Logistics and Security Specialist
In this step, Megan Bassford, Petra Straight, and colleagues (Save the Children) and Rory Peters (UK Med Logistics) outlines the importance of logisticians in outbreak response and preparedness. She will highlight nine areas in which logisticians work and explain how they function across the different response pillars to help control an outbreak.
1) How are logisticians involved in outbreak preparedness?
In preparedness, logisticians oversee a variety of activities that will contribute to a fast and effective outbreak response in the future:
1. Identifying and quantifying stock required for outbreak control across all pillars of the outbreak response team.
- Logisticians use this list of required stock to support further preparedness activities and enable a faster response.
2. Market survey for procurement of goods in local context
The market survey aims to understand how the relevant local market operators work; the materials that can be found in the local area; and the capability of suppliers to deliver required items per the stock list. This allows more rapid procurement of items when an outbreak occurs.
Market surveys are particularly important for medical products as substandard and falsified medicines can make up to 1 in 10 items in low and middle income countries.
The market survey extends beyond items used as treatment in the response and includes other items such as fleet and warehousing.
Once suppliers have been identified, logisticians may then set up framework agreements with them to ensure a predictable and timely re-supply of stock, to either replace stores or go directly to the response.
3. Potential Stakeholder Mapping
- Logisticians also map out partners and other stakeholders in areas identified as high risk for outbreaks. Where possible, logisticians establish logistics platforms and strengthen partnerships to capitalise on available resources that might be needed at the time of response (transport, cold chain equipment, warehouses and rotation of stock).
4. Pre-positioning of essential stock
For essential stock, such as vaccines, drugs, and diagnostics, pre-positioning may be used. Pre-positioning is placing stock in high-risk areas so it is ready in the case of an emergency.
Logisticians check if it is feasible to pre-position stock in high-risk areas based on certain requirements, including existing warehouse space and special storage requirements. Once items are pre-positioned, logisticians will manage the items. Health commodities require close management as incorrect storage can lead to them becoming ineffective and or expired.
5. Supply Routes
Health and logistics professionals determine where the most likely response locations are and then determine what are the potential supply routes and methods to get items to those locations. This also requires identifying potential risks and challenges, and planning alternate strategies if these situations arise.
For each supply option, logisticians will also develop a contingency option. For example, if there was a plan to fly stock into a location but the airlines are not flying, an alternative route will have been pre-identified. For items requiring cold chain (e.g. vaccines), pre-validated supply routes and methods are used to minimise the risk of the item being destroyed by exposure to heat/sun.
For routes that require international procurement, logisticians map out the importation process to bring items into the country, taking into consideration all other potential government restrictions. Pharmaceuticals can be particularly difficult to bring into the country, but are critical to outbreak responses, so logisticians need to be prepared for every situation.
6. Identify Restrictions and Potential Bottlenecks
Logisticians review any potential restrictions on procurement such as required registrations (often required for pharmaceuticals) and payment options.
Where possible, relationships are built with the relevant agencies involved in procurement such as the National Customs agency, Ministry of Health, and Ministry of Taxation to try to reduce any potential bottlenecks.
7. Identification of Tools
- Logisticians need a variety of tools to ensure responses are able to get the right items, in the right place at the right time. These tools include:
-WHO Logistics, System Assessment Tool
-Procurement plan and tracker
-Stock consumption, inventory management system
-Stock monitoring and reporting tools
-Assets register and assess movement
-Distribution plan and reporting
-Logistics Management and Information system (LMIS)
-Logistic cluster documents (if functioning)
8. Capacity Building
- In areas at high risk for outbreaks, increasing the capacity of existing logistics staff is essential so that when an outbreak occurs, the team can perform the required tasks.
2) Why is logistics and security essential to outbreak preparedness and response?
Logisticians are responsible for acquiring, managing and delivering the required supplies/services for a response to occur at the right time and in the right place. This includes ensuring the proper quality and quantity of supplies is procured at an appropriate cost. In the absence of adequate logistics, effective and timely outbreak response is impossible.
Logisticians need to be involved in any outbreak response planning from the start in order to identify possible risks, gaps or challenges in supplying the relevant materials and to identify any services required to control the outbreak.
A well-planned security guideline is also essential to outbreak response. Organizations often have their own security team that is responsible for developing the security plan. Logisticians will provide some support for implementing security guidelines during an outbreak.
3) Why are security and safety measures essential to outbreak response?
A well-planned security guideline is essential to outbreak response. Organizations should have in place a well-researched security plan which often involves logisticians on the front line ensuring these plans and operating procedures are implemented.
Practically speaking, this can mean managing compounds and health facilities; managing vehicles and ambulances; and ensuring appropriate communication equipment is in place. As with everything, the best plans are only of value if they are fully implemented and staff are trained in regards to the reasoning and methodology of the plan.
Specifically for outbreaks, we must consider relations with local communities, including how our work and methods in the regions are to be communicated and accepted. More practical aspects will include the need for appropriate medical equipment and personal protective equipment to keep staff and volunteers safe.
4) How are security plans developed?
Although the profile of an organization and the context will often differ, the methodology of formulating security plans should always follow a similar process:
- Analysis of the organization mission and mandate, as well as individual staff profiles. For example, is there anything controversial in the programming or funding streams?
- Context assessment of our working locations, i.e. local politics, economic situation, other social factors. For example,
-Is there a conflict or political tensions?
-Is there high poverty/ inequality?
-Are there high crime rates?
-Do humanitarian actors have community acceptance?
- Security Risk Analysis - looking at the nature of risks we face and what would be the likelihood and impact of such events?
- We can then consider our Standard Operating Procedures (SOPs), i.e. the rules of life – curfews, use of vehicles, travel safety.
- We must also design Contingency Plans to help manage any incidents or events out of our control. This can include hibernation, relocation and evacuation procedures for staff.
- It is also wise to consider potential crisis management. Who is involved here and how would we best manage any incidents that do occur?
© London School of Hygiene and Tropical Medicine 2019