Alessandro de luca senior vice president merck group
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Improving Access to Health Supply Chain & Delivery Addressing the Last Mile Challenge. Alessandro de Luca Senior Vice President MERCK Group. AGENDA. Access to Health and Supply Chain Challenges Industry approach Beyond a single company? LUMA.

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Alessandro de Luca Senior Vice President MERCK Group

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Improving Access to Health

Supply Chain & Delivery

Addressing the Last Mile Challenge

Alessandro de Luca

Senior Vice President

MERCK Group

Title of the powerpoint


AGENDA

  • Access to Health and Supply Chain Challenges

  • Industry approach

  • Beyond a single company? LUMA


Many constraintsto global access to quality medicines

Barriers to Global Access within the BoP as identified by the WHO

Unaffordable Prices

  • 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

  • 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

  • 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

Unreliable Supply

  • 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

Irrational Use

  • Estimates show that half of all medicines are inappropriately prescribed, dispensed or sold

  • 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

Supply Chain presentation_ Brussels/ September 2013


The Supply Chain Objectives

To deliver the 3 of them is definitively a challenge in developing countries


Typical Pharma Distribution Channels and…

…Distribution Systems


The distribution challenge in Developing Countries:

The differences in the regulatory structure and distribution systems of medicines between developing income countries is significant when compared with high income countries .

Supply Chain presentation_ Brussels/ September 2013


Number of intermediaries in the channel

DEVELOPING COUNTRIES

DEVELOPED COUNTRIES

Source: ACT Watch


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

8


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

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 2013

9


AGENDA

  • Access to Health and Supply Chain Challenges

  • Industry contribution: Some examples

  • Beyond a single company? LUMA


MERCK Example: Logistics for Praziquantel

WHO-Merck Donation Partnership to eliminateSchistosomiasis

THE LAST MILE

CHALLENGE

Yesterday

MoH, NGO…

PZQ MerckSerono

WHO

The Last Mile, who is accountable?

11


MERCK Example: Logistics for Praziquantel

  • WHO-Merck Donation Partnership to eliminateSchistosomiasis

THE LAST MILE

CHALLENGE

Yesterday

MoH, NGO…

PZQ MerckSerono

WHO

Today

The Last Mile, who is accountable?

PZQ MerckSerono

12


MERCK Example: Logistics for Praziquantel

  • WHO-Merck Donation Partnership to eliminateSchistosomiasis

THE LAST MILE

CHALLENGE

Yesterday

MoH, NGO…

PZQ MerckSerono

WHO

Today

The Last Mile, who is accountable?

PZQ MerckSerono

Tomorrow ?

Last Mile Alliance Partners (LUMA ?)

13


Sanofi Train the Trainer ProgramInter-UniversityDegreein pharmaceutical supply chain management

  • Objective: improvesupplychain management of medicines and othercommodities for HIV/aids, malaria and tuberculosis

  • Inter-Universitydegreefrom Ouagadougou (Burkina Faso), Auvergne and Lyon (France) Universities

  • Target audience : certifiedpharmacistsworking in sub-Saharan Africa

  • Results (2011-2013): approx. 120 studentsfrom 14 countries


AGENDA

  • Access to Health and Supply Chain Challenges

  • Industry approach

  • Beyond a single company, towards collective action? LUMA


Last United Mile forAfrica (LUMA)

Strengthening Supply Chain: Last United Mile for Africa (LUMA)

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

Supply Chain presentation_ Brussels/ September 2013


Thank you!

Supply Chain presentation_ Brussels/ September 2013


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