Understanding Challenges in HIV and Malaria Supply Chains in Lao People's Democratic Republic

Lao People's Democratic Republic (Laos) faces a unique set of supply chain challenges for HIV and malaria control. Although the HIV and malaria prevalence rates are relatively low, the country has struggled to maintain an adequate supply of HIV and malaria commodities throughout the country, resulting in delays or stock outs of key commodities for both diseases. Supply chains in developing countries are often strained and weak, but creating sustainable procurement and supply chain management (PSM) processes is vital to the overall success of a county's health system. Poor PSM practices are reflective of and reinforced by a weak health system, and Laos, like other low-income countries, is confronting many PSM challenges. The Global Fund to Fight AIDS, Tuberculosis, and Malaria heavily supports both the HIV and malaria programs in Laos and is now placing increased emphasis on improving PSM processes in grant recipient countries. Research on supply chains in developing countries is scarce and in-depth, country-level analysis of challenges and barriers to successful PSM is essential to improving the long-term sustainability of health systems. The aim of this research is to improve supply chain management for HIV and malaria control programs. The specific objectives are:

1. To identify barriers and bottlenecks through a situation analysis of Laos' supply chains for national HIV/AIDS and malaria control programs.

2. To analyze factors affecting HIV/AIDS and malaria supply chains in Laos.

3. To suggest policy recommendations for the WHO, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Lao Ministry of Health, and other institutional or organizational stakeholders for improved supply chain management and function.

Qualitative research was conducted in Vientiane Capital and Savannakhet Province in May-July 2012 and included 41 key-informant interviews, document review, and informal observations. Data collection and analysis were primarily guided by the USAID

DELIVER integrated supply chains framework, as well as WHO frameworks on health information.

The research findings show four main thematic areas of barriers to successful PSM activities in Laos: data collection and reporting of PSM information, management and leadership of PSM activities, procurement processes, and human resources and capacity with the PSM system. Based on these findings, policy recommendations have been drawn for Laos' Ministry of Health and other key stakeholders to address these issues and challenges.