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Issue 3 2019 - Freight Business Journal


///PHARMA


Logistics remedies for an uncertain world Like the medical profession itself, the freight industry has to be ready for anything, moving anything from a small box of pills to a complete clinic in a box.


Imperial gives Africans hope for the future


For the millions of people in developing countries, cost-eff ective, reliable, secure and sustainable supply chains can save their lives, says medical supply chain pioneers, Imperial Logistics


Many African countries are experiencing impressive economic growth, but along with this comes increased pressure on the supply chain,


creating


challenging business conditions and diffi culty in matching supply with demand, particularly in healthcare. A surge in medicines and


clinical products moving through public health facilities puts strain on existing infrastructure and aff ects supply chain effi ciency. For patients, the very real consequences of shortages and stock-outs


mean dangerous


breaks in treatment. For the public health system, it means funds wasted on emergency orders and rush fees, as well as high freight costs. In addition, improper medicine storage compounds the problem, with products already delivered becoming non-viable for patient use. From warehousing to clinics,


surgical units to laboratories, unique solutions are required to overcome the challenges experienced by ministries of


Solutions-in-a-Box


Imperial Logistics company Resolve Solution Partners has developed a unique answer to these supply chain challenges in Africa. Dubbed ‘In-a-Box’ solutions, these modular infrastructure designs enable the rapid commission and installation of prefabricated warehouses, clinics, laboratories, and storage units with all the components required to deliver a pharmaceutical- compliant,


validated, total


solution, packed and ready for delivery in 40ſt containers. While the challenges of moving in


freight Africa should never


be underestimated, the fact that all components are packed in containers means that they can be transportable by road relatively easily. Imperial Logistics’ healthcare executive vice president Dr Iain


Just what the doctor


ordered: new healthcare head for Imperial Logistics


Imperial Logistics has appointed Dr Iain Barton to the new position of executive vice president – healthcare. He is currently Imperial Logistics’ healthcare strategy executive based in Cape Town in South Africa. His appointment forms part


of a strategy to create sector- specifi c business development posts and he will be responsible for identifying and exploiting healthcare opportunities both within Imperial Logistics’


existing geographic structure, and in new markets. Barton is a medical doctor


with 10 years’ clinical practice experience followed by 22 years in developing and implementing best practice supply chains for major healthcare organisations. During that time, he has led the supply chain support of the US government’s PEPFAR (The US President’s Emergency Plan for AIDS Relief), and The Global Fund’s (The Global Fund to Fight AIDS, Tuberculosis and Malaria)


health, aid organisations and other healthcare providers, if they are to bring healthcare to the remotest areas.


Barton confi rms: “One of the major challenges


is non-compliant


infrastructure, especially infrastructure that is pharma- compliant.” Access to power, water and sewerage can all be diffi cult, he says. Developed with Africa in mind,


Resolve’s solutions address the oſt en chronic lack of supply chain infrastructure, limited storage space and lack of quality warehousing facilities, as well as the need for health posts in remote areas. Suitable for both urban and rural settings, the standards and operational benchmarks are aligned with international good warehousing practices, supply chain and design principles. The materials used in ‘In-a-Box’


producing facilities


are signifi cantly cheaper than traditional


building methods


and boast a 30-year plus lifespan. A high focus is also placed on sustainability – each one can be built to green standards, and designed for water- and solar- harvesting. They can also feature water and waste treatment


central procurement for ARVs (anti-retrovirals). He co-founded pharmaceutical


supply chain


specialist PHD, becoming its chief executive and then served as chief executive of the RTT Group, orchestrating its unbundling in 2012, when its RTT Medical business was acquired by Imperial Logistics to form Imperial Health Sciences. He led a number of pioneering innovations such as Unjani Clinics, Warehouse- in-a-Box,


Clinic-in-a-Box and


Imperial Logistics’ Multi-Market Aggregation mega-distributor model, all of which have enhanced medicine access throughout African markets.


