from other markets, but one of its unique challenges is the need to instill confidence among suppliers by reducing discrepancies between actual and projected procurement and increasing predictability of procurement. He suggested that doing this will require the development of smooth, reliable, and accurate forecasting techniques that suppliers view as realistic and credible.

Yadav suggested that developing more accurate demand-forecasting techniques is necessary for manipulating the push-pull boundary in SCM in order to shift a proportion of component processes from those that are order driven to those that are forecast driven. He noted that improved demand forecasting is essential to resolve the crucial disparity between the number of patients who need treatment and the number of patients who are actually diagnosed and treated.

Schwalbe suggested that improved interaction with manufacturers around that forecasting data would be productive and that it is important to forecast the “whole picture” (i.e., to not forecast the donor-driven and non-donor-driven markets in isolation).

Relatedly, some participants discussed the concept of a buffer inventory or stockpile to address SLD stock-outs and shortages. The buffer would shorten delivery times and increase predictability. Such a mechanism could assist manufacturers by smoothing demand and could help ensure that an uninterrupted supply of SLDs can be delivered where and when needed.

Information Management Systems6

Some participants discussed feasibility and opportunities for improved information management through Web- and mobile-based technology for managing patient care and drug supply. Hamish Fraser, Partners In Health, identified low-hanging fruit in the area of information management, suggesting adoption of universal bar coding in the short term. As a required first step, funders and international agencies would need to agree on standard naming, formatting, and coding conventions. Scanners or mobile phones that would be used to read the bar codes are already widely available, so Fraser suggested that the process would be relatively straightforward. Yadav commented, however, that although the technology for standardizing bar codes is simple, the standardization process itself would be complicated and lengthy, which could pose a serious barrier to the quick


6 This subsection is based on reflections offered by Owen Robinson, Program Manager, Partners In Health, and comments offered by workshop participants during an open discussion session moderated by Robinson and Barry Bloom, Harvard University Distinguished Service Professor and Joan L. and Julius H. Jacobson Professor of Public Health, Department of Immunology and Infectious Diseases, Harvard School of Public Health.

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