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  1. 1. The Drug Management Cycle – Distribution Butch Staley
  2. 3. Working Definitions <ul><li>Supply chain – The network of retailers, distributors, transporters, storage facilities, and suppliers that participate in the sale, delivery, and production of a product. </li></ul><ul><li>Logistics – The overall management of the way resources are moved to the areas where they are required. </li></ul><ul><li>Distribution – The delivery or giving out of an item or items to the intended recipients. </li></ul>
  3. 4. Elements of the Distribution System
  4. 5. Characteristics of Effective Distribution <ul><li>Constant supply </li></ul><ul><li>Maintained quality </li></ul><ul><li>Minimal loss/pilferage </li></ul><ul><li>Accurate and timely inventory and transaction information </li></ul><ul><li>Proper storage </li></ul><ul><li>Efficient transport/delivery </li></ul><ul><li>Adequate geographic coverage </li></ul>
  5. 6. Supply System Models <ul><li>There are many models, ranging from fully public to fully private, each with relative advantages and disadvantages, depending on context. </li></ul><ul><ul><li>Central Medical Stores model: South Africa, Tanzania </li></ul></ul><ul><ul><li>Autonomous supply agency: Uganda, Benin </li></ul></ul><ul><ul><li>Direct delivery: Caribbean </li></ul></ul><ul><ul><li>Primary distributor (prime vendor): USA </li></ul></ul><ul><ul><li>Fully private: Canada, Australia </li></ul></ul><ul><ul><li>Mixed models: Europe, Caribbean </li></ul></ul>
  6. 7. LEVELS FULLY PRIVATE FULLY PUBLIC International National Regional Regional Medical Store District Community District Medical Store Hospitals Health Centers Health Posts Users Private Pharmacies International Suppliers Local Wholesalers Distributors Local Manufacturers Central Medical Store Pharmaceutical Distribution Models Key Product flow in traditional CMS System
  7. 8. Central Medical Store Model LEVELS PRIVATE SECTOR PUBLIC SECTOR International National Regional Regional Medical Store District Community District Medical Store Hospitals Health Centers Health Posts Users Distributors Shops, Pharmacies Local Wholesalers International Suppliers Local Manufacturers Central Medical Store Key Product flow in traditional CMS System
  8. 9. Direct Delivery Model LEVELS PRIVATE SECTOR PUBLIC SECTOR International National Regional Regional Medical Store District Community District Medical Store Hospitals Health Centers Health Posts Users Shops, Pharmacies Central Medical Store International Suppliers Local Manufacturers Local Wholesalers Distributors Key Product flow in traditional CMS System
  9. 10. Primary Distributor Model LEVELS PRIVATE SECTOR PUBLIC SECTOR International National Regional Regional Medical Store District Community District Medical Store Hospitals Health Centers Health Posts Users Shops, Pharmacies Central Medical Store International Suppliers Local Manufacturers Local Wholesalers Distributors Primary Distributor Key Product flow in traditional CMS System
  10. 11. LEVELS PRIVATE SECTOR PUBLIC SECTOR International National Regional Regional Medical Store District Community District Medical Store Hospitals Health Centers Health Posts Users Private Pharmacies Local Wholesalers Distributors Local Manufacturers Central Medical Store Fully Private Model International Suppliers Key Product flow in traditional CMS System
  11. 12. Health System Supply Chain – Theory
  12. 13. The Complex Reality: Health Supply Chains in Kenya
  13. 14. Key Decisions <ul><li>Key decisions include: </li></ul><ul><ul><li>Push versus pull </li></ul></ul><ul><ul><li>Centralized versus decentralized </li></ul></ul><ul><ul><li>Roles and responsibilities: public, private, NGO </li></ul></ul><ul><ul><li>Mix of in-house and contract services </li></ul></ul><ul><ul><li>Levels of distribution and stock requirements </li></ul></ul>
  14. 15. Assessment/Option Analyses <ul><li>Understand context – functionality and current capacity of public, private, and NGO systems and institutions </li></ul><ul><li>Consider variable costs with each option </li></ul><ul><li>Consider capacity to manage and operate proposed system </li></ul><ul><li>Define methods for monitoring and measuring performance </li></ul>
  15. 16. Summary <ul><li>Designing a system for storing and distributing pharmaceuticals is complex and important </li></ul><ul><li>In some countries, private (or parastatal) distribution companies may provide cost-effective alternatives for storage and distribution of pharmaceuticals </li></ul>

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