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Alessandro de Luca Senior Vice President MERCK Group

Improving Access to Health Supply Chain & Delivery Addressing the Last Mile Challenge. Alessandro de Luca Senior Vice President MERCK Group. AGENDA. Access to Health and Supply Chain Challenges Industry approach Beyond a single company? LUMA.

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Alessandro de Luca Senior Vice President MERCK Group

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  1. Improving Access to Health Supply Chain & Delivery Addressing the Last Mile Challenge Alessandro de Luca Senior Vice President MERCK Group Title of the powerpoint

  2. AGENDA • Access to Health and Supply Chain Challenges • Industry approach • Beyond a single company? LUMA

  3. Many constraintsto global access to quality medicines Barriers to Global Access within the BoP as identified by the WHO Unaffordable Prices • Medicines account for 25% to 70% of overall healthcare expenditure in developing countries compared to less than 15% in most high-income countries because of price levels • Leaves households responsible for the cost of essential medicines, placing the heaviest burden on the poor and sick who are least able to pay Unfair Health Financing • One-third of WHO Member States have either no regulatory authority or only limited capacity to regulate the medicines market • Recent assessments by WHO shows 50% to 90% of samples of anti-malarial drugs failed quality control tests and more than half of ARVs assessed did not meet international standards Poor Quality Medicines Unreliable Supply • Inefficient procurement systems have been found to lead to payments of up to twice the global market price for essential medicines and lead to unnecessary waste of resources Irrational Use • Estimates show that half of all medicines are inappropriately prescribed, dispensed or sold • Only 1% of medicines developed over the past 25 years were for tropical diseases and TB, which together account for >11% of global disease burden • Over 90% of R&D is focused on diseases for the richest 20% Lack of New Medicines Supply Chain presentation_ Brussels/ September 2013

  4. The Supply Chain Objectives To deliver the 3 of them is definitively a challenge in developing countries

  5. Typical Pharma Distribution Channels and… …Distribution Systems

  6. The distribution challenge in Developing Countries: The differences in the regulatory structure and distribution systems of medicines between developing income countries is significant when compared with high income countries . Supply Chain presentation_ Brussels/ September 2013

  7. Number of intermediaries in the channel DEVELOPING COUNTRIES DEVELOPED COUNTRIES Source: ACT Watch

  8. “People will tell you that delivering to Africa is impossible. Please don’t worry because that isn’t true. 8

  9. “People will tell you that delivering to Africa is impossible. Please don’t worry because that isn’t true. We can and will always find a way. But just don’t expect it to be the way you think or are used to in Europe.” Global Logistics Provider, June 2013 9

  10. AGENDA • Access to Health and Supply Chain Challenges • Industry contribution: Some examples • Beyond a single company? LUMA

  11. MERCK Example: Logistics for Praziquantel WHO-Merck Donation Partnership to eliminateSchistosomiasis THE LAST MILE CHALLENGE Yesterday MoH, NGO… PZQ MerckSerono WHO The Last Mile, who is accountable? 11

  12. MERCK Example: Logistics for Praziquantel • WHO-Merck Donation Partnership to eliminateSchistosomiasis THE LAST MILE CHALLENGE Yesterday MoH, NGO… PZQ MerckSerono WHO Today The Last Mile, who is accountable? PZQ MerckSerono 12

  13. MERCK Example: Logistics for Praziquantel • WHO-Merck Donation Partnership to eliminateSchistosomiasis THE LAST MILE CHALLENGE Yesterday MoH, NGO… PZQ MerckSerono WHO Today The Last Mile, who is accountable? PZQ MerckSerono Tomorrow ? Last Mile Alliance Partners (LUMA ?) 13

  14. Sanofi Train the Trainer ProgramInter-UniversityDegreein pharmaceutical supply chain management • Objective: improvesupplychain management of medicines and othercommodities for HIV/aids, malaria and tuberculosis • Inter-Universitydegreefrom Ouagadougou (Burkina Faso), Auvergne and Lyon (France) Universities • Target audience : certifiedpharmacistsworking in sub-Saharan Africa • Results (2011-2013): approx. 120 studentsfrom 14 countries

  15. AGENDA • Access to Health and Supply Chain Challenges • Industry approach • Beyond a single company, towards collective action? LUMA

  16. Last United Mile forAfrica (LUMA) Strengthening Supply Chain: Last United Mile for Africa (LUMA) LUMA is a partnership currently under development to strengthen the supply chain in Africa. The goal of the alliance is to: expand access, secure supply, improve health and support development Supply Chain presentation_ Brussels/ September 2013

  17. Thank you! Supply Chain presentation_ Brussels/ September 2013

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