USAID'S Global Health Supply Chain Would Benefit From More Rigorous Risk Management and Actions To Enhance Local Ownership

USAID’s Global Health Supply Chain Program delivers medicines and other healthcare commodities to help save lives around the world. In countries that do not have the systems in place to appropriately safeguard and deliver the commodities needed, effective management of the in-country components of this program is critical. USAID missions we reviewed took some steps to identify country-level supply chain risks, using country-specific tools and various external assessments to identify weaknesses. However, USAID’s risk identification efforts related to its supply chain investments were siloed by country without a coordinated or systematic effort to look across missions for broader risk patterns, limiting the Agency’s ability to proactively address them. Selected activities at the missions we reviewed mostly aligned with good practices we identified from industry standards for addressing the four root causes of supply chain weaknesses. However, in three of the four missions we visited, USAID undertook risk mitigation measures—such as completing work on behalf of government officials, or using parallel supply chains—that can delay countries’ transition to self-reliance. We made, and the Agency agreed with, two recommendations to the Bureau for Global Health to strengthen USAID’s management of supply chain risks worldwide and to increase the capability of host governments to manage health commodity supply chains with reduced donor support in the missions we reviewed.