An evaluation of supply chain management in the implementation of South Africa’s anti-retro viral programme

Abstract

In 2009, Statistics South Africa estimated that there were approximately 1,6 million people in South Africa who were in need of anti-retroviral therapy. Already aware of the gravity of the situation, Government reaffirmed its commitment to tackling the challenge head-on in March 2007 through its Strategic Plan for dealing with HIV/AIDS between 2007 and 2011. The plan involved free testing and ARV treatment to HIV positive patients who meet certain minimum criteria. As can be expected, the implementation of a programme of this magnitude will face some serious challenges at an operational level and the efficiency of the supply chain would be critical to its success. In that context, the purpose of this research was to examine the impact of the public sector supply chain management framework on the implementation of South Africa’s antiretroviral treatment programme. A number of weaknesses were identified in the framework that governs supply chain management in the public sector and the study set out to investigate (a) to what extent these weaknesses were mirrored in the supply chain management practices of the Department of Health and (b) what impact the supply chain management practices in the Department of Health has on the implementation of South Africa’s ARV treatment programme. Qualitative data was collected from the Medical Supplies Depot, five hospitals, three regional pharmacies and four clinics that covered all the regions in Gauteng province. A total of 15 semi structured interviews were conducted and the data was analysed. The results revealed that the weaknesses that were identified in the public sector supply chain management framework are mirrored closely in the Department of Health’s supply chain management practices. It was also clear from the results that within the Department of Health, supply chain management practices such as making policies in isolation; lack of integration and collaboration across the supply chain; limited use of technology; inaccurate forecasting of ARV demand; inefficient iii staff utilization; and lack of customer service management have a significant negative impact on the implementation of the ARV treatment programme. Based on the outcome of the study, recommendations are made with regards to reviewing and updating the public sector supply chain management framework; taking operational limitations into consideration in policy making; managing supply chain costs; taking a different strategic approach to stock management; making more efficient use of technology; taking a different strategic approach to managing the ARV budget; and taking a different strategic approach to staff utilisation.