The world faces a once in a 100-year pandemic that has changed every aspect of our lives. As we all adapt to our new existence during the Covid-19 outbreak, I felt inspired to help my community in Washington State. For most of the last 20 years, I have traveled and managed teams across the world working on public health supply chains. My employer, the Bill and Melinda Gates Foundation, allowed me to volunteer to support the team in Washington State managing their Covid-19 response. That dedicated team consisted of a mix of professionals who have worked on many prior emergency situations we have faced previously in the Pacific Northwest.
Volunteering with Restart Partners, I see parallels between the challenges of the pandemic and my previous international work. Public health supply chain managers in states, cities and counties across the U.S. are facing multiple challenges in determining how much PPE and other supplies to procure.
Tough questions during difficult times
How much PPE should I order for workers on the front line? How is demand for PPE changing as the number of COVID-19 cases increases in my community? Given changes in the types of interactions between local government staff and the public, what types of PPE should I order for those who may interact with the public as the economy opens? Given supply uncertainties and delays, how long until I get my order fulfilled? What is the likelihood of it not being fulfilled in full? With innovation and rapid research on therapeutics, diagnostics and vaccines, what if we procure a product that shows promise in initial trials but is then not approved for use?
Unfortunately, the fragmentation of the U.S. healthcare supply chain contributes to a lack of visibility and coordination. It creates something supply chain managers are familiar with, called the bullwhip effect, where initial demand signals are amplified as they move further from the consumer, exacerbating shortages and overstocks.
Helping supply chain managers
Restart Partners is helping supply chain managers address these issues through its data modeling work. Building on the work done for Washington State, and previous work globally by the World Health Organization (WHO) and the Clinton Health Access Initiative (CHAI) we are creating a suite of modules that link epidemiological models with supply chain models, with population and social data and eventually behavioral models. The challenge is how to respond to the demand we are getting from multiple jurisdictions.
Sharing resources, best practices
During my career, I have worked with thousands of dedicated professionals addressing supply chain constraints that complicate the ability for medicines and equipment to reach populations in need. My work has taken me to Europe, Africa, Latin America and Asia, where I often was working with professionals to address some of the same challenges of meeting uncertain demand with constrained supply. What if that same community of professionals could be mobilized to support the state, city and county officials in the U.S. managing their local COVID-19 response?
Restart Partners is working with smart people in the states of Washington and Utah who are grappling with similar problems. Rather than each individual and team reinventing the wheel by repeating the learning and innovation of others, what if they could have access to work that had been done and build on that? What if the open source models that the Restart Partners team is building could be made available to and amplified to a larger established community?
Launching new U.S. chapter of IAPHL
While the U.S. health system is not used to addressing infectious disease outbreaks, there is a community of supply chain practitioners around the world that has been working on these issues over many years. The International Association of Public Health Logisticians (IAPHL) formed in 2007, has 8,000+ members from 150 countries including 600 in the U.S. As a free peer-to-peer support organization it was established to help logisticians in low resource settings address these types of problems. Might a U.S. Chapter provide support to domestic logisticians in the same way as IAPHL does across the world?
To test this hypothesis, we kicked off an inaugural meeting of the IAPHL’s U.S. chapter with a conference call of 22 people. Prashant from the Center for Global Development and INSEAD stressed the importance of the chapter to provide practical advice to officials working in local jurisdictions. Kathy from the American Logistics Aid Network (ALAN) introduced us to Nicollete at Healthcare Ready, set up after Hurricane Katrina to support the health care sector address humanitarian emergencies. Taylor from the Mitre Corporation is developing their modeling work for the hospital sector and has produced some powerful tools and analysis. In connecting with several IAPHL colleagues from organizations like John Snow Inc., VillageReach, Lynden and the University of Michigan, it became obvious that the interest and appetite for collaboration was there.
Shortly after the first meeting, we connected several members with a local logistician managing her PPE stockpile for city workers. We are currently reviewing her approach and offering advice and insights as a volunteer brain trust. We are boosting her work by connecting her to a community of thousands facing similar challenges across the US and around the world.