Emergency Supply Chain Playbook Helps Prepare and Respond to COVID-19 in Sierra Leone

Sub Title
Implementing the Emergency Supply Chain Framework
Related Supply Chain Topics
Related Global Health Areas
April 12, 2021
Lead Paragraph/Summary

Emergencies present unique supply chain challenges due to unpredictable demand, added strain on existing logistics systems, greater complexity and strain on financial resources. This is especially true in resource-limited settings already facing challenges in routine supply chain infrastructure.

The USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project introduced the Global Health Security Agenda (GHSA) to support the government of Sierra Leone in the preparedness of emerging pandemic threats. Through collaboration with the Ministry of Health and Sanitation (MoHS), the One Health Platform and other government ministries, agencies and key stakeholders, this activity aimed to build health system readiness in preparing for and responding to disease outbreaks. The framework of this activity included the development, adaptation and testing of an Emergency Supply Chain (ESC) playbook, a toolkit which allows the government of Sierra Leone to prepare, respond and manage the public health supply chain during a public health emergency.

GHSC-PSM is supporting the government of Sierra Leone to adapt and implement the ESC Playbook framework. Using the One Health Platform and GHSA framework as a foundation, the project gathered stakeholder input through many meetings, workshops, simulations and one-on-one interviews. This input informed an adaptation of nine key elements of the ESC framework and development of an interactive playbook tool. Representatives of regional and national rapid response teams then tested the framework and tools through simulation exercises.

The government of Sierra Leone has provided leadership throughout the process, with the Honorable Deputy Minister of Health, Dr. Amara Jambai, appointing Chief Medical Officer Rev. Dr. TT Samba as the ESC playbook focal point. The Directorate of Health Security and Emergencies, the Directorate of Drugs and Medical Supplies and the National Medical Supplies Agency served as key decision makers in the customization and implementation of the playbook. To further establish regional governance and ownership, each directorate assigned regional and operational leads. GHSC-PSM also worked closely with the Directorate of Health Security and Emergencies, U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to establish consensus on the integration of the playbook into the national Medical Counter Measures plan.

Preparing for COVID-19

In February 2020, before any cases were recorded in Sierra Leone, the Public Health Emergency Operations Center, Directorate of Drugs and Medical Supplies, CDC, China Center for Disease Control and National Medical Supplies Agency convened a technical review meeting to customize the ESC playbook commodities list with WHO’s recommended commodities package for COVID-19. The commodities included commodities like personal protective equipment, medical equipment, oxygen supplies and essential medicines. The MoHS used the revised playbook to mobilize further action.

In the early stages of the COVID-19 epidemic, information and guidance about treatment, prevention and control was constantly evolving. The ESC Playbook has built-in flexibility to facilitate changes, including the commodity lists for COVID-19. GHSC-PSM worked with the ESC Playbook team to keep current the commodity list.

At a national simulation in March 2020, more than 30 logistics officers and pharmacists learned to use the ESC playbook, with special attention paid to commodities needed to prepare for COVID-19. The simulation exercise included a mapping of regional supply chain infrastructure that was added to the playbook for future reference.

The ESC playbook served as a roadmap for forecasting needed commodities and prepositioning them at designated COVID-19 treatment centers. One year after the first recorded case of COVID-19 in Sierra Leone, the ESC playbook continues to serve as an essential tool for supply chain management.

With the playbook having proved its value, in December 2020 the USAID GHSA Advisor, Dr. Monica Dea, officially handed over the ESC playbook to Chief Medical Officer, Reverend Dr. Thomas T. Samba, who represented the government of Sierra Leone.

Emergency supply chain preparedness saves lives by getting essential medicines to the front lines rapidly, reducing the amount of response funds required by investing in preparedness, and speeding response time in the event of a public health emergency. As of March 15, 2021, Sierra Leone recorded 3,938 cases of COVID-19 and 79 deaths. 132,255 tests have been carried out since the start of the outbreak. Sierra Leone faces the prospect of a protracted COVID-19 epidemic and the threat of an Ebola outbreak from neighboring Guinea. The ESC Playbook will continue to adapt to changing guidelines for COVID-19 and be updated to reflect needs in the event of a second Ebola outbreak.

USAID GHSA Advisor Dr. Dea officially hands over the ESC playbook to Sierra Leone’s Chief Medical Officer, Dr. Samba

USAID GHSA Advisor Dr. Dea officially hands over the ESC playbook to Sierra Leone’s Chief Medical Officer, Dr. Samba. Photo Credit: Marie Kolipha-Kamara