Are we doing enough to protect the health care supply chain?

Are we doing enough to protect the health care supply chain?
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As one of the worst on record, and only just peaking, this year’s flu season has garnered significant media attention. But beyond its particularly aggressive and deadly strain, a feature of this flu season that sets it apart from past years is the amount of attention the pharmaceutical supply chain is receiving.

In particular, analysis and commentary on the connection between supply chain operations and the health system’s ability to respond to the demands of this flu season. These conversations highlight an important notion — our healthcare system is completely dependent on a resilient supply chain and recent events like Hurricane Maria indicate that we may not be doing all we can to create a resilient pharmaceutical supply chain.

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It's important to first acknowledge the progress that has been made and resources committed in this area. Private sector manufacturers and distributors have invested tremendously in technology, business continuity planning, and logistics to ensure they can move product where it is needed. And this investment shows, from coordinating airlift deliveries to creating mobile apps to ensure safe navigation for employees. Meanwhile, emergency managers and public health officials have made a concerted effort to better understand the complexity of the supply chain and how they can better position themselves as a partner to the private sector during crises. This is evident in the creation and activities of FEMA’s National Business Emergency Operations Center and HHS’s Critical Infrastructure Protection program.

Yet, preparedness is a moving target. This is perhaps truer now than ever before with the frequency and intensity of natural disasters and disease outbreaks increasing. This "new normal" has become increasingly evident in just the past six months, during which our country saw three Category 4 hurricanes make landfall, record-breaking wildfires and mudslides, intense outbreaks of hepatitis A and the flu, and successive bomb cyclones. And these are just a few of the highlights.

As much of the media coverage explains, we’re currently experiencing a shortage of IV saline bags, which has been exacerbated due to damage pharmaceutical manufacturing facilities in Puerto Rico suffered during Hurricane Maria. Saline is commonly used for hydration in hospitals when treating severe cases of the flu, so the impact of this particular disruption in supply chain operations and product availability is being felt more acutely this year. This shortage is a prime — and highly visible — example of why a resilient supply chain is essential.

Much of the attention related to the shortage, and the impact it is having on flu season, has focused on highlighting vulnerabilities in the supply chain. While these are important points to make, and necessary conversations to have, to use this time to only point out and call attention to flaws in the supply chain would be a missed opportunity. The attention the supply chain is receiving right now presents an opportunity to dig deeper into the preparedness and response landscape, and think strategically and with a long-term view about how to foster a more resilient supply chain and how supply chain components can be better equipped to contend with inevitable public health challenges. On the heels of Maria, the opportunity to focus on the importance and complexity of the supply is practically unparalleled.

So, what can, or should be done? If preparedness is a moving target, and the supply chain is owned and operated by the private sector, what leverage do policymakers have? Viewing policymaking through a resilience-focused lens, not just a response lens, is an important place to start. This means focusing on policies and initiatives that serve to strengthen public-private sector coordination year-round, not just during the immediate response to a disaster or disease outbreak.

For example, a concerted effort to equip coordinating bodies that already focus on this, like FEMA’s NBEOC and HHS’s Critical Infrastructure Protection programs, with resources they need is one of many ways to strengthen resilience. Another avenue for change is to encourage decision-makers to think strategically and long-term, modeling how policies may influence supply chain operations, even if it may not seem important at the time.

Far too often our attention and resources for disaster response wax and wane with events. Our dependence on the supply chain does not allow for this kind of approach in healthcare, especially in times of crisis. The supply chain is the logistical backbone of healthcare, and it often functions invisibly. It is only when there is a disruption that the field receives attention.

A resilience-focused mindset is needed in both policy and decision-making related to the supply chain. This means taking a hard look at policies and initiatives impacting healthcare and emergency management with an eye towards how they might impact the strength of the supply chain during normal operations and times of crisis. Without this state of mind, we cannot expect to improve the resilience of our supply chain.

Sarah Baker is programs manager of Healthcare Ready. Previously, she provided contract support to Department of Homeland Security components including FEMA’s National Preparedness Assessment Division and National Exercise Division.