A Sound Investment: Supply Chains Key for Neglected Tropical Disease Elimination Programs

By Sarah Andersson

Elephantitis. River blindness. Snail fever. Worms. Also known as lymphatic filariasis, onchocerciasis, schistosomiasis, and soil-transmitted helminths, these and other neglected tropical diseases (NTDs) affect more than one billion—or one in eight—people worldwide. They occur primarily in poor communities with limited access to health care. NTDs can cause blindness, disfigurement, and malnutrition that result in lifelong health complications, social stigma, and the inability to work.

In recent years, 50 countries have eliminated at least one NTD through mass campaigns that distribute preventive medicine to large, under-resourced, and often remote populations. As we recognize World NTD Day on January 30, we applaud this progress. But significant challenges remain, including lack of awareness and limited funding.

For the last 20–30 years, pharmaceutical companies have donated the indispensable medicines at the heart of successful NTD programs, particularly mass drug administration campaigns. The challenge is getting these medicines where they are needed in time for campaigns and before they expire. Strong supply chains, especially at the last mile, are essential. However, in many countries, supply chain inefficiencies contribute to medicine wastage and shortages. Along with higher production and shipment costs, these inefficiencies hamper efforts to reach the disease prevention, control, and elimination goals outlined in the 2030 NTD roadmap.

To bolster NTD programs and ensure donated medicines are still effective when they reach the people who need them, JSI is leading a five-year, multicountry project to strengthen NTD supply chains. With an initial focus on eight African countries, we are collaborating with a group of partners to improve product forecasting and strengthen inventory management, distribution, and reporting systems to create more efficient and cost-effective supply chains. These stronger supply chains will reduce waste and ensure the timely delivery of life-saving medicines. Enhanced stewardship will help sustain medicine donations, and lessons from the eight pilot countries will be applied to NTD programs throughout and beyond the region.

In all our efforts, building relationships with NTD programs and local partners is key, as is tailoring activities to each situation. For example, we used our supply chain tool to understand each country’s context and priorities, which helped us co-design plans for NTD supply chains with local partners. As the project moves into its second year, we are supporting ongoing, country-level activities. This includes efforts to establish standard operating procedures, digitize information systems, and integrate NTD supply chains into national systems to support sustainable, country-led supply chains.

As with all global efforts, collaboration is essential. This project, funded by the Gates Foundation, was co-designed with several partners, including pharmaceutical manufacturers and local ministries of health. It supports global NTD efforts, including the Sustainable Development Goals and the aforementioned roadmap. To implement the project, JSI is collaborating with our East African affiliate, inSupply Health.

Through partnerships and collaboration, we can reduce and even eliminate NTDs and the physical, social, emotional, and economic harm they cause. Sustained investments in supply chains are essential to protect funder investments, strengthen country programs, and, ultimately, improve community and global health.