From Port to Districts: Uganda Streamlines Supply Chain for Neglected Tropical Diseases

02 May 2024

Representatives from USAID and RTI International visit with representatives from Uganda’s National Medical Stores to discuss the supply chain for NTD medicines.

The journey of delivering medicines for neglected tropical disease (NTD) to the people who need them might sound simple at first glance, but it takes significant coordination and planning at each step along the way. From receiving clearance for importation to being transported to district warehouses to reaching the hands of community drug distributors (CDDs), there are many steps to ensure treatments reach those who need it. In Uganda, the management of NTD medicines outside of the national supply chain system has been a major hurdle, and largely reliant on support from donors and external partners.

Recently, the Government of Uganda, with support from USAID’s Act to End NTDs | East program, integrated NTD medicines and supplies into the national supply chain, paving the way for more effective and efficient processes for the delivery of NTD services around the country. This new approach promises greater visibility, swifter delivery, and improved accountability – all crucial factors in ensuring NTD treatments reach those who need them most.

Prior to these supply chain transitions, Uganda’s Ministry of Health (MOH) lacked data on NTD medicines, hindering management and tracking of NTD commodities effectively. Without strong national ownership, shipments of NTD medicines often faced lengthy clearance processes – leading to delays and extra fees – and inefficient last mile delivery systems. While essential medicines were transported to districts as part of a package of health services, NTD medicines had been delivered through a parallel system, funded and tracked by external partners.

To begin overhauling the NTD medicine supply chain, the Act | East program provided technical and financial support to initiate discussions and strengthen collaboration between Uganda’s NTD Division, the Department of Pharmaceuticals and Natural Medicines (DPNM), the National Drug Authority (NDA), the National Medical Stores (NMS), and USAID/Uganda. Together, these stakeholders developed a plan to streamline the supply chain for NTD medicines, strengthen working relationships, and discuss the sustainability of Uganda’s NTD supply chain structure. These collaborations were transformative for knowledge sharing among the different departments, impacting initial quantification of annual drug need to peripheral-level drug delivery and stock management.

The new approach integrates NTD treatments seamlessly into the existing government supply chain. The NDA approves and provides clearance to medicines, while the MOH utilizes the NMS for storage and transportation. Meanwhile, DPNM collaborates with the Division of Vector-borne and Neglected Tropical Diseases to improve tracking and forecasting of NTD drugs.

Currently, there is no electronic tracking system being used by NMS for reporting unused NTD drug quantities following annual mass drug administration campaigns. However, they are working to integrate a process for the return and storage of leftover medicines, which will allow better planning. The newly established communications channels between all the relevant stakeholders are a huge achievement and are pivotal to these next steps.

This process has yielded valuable insights. Collaboration between different government sectors, facilitated by the Act | East program, proved crucial. In addition to the supply chain improvements, these discussions led to the inclusion of NTDs in national clinical guidelines, opening the door for future government procurement of these medicines.

The streamlined approach offers a more transparent, efficient, and accountable system for distributing NTD treatments in Uganda, with the Ministry of Health in the lead.