Tropical Health Matters

Dr Ngozi Okonjo-Iweala, the World Bank managing director, addressed the need for well functioning transport and trade facilitation to boost economic growth. She was quoted in the Monitor as adding that, “You can’t trade without the means to get goods offshore.”

Concerning Africa, Dr Okonjo-Iweala explained that …

We know better logistics are strongly associated with trade expansion, export diversification, the ability to attract foreign direct investments, and economic growth. Yet the 2010 Logistics Performance Indicators (see figure to right) showed that Sub-Saharan Africa is home to the 10 lowest performing countries in the survey. This is a cause for concern. Simplified customs and export procedures to quickly move goods across borders are also important. Yet the World Bank Group’s latest Doing Business report indicates that the average number of days to export from sub-Saharan Africa is 33. This can range from 75 days in Chad, 37 days in Uganda, and 23 in Mozambique.

While these infrastructural weaknesses hinder export and trade, they also hinder procurement and supply management for importing and distributing malaria commodities needed to meet Roll Back Malaria and Millennium Development Goals.

According to Roll Back Malaria, “Controlling malaria through universal coverage is not only about increasing spending and the delivery of malaria interventions. It also requires building, expanding and continuously improving health systems supporting all interventions.” This includes infrastructure such as transport, logistics, and communication.

The ongoing national LLIN distribution effort in Nigeria has been able to document some of the logistical challenges facing malaria program roll out efforts. In one state the reconciliation of LLINs supplied and those received at local government level delayed the implementation of the campaign. A ship containing nets balance had arrived at Lagos port however, due to congestion had not docked. Imbalance in LLINs supplied to local governments required shifting of supplies.

Logistics innovations to address such problems in Nigeria included training staff in use of waybills and stock sheets to help track LLINs. Another helpful factor was identification of appropriate storage facilities in all local governments.

Malaria No More and partners recently conducted Logistics Training to help countries learn from challenges and best practices, like seen in the Nigerian experience. Some of the key steps in Logistics planning that were outlined in the training include –

• Customs clearances (selection of agent, Tax/Vat exoneration)
• Security (personnel, transport and storage)
• Storage (calculate storage volume, storage plan), negotiate with local government, partners and area facilities, physical location and accessibility
• Transport (based on strategy) transport from entry points to the districts (macro) and from district to DPs (micro), identity available resources, develop transport plan
• Micro-planning logistics (micro-planning guide document)
• Tools and control mechanisms and follow-up of the LLINs (tracking)
• Standardized templates in planning (storage, transport,budgets)

Infrastructure improvements will enhance economic growth and enable families in the long term to afford malaria prevention and treatment, but right now, extra effort is needed to overcome infrastructural and logistics challenges to Universal Coverage so that a healthier, malaria-free populations can contribute to their nations’ growth.

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