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Alessandro de Luca Senior Vice President MERCK Group TITLE OF THE POWERPOINT 1 Improving Access to Health Supply Chain & Delivery Addressing the Last Mile.

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Presentation on theme: "Alessandro de Luca Senior Vice President MERCK Group TITLE OF THE POWERPOINT 1 Improving Access to Health Supply Chain & Delivery Addressing the Last Mile."— Presentation transcript:

1 Alessandro de Luca Senior Vice President MERCK Group TITLE OF THE POWERPOINT 1 Improving Access to Health Supply Chain & Delivery Addressing the Last Mile Challenge

2 AGENDA 2 1)Access to Health and Supply Chain Challenges 2)Industry approach 3)Beyond a single company? LUMA

3 Many constraints to global access to quality medicines Leaves households responsible for the cost of essential medicines, placing the heaviest burden on the poor and sick who are least able to pay Unfair Health Financing Inefficient procurement systems have been found to lead to payments of up to twice the global market price for essential medicines and lead to unnecessary waste of resources Unreliable Supply Estimates show that half of all medicines are inappropriately prescribed, dispensed or sold Irrational Use Barriers to Global Access within the BoP as identified by the WHO Medicines account for 25% to 70% of overall healthcare expenditure in developing countries compared to less than 15% in most high-income countries because of price levels Unaffordable Prices One-third of WHO Member States have either no regulatory authority or only limited capacity to regulate the medicines market Recent assessments by WHO shows 50% to 90% of samples of anti-malarial drugs failed quality control tests and more than half of ARVs assessed did not meet international standards Poor Quality Medicines Only 1% of medicines developed over the past 25 years were for tropical diseases and TB, which together account for >11% of global disease burden Over 90% of R&D is focused on diseases for the richest 20% Lack of New Medicines 3 SUPPLY CHAIN PRESENTATION_ BRUSSELS/ SEPTEMBER 2013

4 The Supply Chain Objectives Balance Supply & Demand Ensure there is a sufficient supply available to meet demand Provide consistent uninterrupted supply. Cost Minimize company cost and cost implications to countries and patients Quality & Safety supply of quality medicines till the final patient Ensure drug safety in each step of the supply chain 4 To deliver the 3 of them is definitively a challenge in developing countries

5 Typical Pharma Distribution Channels and… 5 …Distribution Systems

6 The distribution challenge in Developing Countries: 6 SUPPLY CHAIN PRESENTATION_ BRUSSELS/ SEPTEMBER 2013 FactorOECD countriesDeveloping counries Regulatory structure Strong well-defined laws and overall good ability to enforce regulations. Weak fragmented regulatory structures, ill-defined laws in some instances, and poor ability to enforce regulations. Distribution systems  Few large distributors with nationwide coverage  Relatively low markups in distribution  Very fragmented distribution market  Few or none with nationwide coverage  High markups in distribution The differences in the regulatory structure and distribution systems of medicines between developing income countries is significant when compared with high income countries.

7 Number of intermediaries in the channel 7 Source: ACT Watch DEVELOPING COUNTRIESDEVELOPED COUNTRIES

8  “People will tell you that delivering to Africa is impossible. Please don’t worry because that isn’t true. 8 8

9  We can and will always find a way.  But just don’t expect it to be the way you think or are used to in Europe.”  Global Logistics Provider, June

10 AGENDA 10 1)Access to Health and Supply Chain Challenges 2)Industry contribution: Some examples 3)Beyond a single company? LUMA

11 11 Registration Manufacturing Shipping Clearing at country Airport Delivery to Central Warehouse Delivery to Patient 11 The Last Mile, who is accountable? Yesterday WHO PZQ Merck Serono MoH, NGO… MERCK Example: Logistics for Praziquantel WHO-Merck Donation Partnership to eliminate Schistosomiasis THE LAST MILE CHALLENGE

12 12 Registration Manufacturing Shipping Clearing at country Airport Delivery to Central Warehouse Delivery to Patient 12 The Last Mile, who is accountable? Yesterday WHO PZQ Merck Serono Today PZQ Merck Serono MoH, NGO… MERCK Example: Logistics for Praziquantel WHO-Merck Donation Partnership to eliminate Schistosomiasis THE LAST MILE CHALLENGE

13 13 Registration Manufacturing Shipping Clearing at country Airport Delivery to Central Warehouse Delivery to Patient 13 The Last Mile, who is accountable? Yesterday WHO PZQ Merck Serono Today PZQ Merck Serono Tomorrow ? Last Mile Alliance Partners (LUMA ?) MoH, NGO… MERCK Example: Logistics for Praziquantel WHO-Merck Donation Partnership to eliminate Schistosomiasis THE LAST MILE CHALLENGE

14 Sanofi Train the Trainer Program Inter-University Degree in pharmaceutical supply chain management -Objective: improve supply chain management of medicines and other commodities for HIV/aids, malaria and tuberculosis -Inter-University degree from Ouagadougou (Burkina Faso), Auvergne and Lyon (France) Universities -Target audience : certified pharmacists working in sub-Saharan Africa -Results ( ): approx. 120 students from 14 countries

15 AGENDA 15 1)Access to Health and Supply Chain Challenges 2)Industry approach 3)Beyond a single company, towards collective action? LUMA

16 Strengthening Supply Chain: Last United Mile for Africa (LUMA) 16 LUMA is a partnership currently under development to strengthen the supply chain in Africa. The goal of the alliance is to: expand access, secure supply, improve health and support development Last United Mile for Africa (LUMA) SUPPLY CHAIN PRESENTATION_ BRUSSELS/ SEPTEMBER 2013

17 17 Thank you! SUPPLY CHAIN PRESENTATION_ BRUSSELS/ SEPTEMBER 2013


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