This Annual Report summarizes GHSC-PSM's activities and outcomes for Year 4, October 1, 2018 through September 30, 2019. In this reporting period, GHSC-PSM procured nearly $544 million and delivered almost $699 million in drugs, diagnostics, and other health commodities, bringing the life of project delivery total to nearly $1.8 billion. On-time delivery (OTD) and on-time, in-full (OTIF) delivery exceeded the project's target every quarter, with an average OTD of 92 percent and OTIF of 85 percent for the year. Additionally, the project has saved $130 million on commodities and $19.4 million on logistics over the life of the project. GHSC-PSM continues to provide field-based support from 34 field offices in Africa, Asia, Latin America and the Caribbean to ensure an uninterrupted supply of health supplies for patients globally.