Professionalizing WHO's supply chain
Dr Maja Al Baalkaki, a Logistics Officer with the World Health Organization, enters the temperature-controlled section of the organization's warehouse to inspect medical supplies at the International Humanitarian City in Dubai, United Arab Emirates.
WHO has become the fifth largest procurer in the UN system, with the volume of procured goods and services now at around US$ 1.5 billion annually, double what it was prior to the COVID-19 pandemic.
While most of the building blocks of a robust supply chain already existed, this substantial increase revealed some of the cracks preventing it from being fully operational. From resource constraints and keeping up with multiple emerging crises, to fragmentation and duplication in the existing processes, the challenges were many.
As part of WHO's Transformation Agenda, the different existing elements are being pulled together and new competencies and processes are being developed to build a more holistic and professional WHO supply chain. Angela Kastner, WHO Director of Procurement and Supply Services, has led this work since 2022 from the WHO Budapest Centre in Hungary. “We have the three levels of the Organization,” she says. “I coordinate and convene the regional network so that what we’re doing globally is coordinated and harmonized with the regions. Then the regions feed that down to the country level.”
WHO began designing an improved architecture for an emergency supply chain in 2019, addressing gaps and inefficiencies in the existing processes. But it wasn’t until 2022 that this plan was broadened to encompass a whole-of-organization integrated system.
“We had elements that would make up a supply chain but they were fragmented, and we had a lot of duplication,” says Ms Kastner. “Now we have clearer accountabilities and a plan for how those accountabilities will be allocated.”
The mobile clinic in Barakat School, which is supported by WHO, serves the 85 IDP families who live in the school and hundreds of families who live in neighbouring IDP sites, as well as the host community.
Roadblocks and inefficiencies in the supply chain not only create frustrations and challenges for staff delivering programmes in countries; they also cause significant loss of time and money for the Organization. To address these issues, WHO introduced three strategic objectives: to design and implement an end-to-end supply chain function; to deliver responsive and resilient emergency supplies; and to achieve operational excellence in procurement and supply chain. WHO’s new Business Management System (BMS) has been critical to achieving these goals, which has integrated key tools to facilitate a more functional supply chain.
WHO supplies are offloaded at a health facility in Zaporizhzhia Oblast on 28 July 2023. The 14 pallets of medical kits included medical supplies for trauma and emergency surgery as well as noncommunicable disease treatments.
The transport and logistics (TMS) module of the BMS, which has been piloted in 10 countries and one warehouse, has made a particularly significant impact in countries. The module empowers countries to address bottlenecks in customs clearance and get real-time shipment tracking information. The module has taken countries from a more rudimentary process of tracking through emails and excel spreadsheets to a method that allows real-time tracking, streamlined approval processes and more visibility on the pipeline of products. WHO has also integrated two main freight forwarders into the system so that data can be shared.
WHO donated automated external defibrillators (AEDs) to the National Emergency Management Organization of IR Iran (NEMO), funded by European Commission Humanitarian Aid (ECHO).
“How we spend our money and who we spend it with has huge impact,” says Ms Kastner.
In working towards a more streamlined and professional supply chain, WHO developed a global procurement dashboard, with improved methods of capturing and analysing data, and validated key performance indicators. A new procurement policy was also issued in 2023 which reviewed global procurement policy, including emergency-specific aspects, and set global standards and guidance. Progress still needs to be made on social, economic and environmental sustainability, to further professionalize the procurement process, but important strides have already been made.
“In Iraq for example, they are now able to have things as simple as track and trace,” Ms Kastner explains. “That has come through the implementation plan of the technology and their adoption of it.”
Nevien Attalla, a Logistics Manager and Pharmacist at the World Health Organization, performing a medical supplies inventory check at the organization's warehouse within the International Humanitarian City, Dubai, United Arab Emirates.
Challenges remain with WHO warehouse facilities around the world, with even some of the largest warehouses lacking basic industry practices and using outdated systems to track inventory. But the transformative potential is immense, and the Procurement and Supply Services (SUP) department has been making significant headway.
“We have introduced item coding, which is a small step, but we have standardized it. We are moving to a new coding system,” says Ms Kastner. “The item coding is like the little data flag that will flow through the whole chain. That will help us to know what’s in inventory, so we can take something from inventory before we go and buy something.”
Countries now have the technology to manage the movement of goods in and out of their country warehouses and to keep track of what is in stock and of shelf-life. There is still work to do on warehouse and inventory management, but the system is becoming more efficient, and this has already resulted in cost-saving and less wastage.
With support from WHO donors, WHO IRAQ delivered 43 tons of medicines and medical equipment, valued at US$ 429K, to Ninawa Governate to boost essential and secondary healthcare services in several health facilities of the governorate.
A new tool for a green light customs clearance process has been introduced and mapped for all countries.
“We now know the countries that have to do green light customs clearance, and what those processes are,” explains Ms Kastner. “Some of the countries have already moved to digitize that too using the new BMS system.”
The system pulls together information and documentation and tracks international shipments through approval steps. This is a potential game-changer for WHO, particularly in emergency settings where supplies need to be delivered with speed and efficiency.
WHO supplies are offloaded at a health facility in Zaporizhzhia Oblast on 28 July 2023. The 14 pallets of medical kits included medical supplies for trauma and emergency surgery as well as noncommunicable disease treatments.
One of the positive developments which arose from the transformation of the WHO supply chain is the way it has aligned the procurement processes of emergency and non-emergency programmes.
“When I started, we had an emergency track and then we had an everything else track and the two didn’t really come together,” says Ms Kastner. “Now we have one supply chain for the Organization that can manage emergency and non-emergency.”
Broadening the scope of the supply chain transformation has allowed WHO to build crucial efficiency into the non-emergency scope of procurement, which budget-wise constitutes the majority of WHO’s procurement.
On 25 February 2024, about 6700 fixed and mobile vaccination teams set out to reach nearly 1.3 million children aged under 5 years with the novel oral polio vaccine type 2 (nOPV2).
The extensive changes made to WHO’s supply chain ultimately amount to more impact at country level in programmes and for the people the Organization serves. To ensure greater accountability, seven Key Performance Indicators (KPIs) were established, tracking performance against speed, time and cost targets, which are then reported through mechanisms established by the WHO Global Service Centre (GSC) in Kuala Lumpur, Malaysia. The SUP department is focused on harmonizing and professionalising the supply chain process further through global standards, policies and standard operating procedures. This will be supported by new technology and more consistent use of data to inform changes in policies and procedures.
WHO Somalia is maintaining 3 warehouses across the country to maintain and sustain provision of life-saving health services across the country.
As one of the key initiatives of WHO’s transformation, the professionalization and harmonization of the global supply chain is on track, but there is still a lot to be done to reach the vision of a seamless end-to-end process. As demand for goods increases and WHO’s position in the humanitarian response sphere shifts, continuous learning and building on opportunities will be key. WHO’s supply chain will need to remain flexible to be able to provide tailored support to country offices while avoiding inefficiencies and increased fragmentation.