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Decentralised supply chain logistics are constraining impact malaria control across Africa. In Nigeria, for example, seasonal malaria prevention campaigns and routine treatment pipelines operate through separate channels. In this op-ed, Michael Audu, a Nigerian public health professional, explains how fragmented logistics systems increase the burden of malaria.
"Fragmentation can contribute to stock imbalances at service delivery points. A facility may have ample malaria supplies during seasonal campaigns while routine treatment supplies may be temporarily unavailable, resulting in interruptions in access to essential care."
He explains how this fragmentation reduces efficiency and limits use of scarce resources and argues that harmonised supply chains can make every malaria dollar count in protecting communities across the continent.
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Michael Audu, MPH, DrPH (c) is a Nigerian public health professional and researcher dedicated to advancing climate-smart health systems across Africa. His work explores the intersection of malaria, climate resilience and health systems strengthening, driving innovation and policy dialogue for sustainable change.
Africa carries the heaviest burden of malaria, and system performance increasingly plays a critical role in outcomes. Medicines and preventive tools exist but getting them to the people who need them every day is another matter. And right now, that problem is becoming urgent.
As malaria programs enter a period of tighter financing and heightened accountability, operational efficiency has never been more important. Recent global malaria reports highlight that funding levels remain significantly below what is required to meet elimination targets. In such an environment, countries must maximize the impact of every available resource.
One structural challenge that deserves greater attention is the way malaria supply systems are often organized.
Across many African countries, malaria prevention campaigns and routine treatment systems operate through different planning, distribution and reporting mechanisms. Campaign-based approaches such as seasonal malaria chemoprevention (SMC) are designed for rapid, high-coverage delivery during peak transmission periods. Routine case management systems, by contrast, function continuously through health facilities.
Both approaches are essential. Campaigns save lives. Routine systems prevent deaths every day. However, when these streams are planned and managed separately, inefficiencies can emerge. Distribution schedules may not align. Reporting cycles may differ. Inventory visibility may be fragmented. In some cases, facilities may receive adequate campaign supplies while experiencing pressure on routine stocks such as rapid diagnostic tests or artemisinin-based combination therapies.
This is not a failure of individual programs. Rather, it reflects the “verticality” that has historically characterized global health financing and implementation where well-funded, high-visibility campaigns operate alongside routine systems that are structurally separate.
Nigeria illustrates the problem clearly. The country runs two main malaria supply streams: seasonal malaria chemoprevention (SMC) and routine case management with rapid diagnostic tests and artemisinin-based combination therapies (ACTs).
Seasonal malaria chemoprevention is delivered through a campaign-style platform targeting high-transmission states during specific months. Routine diagnosis and treatment, meanwhile, rely on ongoing facility-based supply chains. Both systems function, but when their logistics structures are not fully harmonized, gaps can occur at the interface.
As financial pressures increase globally, greater alignment has become strategically important. Donors and national governments alike are seeking greater efficiency, improved data integration and stronger value for money. In this context, better-aligned supply chains are no longer simply desirable-they are strategic.
In a recent webinar titled “From Parallel to Integrated: Harmonizing Seasonal Malaria Chemoprevention (SMC) and Routine Supply Chains in Northern Nigeria – An Integrated Logistics Framework”, where I was one of the panelists, I described this as a “verticality trap.” The result is stockouts in the gaps.
The way forward is not to reduce campaigns or weaken prevention efforts. It is to better integrate planning, forecasting and last-mile delivery.
Countries can benefit from:
A unified national visibility framework for malaria commodities
Shared transport and redistribution mechanisms where feasible
Harmonised logistics management information systems
Coordinated supervision and accountability structures
Stronger linkage between campaign microplanning and routine replenishment cycles
Integration does not mean centralization of everything. It means reducing avoidable duplication and strengthening the interfaces between systems.
Malaria persistence in Africa is increasingly shaped by systems performance as much as epidemiology. Innovations in medicines, vaccines and vector control are advancing. To translate these into sustained impact, supply chains must be resilient, coordinated and adaptive.
If Africa is to make every malaria dollar count, structural alignment in commodity delivery will be just as important as the tools themselves.
Disclaimer: The views expressed in this article are solely those of the author and do not necessarily reflect the views of any current or former employer, client, or affiliated institution.