Health systems encompass the institutions, organizations, and resources (physical, financial, and human) assembled to deliver healthcare services that meet population needs. In many low- and middle-income countries, health systems are faced with a huge burden of disease, and decision-makers have to make difficult choices to expand public health within the constraints of limited resources and competing health priorities.

COVID-19 revealed stark health inequalities between and within countries and focused the attention of decision-makers on the need to take strategic action to bridge the existing gaps and improve access to healthcare among marginalized groups.

Access to essential medicines and other healthcare commodities is fundamentally important for the effective functioning of health systems as clarified by the World Health Organization (WHO) Health Systems Framework.  Unfortunately, procurement and supply chain management (PSCM) systems for healthcare in many low- and middle-income countries are particularly weak vulnerable and under-resourced leading to poor health outcomes.

Strategic corporate philanthropy could play a vital role in strengthening the PSCM function within the healthcare system, through various modalities that could be adapted according to the local prevailing needs

Considering the priority given to public health outcomes in the attainment of the United Nations Sustainability Development Goals (UNSDG), a functioning health system is fundamentally important for any country to make progress. Unfortunately, no single organization can marshal all the resources required for a full-functioning health system, making the case for multi-stakeholder partnerships to make progress. WHO published a compelling technical report clarifying that strengthening health systems was everyone’s business, where all stakeholders need to collaborate towards a common goal [1].

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) continues to partner with various stakeholders (public, private, and nonprofit) to strengthen health systems in low- and middle-income countries. Central to this agenda is technical and financial support to strengthen PSCM for healthcare in countries.  Recently, the Africa Institute for Health Policy has independently evaluated two such projects in Ethiopia and Tanzania, to verify the results and document lessons to inform future programs.

Briefly, in Ethiopia,  Lesego A, et al.,  established that the Global Fund-supported initiatives led to improvements in the country’s PSCM performance, despite several persistent challenges. It was further clarified that to sustain and secure the gains achieved, it is important that various stakeholders, including the government and the donor community, work together to support the initiative. Similarly, in Tanzania Githendu P, et al.,  determined that positive results were realized through the Global Fund-supported reforms. However, despite the progress, there were risks, particularly resource limitations that jeopardized the sustainability of the gains. This called for multistakeholder efforts to make progress and expand public health in the country.

These two case studies demonstrate that there has been significant progress in strengthening health systems through donor funding but more needs to be done by various stakeholders. In this article, we highlight some of the actions that the business community could take to support health systems in low- and middle-income countries.

A few of the modalities through which corporates could support health systems are highlighted below:

• Strategic sharing of best practices and operational management principles

Corporations have some of the best-performing procurement and distribution systems that enable them to efficiently procure the resources they need and the capacity to distribute their products and services to reach their target consumer base. Critical functions such as contract management, warehousing, agile distribution, and data management are some of the areas for continuous learning and sharing of lessons to improve performance.

Businesses also collect and use data effectively to drive decision-making so that friction and inefficiencies are reduced within their PSCM systems, driving cost reduction and profitability. Through effective partnerships, health systems can take lessons from such corporations and adapt them to their needs and objectives, driving results in public health outcomes.

• Technology adoption and deployment

Corporations have robust ways of assessing, procuring, and adopting technologies that they need to optimize their operations and productivity. Healthcare systems are often faced with similar scenarios where they have to procure and deploy technologies at scale while contending with resource limitations and human resource constraints. Through stakeholder interactions, there are opportunities to learn from various case studies and identify examples to emulate and pitfalls to avoid.

In addition, as part of their corporate philanthropy, companies could second their seasoned experts to healthcare systems for a specific period to provide technical support as needed. Of course, caution must be exercised to avoid conflicts of interest in such partnership arrangements.

• Leveraging corporate distribution systems to reach the last-mile

It is often the case that many products that are manufactured and distributed by leading corporations have a wide population reach. Unfortunately, this is not the case for essential medicines and other life-saving technologies, such as vaccines.  This presents an opportunity for collaboration where corporate distribution systems, particularly those in the food and beverage segment, can be leveraged by the health systems to reach the last-mile populations.

• Bridging resource gaps through strategic community health initiatives

Several corporations are involved in charitable giving as part of their corporate social responsibility (CSR). Considering that many of these initiatives are focused on the achievement of the UNSDGs,  healthcare-related objectives such as access to medicines and other health commodities could be prioritized in the CSR initiatives. This would help bridge the resource gaps that are constraining healthcare systems in many low- and middle-income countries.

Ultimately, to be effective in strengthening healthcare systems, proactive corporates will need to partner with local stakeholders, including technical experts who are knowledgeable about the local context to help them identify opportunities to unlock shared value – at the intersection of the economic and social objectives of the corporate and the community respectively. Invariably, health system strengthening must thus be seen as a long-term process that involves complex systems and requires carefully orchestrated action on several fronts.

[1] WHO. Everybody business: strengthening health systems to improve health outcomes: WHO’s framework. Geneva: WHO, 2007.

Tom Achoki, MD is the Research Lead, at Africa Institute for Health Policy, a full-service research and technical consulting agency. E-mail: tachoki@africahealthpolicy.org