Frontline perspectives: For Gita Maitra, GHSC-PSM’s wholesalers are the unsung heroes in the rush COVID-19 products.

Gita Maitra hit the ground running after joining our COVID-19 response team in 2020 as the team lead. “I had worked on GHSC-PSM previously. I generally knew the procurement policies and have a deep background in contracts, putting together requests for proposals, and doing market research.”

“Something I hadn't done previously was develop a sourcing strategy. Very often with sourcing strategies, you have a robust market that you want to maintain, with a lot of history and stable supply and demand. But we didn’t have any of that. Demand was out of control.”?

“The World Health Organization defined a set of commodities that they believed would be considered best practice and there was a massive run on all those products. So it was suddenly very difficult to get things like masks or gloves or supplies associated with oxygen concentrators or ventilators.”

“Whole containers of personal protective equipment would be sold out from under somebody because somebody else paid more money for it. It was emblematic of the challenge.”?

For commodities the project had not procured before, “We identified and talked to vendors quickly.” During this unprecedented public health emergency, Gita found collaboration among companies that were usually competitors. “One constant was the esprit de corps across the sector. There was a lot of really open communication and knowledge sharing that helped us identify who was out there” to procure from.

“We did sourcing strategies and full and open competition for pressure swing absorption machines and oxygen concentrators. But for everything else, we went through our existing wholesalers.That was a deliberate approach. We instinctively knew that we as GHSC-PSM would not have the kind of buying power to go directly to manufacturers. We were by far a much smaller buyer than partners like the Global Fund or UNICEF.”??

“So instead we leveraged our existing relationships with wholesalers. They took really good care of us in that they were transparent and forthcoming with information. I would get emails from wholesalers with new information they wanted to share” about what was happening in the market. “Those types of insights were very, very useful. The unsung heroes for us were the wholesalers.”?

One useful insight was that UNICEF had become USAID’s purchaser of choice for syringes used for COVID-19 vaccines, able to procure large volumes directly from manufacturers. “We couldn’t compete on price with the small volumes we were ordering, so we didn’t have a competitive advantage. It made sense for UNICEF to do that.”?

However, GHSC-PSM still had a role to play at times. “There were specific instances in which UNICEF could not get the syringes for the USAID missions, but we were able to tap into the exact same product through our wholesalers.”?

Supplying syringes and all other commodities was a delicate dance negotiating delivery lead times. Global supply chains were disrupted in many ways due to lockdowns, shortages of raw materials, and more. “We would be on the phone every day with our suppliers asking, ‘What would be your lead time if I placed the order today? What would be your lead time if I placed it tomorrow?’ If we placed an order in a week, we could get the commodities on time, but if we missed that window of opportunity, it could be another three months or six months. We were doing supply chain work when the supply chain itself was snarled up.”

For Gita, one of the biggest lessons learned from COVID-19 response goes back to the team’s work providing support for medical oxygen. “Each country needs an oxygen strategy.”

“There are two primary ways to get oxygen. One is for the hospital to produce oxygen with a pressure swing absorption machine. The other way is to get regular deliveries of bulk liquid oxygen. The industry base and the manufacturing base for those two modalities are very different, and there is a healthy competition around the world between the bulk oxygen producers and PSA manufacturers.”?

“There are pros and cons to each method, and there is room for both.” But it is a mistake, “to accept donations without a budget or a strategy to maintain an oxygen program.” For example, there are few countries in sub-Saharan Africa with bulk liquid oxygen producers. Unless a country is close to a production site, “You have to transport it a long distance, and doing so is not cheap.” Relying on bulk liquid oxygen can work in some countries, while in others a strategy based on pressure swing absorption machines placed in major hospitals, who would then supply other health facilities, would make more sense.

“A strategy signals to the industry what you’re going to do. Industry loves predictability and planning, and industry will stay away from investing in a country if there isn't a strategy.”