Examples of the Impact

WDI’s Healthcare Supply Chain team conducts strategic and analytical research for numerous healthcare supply chain organizations in emerging economies. Our research helps these organizations improve the efficiency of their medicine distribution operations, address key performance bottlenecks, and identify the investments needed to address future supply chain trends and challenges. Ultimately, these results help strengthen health systems and improve patient access to lifesaving medicines. A few examples of our work and impact are described below.

Countries: Global

Project Dates: March 2015 – September 2016

Unfortunately most real-world health supply chains must make tradeoffs between different performance metrics. For example one model may be cheap to operate but feature poor data quality and equity of coverage; another model may offer highly reliable and equitable coverage but be unsustainably expensive.  Furthermore, key supply chain stakeholders often value tradeoffs differently, creating disagreement and political tension when deciding on a supply chain strategy.  To address these challenges WDI developed an approach for quantifying the priorities of individual stakeholders and then used those priorities to weight the observed performance of a supply chain model.Cost Effectiveness Chart - Togo IPM EvaluationDrawing upon academic and industry research in multi-criteria decision analysis, this approach resulted in a simplified, composite performance metric that enables easy comparison across different supply chain models and stakeholders. By applying this approach retrospectively to health supply chain pilot analyses in Zimbabwe, Tanzania, Nigeria, and Togo, WDI increased government and donor awareness of the true diversity of real-world stakeholder priorities, and highlighted the importance of addressing such priorities in the performance management process. This project was funded by the Bill & Melinda Gates Foundation.

Countries Impacted: Global

Time Frame: February 2016 – July 2017


The objective of this project, funded by the Bill & Melinda Gates Foundation, was to build alignment among donor agencies, governments, and private companies as to the supply chain investments that must be made now to prepare for future changes in healthcare demand. The convergence of trends in technology, innovation, economic growth, and shifting disease burdens will likely drive large-scale changes in the type and quantity of medicines that patients seek, as well as the location and delivery mechanism they prefer. However, the types of investments needed to address these changes – building additional supply chain capacity or developing new workforce competencies – require years to plan and execute, and they cannot be successful without a clear and well-informed vision of future supply chain needs.

WDI helped provide this clear vision through a number of different research avenues:

  1. Synthesizing reports on future trends across several industries, breaking down the meaning and applicability of those trends for the governments, donor agencies, private companies and patients who comprise the global health supply chain
  2. Developing quantitative models to estimate future changes in health supply chain demand levels, based on existing epidemiological, socioeconomic, and medical trends research
  3. Simulating the impact of future demand changes on supply chain capacity needs and choice of optimal strategy

Through these various approaches, WDI successfully started a global conversation about the need for more future-oriented supply chain investments.

Countries: Madagascar

Partner: Abt Associates, Inc.

Project Dates: April-October 2016


This project was completed as part of the Sustaining Health Outcomes through the Private Sector (SHOPS) Plus initiative. Our objective was to make recommendations to improve the financial mechanism used to recover logistics and administrative costs for the provision of essential medicines in Madagascar.  This public-sector “cost-recovery” system has historically faced challenges in both performance and sustainability.  WDI developed a report which identified system bottlenecks and provided recommendations to address these challenges.

This report was created through an in-depth document review and interviews conducted with various actors in the cost-recovery system.  The majority of the bottlenecks identified were fundamental, centering on roles and responsibilities which were poorly defined and enforced, as well as an underlying structure which inhibits effective performance management.  WDI’s report, along with previous audits and reports on the same topic, led the Secretary General of Madagascar’s Ministry of Health to initiate a full, structural reform of the existing cost recovery system, rather than making only incremental changes to the system.  This reform process began in 2017 and is ongoing.

Countries: Burkina Faso, Chad, Côte d’Ivoire, Mali, Mauritania, Niger

Project Dates: January 2016 – March 2017


The objective of this project, funded by the Bill & Melinda Gates Foundation, was to support the six countries included in the Sahel Women’s Empowerment and Demographic Dividend (SWEDD) initiative to develop technically sound plans for investments to be made in their health supply chains. The SWEDD initiative began as a response to a lack of access to reproductive, child, and maternal health services in the countries of the Sahel region of Africa.  The supply chain component of this initiative focuses on investments in the logistics systems which allow the products needed for reproductive, child, and maternal health services to be made available.  WDI provided supply chain expertise to country representatives during the SWEDD supply chain launch meeting, ran in-country workshops alongside local partners to identify health supply chain investment opportunities, and reviewed the final investment plans for each country.  Additionally, WDI developed a report summarizing the strengths, weaknesses, and lessons learned during the execution of the initial phases of SWEDD supply chain activities.  As a result of the assistance provided by WDI and other partners, the investment plans for all six SWEDD countries were approved by the World Bank.  Furthermore, the lessons learned from the execution of the SWEDD supply chain activities were shared with teams at the Global Fund and the Bill & Melinda Gates Foundation, encouraging greater efficacy and efficiency of future, similar country engagements.

Countries: Togo

Project Dates: January 2016 – June 2017



The objective of this project, funded by the Bill & Melinda Gates Foundation, was to assist the government of Togo in identifying and addressing performance bottlenecks in the public-sector health supply chain. In Togo, this supply chain faces a number of chronic challenges to effective and efficient operations.  In order to address these challenges, WDI first performed an assessment of the current operations of the supply chain across a wide range of functions, products, and health system levels.  WDI identified root causes for the last-mile stock out of essential medicines and validated these root causes during a meeting convening 50 high-level local stakeholders.  WDI then developed a clear process and strategic framework for designing and implementing activities to address root causes.  This project provided the government of Togo with the evidence and tools needed to make significant improvements to the public-sector health supply chain.  Moreover, many aspects of WDI’s engagement – from the use of management consulting-based strategic frameworks to research on capabilities of private pharmaceutical wholesalers – helped to lay a foundation for supply chain improvement activities which are driven by private sector principles and lead to market-oriented solutions.

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