Procurement, Health and The Last Mile

Key Insights from the HLA conference – Brussels 16 – 17 November 2022

It was my privilege to chair three panel sessions at the Humanitarian Logistics Association conference track at the Aidex2022 exhibition and conference. The themes that were explored by speakers covered Procurement, Health and Last Mile.

In the real world of aid, development and disaster relief, these themes overlap considerably as illustrated below; a core conclusion was that all the experts’ experience and perspectives exist in a wider ecosystem with significant organisational and business model dependencies.

The second insight from the discussion is that the sector has increasingly exciting opportunities from technology that are opening up. The complexity and scale of the sector is the challenge that lies behind making change and leveraging better outcomes.

Sustainable procurement with an increasing local content was a recurring theme across all the sessions. Claire Barnhoorn of Solvoz pointed to the opportunity to widen access to accredited suppliers through the Solvoz platform; she stressed the importance of making specifications relevant and accessible and understanding the end-to-end cost of acquisition and deployment. The complexity of the sector brings difficulties in such cost accounting. It became clear that this is not enabled by funders reporting requirements as well as gaps in expertise across the sector. Kuldeep Bandhu Aryal of Field Ready and BRAC told the story of developing the local supply of buckets in Bangladesh. The idea of moving the moulds and not the finished product to save last mile costs was a critical insight as was the importance of a generalist specification across agencies. This echoed Claire’s point.

Scott Dubin of the Global Health Fund talked of the importance of outsourcing logistics correctly to get the maximum the value from such relationships. Again the importance of getting the right specification and appropriate costing for the capacity commitment was tightly aligned with Claire’s experience at Solvoz, and the potential for innovative supply chain networks as described by Kuldeep. The diversity and fragmentation of the sector is a significant barrier to major change but it did seem to me that there is potential for what are often called 4PL (fourth party logistics) services; this could introduce platform collaboration and more advanced cost management in both primary logistics and the last mile; a point echoed by Frank van Gelder in his talk on the technology panel.

Dr Rudi Pauwels introduced the mobile test lab developed by the Praesens Foundation – taking the testing to the area, particularly in pandemics and for endemic illness. It avoids the dependency on transport for test samples and the movement of people. It seemed to have close parallels to Kuldeep’s solution of moving the moulds and not the buckets. He made the point that the Foundation has a stock of these specially fitted vehicles ready to go to difficult places – an amazing resource and humanitarian contribution.

The particular challenges of supporting vulnerable communities in health and last mile contexts were emphasised by Judi Heichelheim of Chemonics and Andrew Parkes of Relief International. In all such cases the constraints on capacity and freedom to operate collide with the specifics of the situation such as scale, access, needs and inequalities. It seemed to me from their powerful insights that collaborative situational definitions should be widely agreed and response protocols prepared; this would provide focus through such difficult situations. The risks seem to be in making such approaches too complex alongside limited collaborative ‘good practice’ in the sector. The spectrum of vulnerability and situational needs was made truly evident through their contribution.

This prioritisation and focus is perhaps the toughest challenge for the entire sector. No support given should be disrespected, neither will that support be irrelevant; but the implications for the maximising the ‘good’ create choices that have not historically been worked through.

The final panel of the conference looked at technologies with the potential to transform the performance of the sector. In preparing my reflections on this I have cross referred to the Solvoz platform. There were two themes: (1) ICT platforms and Apps  (2) Drones / UAVs.

All of these developments are exploiting the now ubiquitous low cost availability of ICT including in developing countries. The proportion of people with a handheld device continues to rise across the world and access to 3G and 4G signals as well as Wi-Fi has likely reached critical mass, albeit that in difficult and vulnerable places bandwidth and capacity may be limited.

The question was the extent to which technology can enable better outcomes for people and improved costs of its provision. In introducing the topic I tried to stress that gains in processing and access simply enable new business models which can transform operations. The evolution of those new models, when they really work, usually involves 2 or 3 features that combine to be the secret sauce. I used the diagram to illustrate this: adapted from my book.

On the software platforms (1) we heard from:

  • Solvoz – Claire Barnhoorn explained that Solvoz enables local procurement by providing access to 300,000 suppliers across the full range of categories. It also provides good practice guidance on specification and contracting. The business model does not take a margin on supply and covers its costs through subscription from buyers.
  • ESUPS – Florent Chane and Jason Acimovic introduced ESUPS which helps agencies with optimised pre-positioning of inventory and gives cross agency stock visibility and sharing. One of the exciting insights was the ability to forecast the scale and nature of disasters and aid needs – even if the timing is more difficult. The idea of making that ‘pool’ of stock visible to all in terms of items and locations across agencies is a truly collaborative opportunity.
  • Trellyz and RefAid – Shelley Taylor introduced her two complementary apps which enable real time demand and supply matching across logistics, public authorities, humanitarian and emergency situations. This is a non-hierarchical and open architecture solution that enables many-to-many relationships between the agents/actors in the network.
  • International Medical Corps – Marin Thomas and Dr Yazeed Ayasra introduced their PIMS solution (Pharmaceutical Information Management System) which provides medical practitioners in development and disaster situations with fully compliant patient and pharmaceutical admin support. The requirements of medical systems are very special: batch control, right medication, right application etc. It was inspiring to learn that the aggregated data had provided advance warning of a serious outbreak of disease and enabled appropriate actions to be taken.

It quickly became clear that these platforms have the potential to complement rather than compete and that there were opportunities for parallel application in the same setting as well as interoperability. It will be the challenge of field operations to configure how they may be able to leverage the potential – collaboration and process skills will be part of that business model innovation.

Drones was the second focus (2). The experience of the Ukraine war has served to emphasise the potential of drones in a whole range of less humanitarian situations but the parallels of surveillance and delivery are universal.

Professor Muhammad Azmat from Aston University introduced the idea of autonomous drone swarms to put capacity on the ground quickly with limited needs for controllers and much reduced risk vs other methods. He made the point that so much airdropped aid is damaged and unusable where in contrast a swarm of drones could overcome that difficulty and be manageable from a control point of view. Clearly, there is more to do here, but the opportunity is exciting.

Finally, Frank van Gelder talked about the integrated pharmaceutical response in the pandemic that he organised with the EU through The last mile achievement, getting vaccines into difficult places, relied on drones to deliver packs of vaccines in temperature compliant conditions in the harshest of environments. 10 years ago it would have been impossible to envisage such an initiative for the last mile, let alone the end-to-end supply chain coordination.

The event was inspirational, and the opportunities seem to be limitless. There was widespread agreement that the pandemic has changed attitudes and outlooks. It is time to invest in collaboration and end-to-end decision-making skills to accelerate achievement using known solutions.

Thank you HLA and Aidex for the invitation. Alan Braithwaite, Chair of the Disasters Group at Catalyst2030