A critical area of study for WDI’s Healthcare Initiative involves supply chain management — that is, managing distribution networks so that needed medicines and medical products are moved efficiently from warehouses to village clinics to those in need. The Institute has also focused on shaping a global discussion of the future of distribution and how to improve the process with technology and enhanced forecasting. Examples of this forward- looking work can be found in WDI’s extended relationship with the Bill & Melinda Gates Foundation. One critical challenge that must be addressed for the future of distribution in low- and middle-income markets is the lack of data infrastructure. In fact, many developing countries still depend on paper order forms, which obscure how products flow through the system. In a recent project supported by the foundation, the WDI Healthcare team worked to develop tools for ministries of health — and the donor agencies that support them — to help improve this situation. Institute staff partnered with the Ann Arbor software firm LLamasoft, utilizing the latter’s modeling technology to capture the behaviors of different supply chain structures and strategies. “Using simulation software, we have been able to rapidly adjust these models in an artificial environment and see how those designs respond to changes in demand and geography,” said Michael Krautmann, senior research associate for the Healthcare Initiative. Another deliverable of the collaboration with the Gates Foundation has been a report titled “Designing Global Health Supply Chains for the Future.” In formulating their approach to this topic, Institute researchers reviewed the trend reports of assorted think tanks, institutions and logistics companies and gathered the opinions of analysts from industries such as pharmaceuticals, consumer packaged goods and high- tech electronics. From that work, the team identified six forces with the greatest likelihood of impacting the distribution process in 2030 and beyond: economic growth, shifting disease burden, urbanization, increased patient-centric care, proliferation of data, and the rapid pace of innovation. At the conclusion of the report was a series of recommendations for initiatives that governments, global development agencies and those in the private sector could undertake immediately to build supply chain capacity in anticipation of these increasing demands. By anticipating and preparing for future scenarios, leaders in every sector can more efficiently recognize and adapt to change for their own benefit and that of the most important element in the supply chain: the patient. Bill & Melinda Gates Foundation Healthcare 25th Anniversary 33