South Sudan faces ongoing security challenges that hamper its health commodity supply chain. After independence in 2011, conflict broke out in 2013 and again in 2016, displacing many people. Though a peace deal was signed in 2018, sporadic violence has continued. Aid workers are regularly attacked, with several killed in 2020 and 2022 while transporting health supplies or working in facilities. Assessments identified a fragile supply chain system with challenges including limited government funding, lack of quality oversight, insufficient data and staffing shortages. Key priorities are strengthening governance, regulatory structures, supply chain capacity, and developing long-term pharmaceutical sector support to ensure communities have access to medicines despite the volatile security environment.

1. Jean Claude Tayari
Health commodities supply chain management in a conflict
environment
Case of Republic of South Sudan

2. South Sudan - Geo-localization

3. South Sudan - Security
UN peacekeepers deploy to stop communal violence in South Sudan UN peacekeepers during security patrol in South Sudan

4. South Sudan - Security
• After a peaceful secession from Sudan, the Republic of South Sudan became
Africa’s 54th country on July 9, 2011.
• South Sudan descended into violent conflict in 2013 and a peace deal signed in 2015 for a
unity government collapsed in 2016 and spread further conflict.
• That deal was “revitalized” by warring parties in 2018 and but sporadic violence has
continued.
• After the cease-fire signed in 2018, the security situation has generally improved and
some displaced people returned to their places of origin
• However, the situation remains volatile and, since 2020, organized violence at
subnational level increased, resulting in new displacements, with armed clashes forcing
people to leave the country
• The United Nations Mission in South Sudan (UNMISS) documented hundreds of cases of
civilian killings and injuries, the majority by community based “civil defense groups”

5. South Sudan - Security

6. • Aid workers continued to be attacked, hampering greatly needed aid efforts, with UN warning that South
Sudan was becoming one of the most dangerous places for humanitarian workers to operate.
• There has been several roadside ambushes to health humanitarian organizations
• UN condemns killing of aid worker in South Sudan: The aid worker was killed travelling to or from health
facilities
• In Jan 2022, a humanitarian worker was shot dead while returning from his work supporting vulnerable
families
• In Feb 2022, a group of unknown gunmen attacked a humanitarian vehicle carrying polio vaccines killing
three health workers and injuring four others.
• In Apr 2022, staff from a UN agency and an NGO staff were physically assaulted
• In on Admin Area, youth entered an International Rescue Committee (IRC) compound and physically attacked
staff, resulting in multiple injuries.
• In May 2022, a female aid worker from Cordaid was shot dead and May, an IRC Doctor died inside a health
facility, in “unclear circumstances.”
• Nine aid workers were killed in 2020
Source: GIEWS Country Brief: South Sudan 22-July-2022
Human rights watch, World report 2022
South Sudan - Attacks on Aid Workers

7.  Supply Chain Management (SCM) encompasses the planning and management of all
activities involved in sourcing and procurement…and all logistics management activities.
 Importantly, it also involves coordination and collaboration with partners, which can be
suppliers, third party service providers and customers.
 SCM integrates the demand and supply management within and across various levels.
Definition

8. • The goal of every Public Health logistics
system is to ensure that every customer
has commodity security.
• Commodity security exists when every
person is able to receive and use quality
essential health supplies whenever he or
she needs them.
The goal of SCM

9. • Covid – 19 has demonstrated the fragility of health system in
low developed countries and severely in country in conflict
with high need for response planning and more sustainable
and stronger model of health commodity supply chain.
• In additional, challenges were amplified by:
• Supply chain which could be described as ‘fragile’; based
on typical health indicators and fundamental economic
structure as well as current economic developments
• Constitutional provision for access to medicines => out of
pocket for all health services
• Medicines are purchased largely with donor funds and
supplied through same structures: There is limited
allocation from the SS Gov for procurement of medicines
and health technologies
Health Supply Chain System challenges

10. • Though products could be physically stored together,
the management of these products are not necessarily
integrated.
• Product quality remained challenging in almost all the
states while there is no emphasis on quality of practice.
• National priorities sometimes overshadow supply chain
priorities.
• Government driven data on the supply chain sector is
limited (timely availability of accurate data)
• Lack of sustainable human resources: Staff count and
capacity challenges exist within the supply chain
management functions
• FDCA not fully functional: does not have the necessary
resources to perform its optimal functions
• These challenges magnify existing weaknesses of the fragile
health system including health commodities supply chain
and last mile delivery.
Health Supply Chain System challenges (Cont’d)

11. UNDP in collaboration with other stakeholders did SC
assessment & recommended key priority for support:
• Improving MoH governance of the policy
implementation mechanisms
• Strengthening of the regulatory structures and
functions for pharmaceutical sector, professional
practice and the premises for operations
• Strengthening the health commodity supply chain,
while building capacity of local partners and
partnerships
• Addressing gaps in capacity building for the
pharmaceutical sector in the short, medium and
long term
• Advocating for legislative tools around Quality
Assurance, Practice and Supply Chain
Key health supply chain priorities assessment

12. • Despite security situation, access to health care services in SS should be assured
through continual investments to build strong systems which ensure that the right
medicines, as well as services, are accessible by the right patient, at the right time, at
the right dose, at acceptable quality, at an affordable price, in a sustainable manner.
• System strengthening interventions should be allocated to decisive interventions
which deliver sustainable improvements in the structures, people, assets and
processes serving as the components of the supply chain system in order to ensure
resilience and responsiveness.
Key lesson learnt

13. WHO South Sudan: October 2021

14. THANK YOU