Harvard Case - Sms For Life (A): A Public-Private Collaboration To Prevent Stock-Outs Of Life Saving Marlaria Drugs In Africa
"Sms For Life (A): A Public-Private Collaboration To Prevent Stock-Outs Of Life Saving Marlaria Drugs In Africa" Harvard business case study is written by Donald A. Marchand, Anna Moncef. It deals with the challenges in the field of General Management. The case study is 20 page(s) long and it was first published on : Aug 30, 2010
At Fern Fort University, we recommend a multi-pronged approach to address the stock-out issue of life-saving malaria drugs in Africa. This strategy focuses on strengthening the existing public-private partnership (PPP) between SMS for Life and the Ministry of Health, leveraging technology and data analytics, and fostering a sustainable, long-term solution.
2. Background
This case study examines the challenges faced by the Ministry of Health in Tanzania in ensuring consistent availability of malaria drugs, particularly in remote areas. The Ministry, in collaboration with the non-profit organization SMS for Life, implemented a system using SMS technology to monitor drug stock levels and trigger timely replenishment. While the system showed initial success, challenges remain in terms of scalability, sustainability, and integration with existing healthcare infrastructure.
The main protagonists are the Ministry of Health, SMS for Life, and the healthcare providers in Tanzania. The case highlights the critical need for effective collaboration between public and private entities to address complex healthcare issues in developing countries.
3. Analysis of the Case Study
Strategic Framework: This case study can be analyzed through the lens of Porter's Five Forces framework, focusing on the competitive landscape of the healthcare industry in Tanzania.
- Threat of New Entrants: The entry barrier for new players in the pharmaceutical sector is high due to regulatory hurdles, capital requirements, and the need for specialized expertise. However, the emergence of generic drug manufacturers and potential for disruptive innovation in drug delivery systems could pose a threat.
- Bargaining Power of Buyers: The Ministry of Health, as the primary buyer of malaria drugs, holds significant bargaining power. However, the need for consistent supply and the limited availability of alternatives limit their leverage.
- Bargaining Power of Suppliers: The bargaining power of drug suppliers is moderate, influenced by the availability of alternatives and the scale of demand.
- Threat of Substitute Products: The threat of substitute products is limited, as there are few effective alternatives to artemisinin-based combination therapies (ACTs) for malaria treatment.
- Rivalry Among Existing Competitors: Competition among existing drug manufacturers is intense, driven by price pressure, quality considerations, and the need to secure market share.
Key Challenges:
- Scalability: The SMS system needs to be scaled to cover all healthcare facilities in Tanzania, requiring significant investment in infrastructure and personnel.
- Sustainability: The long-term financial sustainability of the program needs to be ensured, considering the limited resources of the Ministry of Health and the need for ongoing maintenance and upgrades.
- Integration: The SMS system needs to be seamlessly integrated with existing healthcare information systems, ensuring data accuracy and efficient communication.
- Data Analytics: The potential of the collected data for improving drug procurement, distribution, and patient management needs to be realized through robust data analytics capabilities.
4. Recommendations
1. Strengthen the Public-Private Partnership:
- Formalize the partnership: Establish a clear legal framework for the PPP, defining roles, responsibilities, and financial contributions of both parties.
- Joint governance structure: Create a joint steering committee with representation from the Ministry of Health, SMS for Life, and other relevant stakeholders to oversee the program's implementation and decision-making.
- Capacity building: Invest in training and capacity building for Ministry of Health staff to manage the SMS system effectively and leverage data analytics for informed decision-making.
2. Leverage Technology and Data Analytics:
- Enhance the SMS platform: Upgrade the SMS platform to incorporate features like automated drug ordering, real-time stock tracking, and data visualization dashboards.
- Integrate with existing systems: Connect the SMS system with existing healthcare information systems, such as the National Health Management Information System (NHMIS), to ensure data consistency and facilitate data-driven decision-making.
- Develop data analytics capabilities: Invest in data analytics expertise to analyze the collected data to identify patterns, predict demand, optimize drug procurement, and improve patient care.
3. Foster Sustainability:
- Explore alternative funding sources: Seek funding from international organizations, private foundations, and corporate social responsibility initiatives to ensure long-term financial sustainability.
