In the wake of last month’s United Nations General Assembly, where world leaders renewed their pledge to build stronger, fairer health systems, Peter Oluka, the editor of Techeconomy received this letter from Scott Dubin, advisor for Supply Chain – Private Sector Engagement at the Global Fund.
We considered it necessary to share it with our readers as Scott’s reflections resonate deeply; the “last mile” problem remains one of the biggest obstacles to achieving equitable healthcare delivery on the continent.
His emphasis on collaboration, visibility, and leveraging technology-driven logistics solutions like the Logistics Marketplace aligns strongly with the conversations we’ve been covering around innovation, efficiency, and partnerships in Africa’s development sectors.
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Dear Peter,
In the wake of last month’s United Nations General Assembly, where world leaders renewed their pledge to build stronger, fairer health systems, I was reminded of a recurring problem I’ve witnessed for over two decades across Africa: even when medicines are available, they too often fail to reach the people who need them most.
For over two decades, I have worked in health supply chains across Africa and in fragile settings, first delivering humanitarian and medical commodities on the ground and later advising on systemic improvements with organizations such as the Global Fund and the US government.
Over the years, my work has taken me to countless rural clinics where I repeatedly saw the same challenge: shelves sitting empty while warehouses serving those locations overflowed with stock.
These experiences highlighted a persistent reality: despite donor programs and the availability of essential medicines, patients are too often left waiting because critical and life-saving treatments cannot reach the last mile.
Consider Nigeria, where malaria kills more than 80,000 people each year, in part because up to 40% of health facilities face antimalarial drug stockouts. In Uganda, tuberculosis remains one of the leading killers, with thousands of preventable deaths every year.
These are not isolated crises. Across Africa, more than 1,000 people die every single day from preventable diseases because logistics within supply chains break down before medicines can reach the people who need them most.
The problem is not only that medicines often don’t arrive when and where they are needed, but also that we overpay to move them.
In many African markets, logistics can consume 30–40 cents of every dollar spent, two to three times higher than in more efficient systems.
Every dollar spent on transport that is inflated is a dollar that cannot buy more medicines, vaccines, or mosquito nets. This double burden, including delayed deliveries and excessive costs, undermines health programs and wastes scarce resources.
Frustratingly, it is not a lack of goodwill, donor programs, or infrastructure that holds health initiatives back. For medicines and health programs to succeed, multiple stakeholders; governments, NGOs, donors, pharmaceutical companies, health workers, and logistics providers, must work in harmony.
Yet the missing link is visibility into on-the-ground logistics partners: without the ability to efficiently connect, vet, and coordinate these providers, even well-resourced programs fail to reach patients, leaving health workers frustrated, communities vulnerable, and patients waiting for care they urgently need.
This is why I worked alongside partners and international organizations to launch a global good platform that addresses the urgent friction in health logistics, providing access at no cost.
The Logistics Marketplace is funded by the Global Fund and Gates Foundation, connects buyers and providers, streamlines procurement, and brings visibility to fragmented markets. In short, it applies cooperative principles to the final mile: reducing friction, increasing competition, and ensuring that medicines and humanitarian goods move faster and more reliably.
This global good is to ensure that logistics are no longer a barrier to delivering essential healthcare. But transforming this space requires more than the existence of a marketplace solution; it requires active cooperation across the sector between public and private partners. Only then will we see the intended delivery and impact of health programs across Africa.
As UNGA calls for global cooperation, I urge governments, donors, and partners not to stop at developing and funding medicine – it must carry the final mile, into the hands of the people who need them most.
Sincerely,
Scott Dubin, Advisor for Supply Chain – Private Sector Engagement at the Global Fund.
