Over the past two decades, investments in national health programs through global health initiatives such as the Global Fund, Stop TB, Roll Back Malaria, and GAVI have increased exponentially. This increase in financial resources has enabled the mobilization of key medical and pharmaceutical inputs (drugs, vaccines, and biologics), but has highlighted new challenges related to the implementation capacity by developing countries’ health systems. One of the most pressing issues for the implementation and efficiency of new health programs and services concerns the management of the health commodity supply chain (HCSC), sometimes called the health supply chain.

In 2005, in the report “Health and the Millennium Development Goals”, the World Health Organization highlighted the problem: “Most diseases can now be prevented or cured using known and inexpensive techniques. The problem lies elsewhere: we must succeed in providing personnel, medicines, vaccines and information to those who need them, at the right time, in sufficient quantities, reliably and sustainably, and at an acceptable cost. However, despite this awareness of the importance of an efficient logistical system, the HCSC of countries, particularly in Africa, have very quickly shown their limits. Indeed, under the pressure created by the increased availability of inputs to fight HIV-AIDS, malaria, tuberculosis and other vaccine-preventable diseases, traditional ad hoc adaptation measures, such as increasing storage capacity or transport frequency, have proven insufficient to meet the new challenges posed by the current changing environment.

In addition, support for disease-specific health programs is essentially limited to supplies and does not take into account other components that affect the overall performance of the HFA: maintenance and disposal of medical and technical equipment, infrastructure and health facilities, biomedical waste management, etc..

With regard to the EPI in particular, successive evaluations of effective vaccine management (EVM) show that serious shortcomings persist in the management of the HCSC despite the improvement plans that have been developed and implemented. The financing provided by the governments and their technical and financial partners (TFPs), particularly GAVI, seems to bear more fruit in areas related to infrastructure and equipment and less in cross-cutting areas such as maintenance and supervision. On the other hand, this support has not given rise to any tangible prospects for the development and management of the human resources necessary for the optimal functioning of the logistics system in the long term, particularly at the level of the health districts (middle management).

Improving the efficiency of health systems and their ability to manage the ever-increasing number of new, larger, and more expensive inputs therefore requires effective management of CAPS, coordinated from the central to the peripheral level by professionals. With this in mind, a number of African health logistics specialists have come together in an institution called The Balanzan Institute (TBI) to support HCSC management in countries in Africa and beyond..