- Develop a cost-recovery model: Consider implementing a cost-recovery model for drug procurement, where a portion of the drug costs is recovered from patients or insurance providers, contributing to the program's sustainability.
- Promote local manufacturing: Explore opportunities to promote local manufacturing of malaria drugs, reducing reliance on imports and creating local employment opportunities.
5. Basis of Recommendations
These recommendations are based on the following considerations:
- Core competencies and consistency with mission: The recommendations align with the Ministry of Health's mission to improve healthcare access and quality in Tanzania. The partnership with SMS for Life leverages their expertise in technology and data analytics, complementing the Ministry's strengths in healthcare delivery.
- External customers and internal clients: The recommendations aim to improve the experience of both external customers (patients) and internal clients (healthcare providers) by ensuring timely access to essential medicines.
- Competitors: The recommendations focus on improving the efficiency and effectiveness of the existing system, creating a competitive advantage in terms of drug availability and patient care.
- Attractiveness ' quantitative measures if applicable: While quantifying the benefits of improved drug availability is challenging, the recommendations are expected to lead to increased patient satisfaction, reduced mortality rates, and improved resource allocation.
6. Conclusion
By strengthening the public-private partnership, leveraging technology and data analytics, and fostering sustainability, SMS for Life can evolve into a robust and scalable solution for preventing stock-outs of life-saving malaria drugs in Tanzania. This approach not only addresses the immediate challenge of drug availability but also lays the foundation for a more efficient and effective healthcare system in the country.
7. Discussion
Alternative Options:
- Focusing solely on the Ministry of Health: This option would require significant investment in infrastructure, technology, and training, potentially straining the Ministry's limited resources.
- Reliance on private sector: This option could lead to unequal access to essential medicines, as private providers may prioritize profitability over public health needs.
Risks and Key Assumptions:
- Political instability: Political instability in Tanzania could hinder the implementation and sustainability of the program.
- Data security and privacy: Ensuring data security and patient privacy is crucial, requiring robust data management protocols and compliance with relevant regulations.
- Technological advancements: The rapid pace of technological advancements requires continuous adaptation and investment in upgrading the SMS platform and data analytics capabilities.
8. Next Steps
- Establish a joint steering committee: Within the next three months, establish a joint steering committee with representation from the Ministry of Health, SMS for Life, and other relevant stakeholders.
- Develop a comprehensive implementation plan: Within six months, develop a detailed implementation plan outlining specific actions, timelines, and resource requirements.
- Pilot the upgraded SMS system: Within nine months, pilot the upgraded SMS system in a select group of healthcare facilities to test its functionality and gather feedback.
- Secure funding for sustainability: Within twelve months, secure funding from international organizations, private foundations, and corporate social responsibility initiatives to ensure the long-term financial sustainability of the program.
By taking these steps, the Ministry of Health and SMS for Life can create a sustainable and impactful solution for preventing stock-outs of life-saving malaria drugs in Tanzania, contributing to the overall health and well-being of the population.
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Case Description
Drugs to cure the disease exist, however they don't reach the demand where it occurs and stock-outs of drugs to treat malaria cost lives. Jim Barrington, former chief information officer (CIO) at Novartis and current director of the SMS for Life project, had been trying to solve the problem since 2006, when he first heard about the "last mile" problem from Silvio Gabriel, executive vice president (EVP), Novartis Malaria Initiatives. The case talks about how he approached the supply-chain problem and established a public-private partnership to develop a simple solution suitable for the rugged African environment. The essential idea was to create an in-county forecasting system based on the use of SMS messaging between the health posts that dispense the drugs and the district and regional warehouses that distribute the drug. A data management system with a reporting interface using charts provided stock level information from all facilities to facilitate stock movement and supply, as well as improving stock forecasting and planning. The case describes the process of developing and implementing the solution through a pilot in three districts in Tanzania. The pilot was successful and the case ends with the question how to approach a country-wide and even a pan-African roll-out. Learning objectives: There are three learning objectives, and ways to teach the case: 1) To discuss a new, collaborative way, involving private and public companies (and contrast it other available approaches), to solve world-wide problems, which demand solutions beyond the capabilities and responsibilities of single players. 2) How simple technology, e.g. based on available mobile phone networks, can solve supply chain problems in most difficult environments. 3) How external collaborations can bring innovation into well established multinational players, and have a potential impact on their business model.
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