopian people pose many roadblocks. Education about hygiene is inadequate, for example. Another major challenge is the inaccessibility of health services for the needy. And Ethiopia always has a deficit of health care professionals. Lastly, attitudes about health care are difficult to change. Many Ethiopians rely on religious or traditional healers.

MSH: What are the objectives of the SCMS project in Ethiopia? What is MSH’s role in the program in Ethiopia?
The objective of SCMS is saving lives through strong management of supply chains. SCMS works on getting medicines and products at more affordable prices for those most in need. Our main objectives are deploying innovative solutions, making sure accurate and useful data are collected, and providing products of assured quality.

MSH: How is SCMS making an impact on the AIDS epidemic in Ethiopia?
SCMS supports the care and treatment of HIV-positive people. It offers the quality medicines and supplies that are critical in the management of HIV & AIDS in Ethiopia, has created systems for managing health commodities, and works to coordinate partners, including government agencies, in the areas of quantification and commodity security of HIV & AIDS products. The past three years have brought many good results: we are working with major health care providers and partners to help build local capacity in supply chain management of HIV & AIDS commodities. More comprehensive care and support to people living with HIV is possible in the country partly because SCMS is procuring and delivering more commodities.

MSH: What has been the project’s greatest accomplishment in Ethiopia or elsewhere in Africa?
One of the greatest accomplishments is that SCMS, with its partners and the government, has prevented stock-outs, at the national level, of laboratory reagents and supplies and of antiretrovirals (ARVs). As a result, these commodities are generally available at all times. Before SCMS, ARVs and laboratory reagents were delivered through a “push” system; now the system has been transformed to a “pull” system. As of 2008, SCMS started gathering data and providing products based on consumption levels.

 SCMS, with its partners and the government, has prevented stock-outs, at the national level, of laboratory reagents and supplies of antiretrovirals.

MSH: How does improved management of medicines affect people who are living with HIV?

Managing supply chains gets people the medicines, diagnosis, and support that enable them to be productive and have a better life. Before, people had to watch their friends, family, and children die. Now, they have an opportunity to live their lives and raise their children.

 Managing supply chains gets people the medicines, diagnosis, and support that enable them to be productive and have a better life.

MSH: How has AIDS care evolved in Ethiopia?
AIDS care has been transformed, and our work is more comprehensive. Before 2005, only the rich could afford treatment, but PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief) started to offer free HIV treatment—a major opportunity for Ethiopians. Now services are being decentralized and are available in communities. Many partners are involved, and more resources are invested. After many years of advocacy, society is much more open about discussing HIV & AIDS. The stigma and discrimination associated with the disease are waning. Some communities have organized associations or fundraising efforts to help support HIV-positive people. Now people living with HIV get better care and support and can actively participate in life health care.

MSH: What are your hopes for health care services in Ethiopia?
Poverty needs to be addressed in my country. We must work on prevention, not just treatment. Most of the health problems we encounter now can be prevented, with better health services and better managed service-delivery systems. I hope this happens in my lifetime. I also hope that the professionals who are benefiting from donor countries start taking ownership of the projects. We need better leaders who can help make the projects sustainable. I want the attitudes of people to change; this change goes hand in hand with education. Modern medicine needs to be explained better, so we can encourage people to seek modern health care.

MSH: What achievement gives you the greatest sense of accomplishment?
Our work in Ethiopia is being used as a model throughout the world, and we can be proud of that.