Public-private supply chain effort brings lifesaving medicines to the last mile in Ukraine

 The USAID SAFEMed Activity in Ukraine launched an innovative public private partnership to improve the distribution of antiretrovirals for HIV and TB medications.

The rates of HIV and TB in Ukraine are high, yet some regions lack access to enough medicines for these and other conditions. The country has the second-largest HIV epidemic in Eastern Europe and Central Asia. Tuberculosis, which is the leading cause of death among infectious diseases in Ukraine, is especially dangerous due to the high estimated number of patients with multidrug-resistant TB. The heavily centralized delivery system wasn’t able to keep pace with the challenges of getting medicines to far-flung regions.

USAID, through the SAFE and Affordable Medicines for Ukrainians (SAFEMed) Activity, which Management Sciences for Health (MSH) implements, worked with the country’s Ministry of Health to engage a private pharmaceutical logistics company, and its nimble fleet of trucks and vans, for last mile distribution of HIV and TB medicines.

The team piloted the work in December 2019 with 58 health facilities in the Odessa region, one of the most affected by HIV. In less than a year, the pilot showed improvements in the quality of transportation, the frequency and consistency of deliveries of HIV and TB commodities, the optimization of stock levels in facilities across the region, and health worker efficiency.

In the past, HIV, TB, and hepatitis commodities, procured by central government programs, were transported from national warehouses to regional distribution centers. That’s where the supply chain ended. The warehouses lacked a systematic way to deliver these products to public health facilities. Their vehicles weren’t equipped with cold-chain capabilities, either, making some deliveries particularly difficult.

Following the success of the pilot, the Ministry of Health and the Center for Public Health expanded the activity to cover the entire country, adding Hepatitis C and B to the list of medicines slated for deliveries. One private operator will provide logistics services to at least 15 regions of Ukraine; in others, local private logistics companies will provide services. If the scale-up works, the government plans to fully integrate the program into state budgets and benefits packages. The Council of Supply Chain Management Professionals nominated this work to be a finalist for the organization’s Supply Chain Innovation Award 2021.

MSH has been helping countries strengthen their pharmaceutical systems for more than 20 years, including improving access to quality medicines via robust, efficient supply chains. From pharmaceutical policy and regulation to procurement and logistics, we work with the public and private sectors, nongovernmental organizations, and donors to create replicable solutions through operations research, technical services, documentation, and information sharing.

Watch a video about the pilot here.