Supply chain failures amid Covid‐19 signal a new pillar for global health preparedness

Abstract

The COVID‐19 pandemic has challenged health systems around the globe and exposed a myriad of fault lines, demonstrating how critically important the healthcare supply chain, and its integrity, is to health systems and as a consequence, to the well‐being of individuals, families, and communities. Supply chain inefficiency, and its brittleness in times of crises has been a well‐noted barrier in low‐ and middle‐income countries but the graphic descriptions of preventable death through absence of effective personal protective equipment (PPE) in developed economies is both chastening and confronting.

Supply chain resilience during pandemic disruption: evidence from healthcare

“…The limitations of the ability to respond in terms of emergency procurement, the mechanisms to secure supplies and access to funds have been assessed more generally for low-income and developing country healthcare systems (Dowling, 2011; Durrani, 2016). During COVID-19, Dai et al (2020) and Garber et al (2020) have highlighted the ethics in terms of the purchasing power available to Western countries versus developing/low-middle income countries in securing critical supplies during a pandemic. COVID-19 is not the only instance that access to critical materials or fragmented SCs is evident, as the Ebola outbreak saw similar challenges (Garber et al , 2020).…”

“…The use of distributors makes it harder for organisations to trace the origin of their supplies, which can leave them vulnerable to SC disruptions (Graves et al , 2009; Kwon and Kim, 2018). The lack of SC visibility (Dai et al , 2020), increased globalisation (Graves et al , 2009) and medical supplies coming from outside the country of use (Kwon and Kim, 2018) further increase healthcare SC vulnerabilities. For example, 95% of all surgical masks and 70% of respirators purchased in the US each year are sourced from Mexico and China (Kwon and Kim, 2018).…”

“…PPE includes protective clothing specifically designed to protect the wearer from infection (Patel et al , 2017). Patel et al (2017) and Dai et al (2020) discuss issues with the PPE SC, resulting from most PPE being produced offshore and limited ability to rapidly increase production during a public health emergency. Export restriction or the nationalisation of manufacturing facilities are noted as a possible cause of availability issues during an emergency (Patel et al , 2017).…”

“…In addition, previous pandemic experience has shown risks of PPE being hoarded, impacting visibility and knowledge of stocks, as was illustrated during the outbreak of SARS, when the public and healthcare staff stockpiled out of fear of SC disruption (Sheffi and Rice, 2005; Day, 2014). However, despite potential hoarding, there is recognition from post-SARS evaluations that suppliers do not want to handle large amounts of inventory when pandemic risk recedes (Dai et al , 2020).…”

Organizational approaches to implement rapid change in hospitals to respond to public health emergencies

“…A report on the operational readiness of nations on several indicators of preparedness found that only 57% of 182 countries had the functional capacity to execute crucial emergency-related activities (7). Elements of health care systems that have been implicated in low levels of preparedness have varied, ranging from supply chain failures, workforce shortages, organizational readiness for change, and resource constraints, among others (8,9). The COVID-19 pandemic has certainly impacted these elements.…”