“Health supply chain personnel: an integral part of the health workforce.”

Approximately a third of the world population – and about half in the most underdeveloped settings – have been estimated to lack access to essential medicines and diagnostics [1]. Effective supply chains are vital to deliver essential health commodities. In high-income countries the availability of medicines in the public and private sector is taken as a given: quality assurance is managed by robust national regulatory agencies; supply and distribution are increasingly privatized, with performance measured against timeliness and cost. Conversely, in many lowand middle-income countries, stock-outs of essential commodities are commonplace, with a mean availability of core medicines in the public sector ranging from 38.2% in sub-Saharan Africa to 57.7 % in Latin America and the Caribbean [2]. Vulnerability of supply chain functions also increases the potential for the entry of counterfeit and substandard products [3]. While availability of medicines is determined by multiple factors, there is a growing recognition of the need to address human resources requirements for supply chain systems [4]. A systematic review of the global pharmacy workforce revealed a dearth of evidence from lowand middleincome countries [5] . It also underscored several challenges, including inadequate numbers of pharmacists and pharmacy support workforce cadres, issues of maldistribution (across public and private sectors, and urban and rural areas), uneven implementation of education, staff management and retention strategies. Further, this study did not find evidence on the broader range of health logisticians and supply chain managers. Other analyses focused on lowand middle-income settings have highlighted dramatic supply chain workforce shortages, with some countries facing vacancy rates up to 71% for public sector posts that would require accredited pharmaceutical training [6]. This situation is often determined by a combination of insufficient training capacity as well as 100-150% higher wages in the private sector as compared to the public sector. Some of these problems reflect those affecting human resources for health more broadly. A cross-country analysis of the health workforce conducted in 2013 showed that multi-pronged strategies are required to improve forecasting, planning, education, deployment, retention and performance management of human resources for health [7]. Only by addressing these factors in an integrated manner, will it be possible for health systems to improve availability, accessibility, acceptability and quality of the human resources. This is a requirement to accelerate progress towards attaining universal health coverage. Better health workforce intelligence and data can shape more effective planning, implementation and monitoring of such policies. A stronger evidence base on quantities, geographic distribution, competency frameworks, as well as the labour market conditions that determine the availability and performance of the health supply chain personnel, would similarly be required. A more effective response to health supply chain workforce challenges therefore requires comprehensive and reliable data on availability, distribution, education curricula, competency frameworks, levels of remuneration, regulatory environment and supporting systems. Dedicated tools exist for assessment of operational and technical capacity in public health supply chain personnel [8], and related analyses have been conducted in some contexts [9,10]. There are also good governance initiatives focusing on legislation, transparency and integrity to reduce corruption and advance the professionalization of the supply chain profession [11]. Both these aspects are important, * Correspondence: [email protected] Global Health Workforce Alliance, World Health Organization, Geneva, Switzerland Full list of author information is available at the end of the article Cometto et al. Journal of Pharmaceutical Policy and Practice 2014, 7(Suppl 1):I1 http://www.joppp.org/content/7/S1/I1