The global pharmaceutical market is still growing, but it has slowed from the rapid expansion seen in the past fi ve years, says Eric ten Kate, vice president global life science at freight forwarder, Agility (pictured). In its January 2019 report, the


IQVIA Institute for Human Data Science is forecasting growth of 3-5% for the global pharmaceutical market over the next fi ve years. The


growth witnessed in


emerging markets is largely due to changing demographics such as growing and ageing populations,


urbanisation and better access to healthcare. Kate declares: “We’re winning


the fi ght against communicable diseases, but non-communicable diseases continue to grow.” Challenges to continued growth include pricing policies, sales losses to generics and biosimilars and exclusivity loss in developed markets. In developed markets, growth is expected to come from new, specialty products. Developments in biotech


are also expected to contribute signifi cantly; Deloitte’s 2019 Global


options, as well as reduced cooling and energy costs due to their energy-effi cient panels, doors and lighting design.


Warehousing solutions


Pharmaceutical warehouses are largely invisible to patients, but they are essential to ensuring that health commodities are available and maintained in good quality. Poorly constructed, maintained or managed storage put products at risk of damage, diversion or expiry – in turn jeopardising health


scalability is possible through the modular design, which is readily adjustable to accommodate future growth demands. Another Warehouse-in-a-Box in


Abidjan, the capital of Côte d’Ivoire, was implemented on behalf of New Public Health Pharmacy (NPSP),


responsible for the


distribution of products operated by the country’s Ministry of Health. This $5.8 million, 4,095sq m warehouse signifi cantly enhances the distribution network, as well as storage capacity for the distribution of quality medicines.


Resolve’s Clinic-in-a-Box is a


prefabricated health post that includes a dispensary, and has been deployed all over Africa. The design won the Corporate Innovation Award at the 2015 SA Innovation Awards. Dr Barton points out that these


are not mobile or temporary clinics. Their purpose is to extend healthcare services permanently and in all respects are normal clinical facilities, staff ed by the relevant ministry of health. Most


of the Clinic-in-a-Box


deployments have been in rural areas so far, says Dr Barton. Like the Warehouse-in-a-box,


they are packed carefully into 40ſt containers,


to eliminate


transport damage, and can be handled in the same way as any other shipping box. Closely linked to this


design are Storage-in-a-Box and Cold-Storage-in-a-Box – pharmaceutical compliant


regulatory solutions,


programmes and patient health. Warehouse-in-Box


A Warehouse-in-a-Box is also solutions


have addressed these issues in urban and rural areas, says Dr Barton. In Tanzania, Warehouse-in-


a-Box was the solution for the country’s expanding need for a scalable, secure, reliable and sustainable means to store and distribute medicines and healthcare commodities. The design


can deliver between


1,000 and 10,000sq m of pharmaceutical-compliant warehousing space, and long-term


currently nearing completion in Mali, and construction on a further three has recently begun.


Health post and storage solutions


Clinics – or health posts – in rural and semi-urban areas are a critical part of the healthcare supply chain in Africa, ensuring ‘last mile’ access to medicines and healthcare services for patients who do not have the means to travel for these services.


prefabricated and ready for deployment wherever a healthcare supply chain needs expansion. Two Storage-in-a-Box units have even been deployed on Likoma Island in Malawi. Resolve has deployed over


500 clinic and storage solutions across Africa, a number of which are capable of operating ‘off -grid’ using solar power and water storage facilities – a particular benefi t when many


African


countries suff er from crippling power outages and unreliable access to water in rural areas.


Life Sciences Outlook forecasts that biotech will represent 27% of the global market in 2019, but will swell to 31% by 2024. The pharma market is growing


everywhere, says Kate, but in some places more than others. Expansion is predominantly coming from the US and emerging economies, but growth is slowing even in the latter. China, Brazil and India have


the greatest medicine spending in emerging markets, while Turkey, Egypt and Pakistan are forecast to have the greatest growth between 2019-23, according to Iqvia’s Global Use of Medicine in 2019 and Outlook


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