An evaluation of supply chain management in the implementation of South Africa’s anti-retro viral programme

In 2009, Statistics South Africa estimated that there were approximately 1,6million people in South Africa who were in need of anti-retroviral therapy. Alreadyaware of the gravity of the situation, Government reaffirmed its commitment totackling the challenge head-on in March 2007 through its Strategic Plan fordealing with HIV/AIDS between 2007 and 2011. The plan involved free testingand ARV treatment to HIV positive patients who meet certain minimum criteria.As can be expected, the implementation of a programme of this magnitude willface some serious challenges at an operational level and the efficiency of thesupply chain would be critical to its success. In that context, the purpose of thisresearch was to examine the impact of the public sector supply chainmanagement framework on the implementation of South Africa’s antiretroviraltreatment programme.A number of weaknesses were identified in the framework that governs supplychain management in the public sector and the study set out to investigate (a) towhat extent these weaknesses were mirrored in the supply chain managementpractices of the Department of Health and (b) what impact the supply chainmanagement practices in the Department of Health has on the implementation ofSouth Africa’s ARV treatment programme.Qualitative data was collected from the Medical Supplies Depot, five hospitals,three regional pharmacies and four clinics that covered all the regions in Gautengprovince. A total of 15 semi structured interviews were conducted and the datawas analysed.The results revealed that the weaknesses that were identified in the public sectorsupply chain management framework are mirrored closely in the Department ofHealth’s supply chain management practices. It was also clear from the resultsthat within the Department of Health, supply chain management practices such asmaking policies in isolation; lack of integration and collaboration across the supplychain; limited use of technology; inaccurate forecasting of ARV demand; inefficientiiistaff utilization; and lack of customer service management have a significantnegative impact on the implementation of the ARV treatment programme.Based on the outcome of the study, recommendations are made with regards toreviewing and updating the public sector supply chain management framework;taking operational limitations into consideration in policy making; managing supplychain costs; taking a different strategic approach to stock management; makingmore efficient use of technology; taking a different strategic approach to managingthe ARV budget; and taking a different strategic approach to staff utilisation.