Amid growing concerns about a Covid-19 third wave in South Africa, The Professional Body for Supply Chain Management in Southern Africa (Sapics) has highlighted the logistics and supply chain management issues that must be addressed to ensure that lives can be saved with a sustainable supply of medical oxygen.
According to the World Health Organisation (WHO), affordable and sustainable access to oxygen has been a growing challenge in low- and middle-income countries (LMICs) since the start of the pandemic.
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"Covid-19 has put huge pressure on health systems, with hospitals in many LMICs running out of oxygen, resulting in preventable deaths and families of hospitalised patients paying a premium for scarce oxygen supplies," the WHO reported.
"Oxygen is an essential medicine, and despite being vital for the effective treatment of hospitalised Covid-19 patients, access in LMICs is limited due to cost, infrastructure and logistical barriers. Health facilities often cannot access the oxygen they require, resulting in the unnecessary loss of lives."
"In July last year, patients in Eastern Cape hospitals were reportedly fighting over oxygen. The short supply of medical oxygen is currently claiming lives in India, as the second wave of the Covid-19 pandemic continues to overwhelm the country’s healthcare system. We need to ensure a secure, sustainable supply of medical oxygen in South Africa," comments Keabetswe Mpane, Sapics president.
Supply management issues
Reports that seven Covid-19 patients died at an Indian hospital because the driver of an oxygen tanker scheduled to deliver to the facility got lost highlight problems that go beyond simply increasing the capacity of oxygen plants, Mpane stresses. "This crisis is not just due to supply constraints, but to logistics and supply chain management issues.
"Medical oxygen is considered a hazardous material to transport. Specialised vehicles and specially trained drivers are required to transport medical oxygen. Many hospitals in South Africa rely on oxygen cylinders rather than on-site storage tanks. Cylinder deliveries are a logistical issue. Empty cylinders must be collected timeously to be refilled.
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"Hospital and clinic staff need to understand this process. They need supply chain management skills and knowledge to ensure that they understand things like demand planning, turnaround times, and reverse logistics, to ensure an uninterrupted supply of oxygen. This is a complex supply chain that lives are depending on."
Collaboration is key
According to Sapics the robust, reliable supply chains that are essential for positive health outcomes – including medical oxygen supply chains - require a skilled, knowledgeable and connected supply chain workforce. "This applies to everything from essential medicines, medical oxygen and diagnostic supplies to commodities for family planning, immunisation and to treat diseases like malaria and tuberculosis," says Mpane.
"The health commodities supply chain, particularly in the public sector in Africa, has traditionally been managed and operated by healthcare professionals with an intuitive understanding of supply chain operations, but often without the relevant supply chain training or qualifications. There is a need to increase the capabilities and skills of the existing supply chain resources while creating awareness and an environment that will attract appropriately skilled supply chain professionals.
"There is also an imperative to ensure that effective collaboration takes place between private and public healthcare and other involved role players. In this way, we can improve health outcomes in South Africa and across the continent."