The challenge

A well-functioning Last Mile delivery system is one that reaches the patient and point-of-care. Such a system is essential for adequate access to and availability of medicines for day-to-day medical needs and large or localized medical emergencies. Across Africa, governments and donors are investing billions of dollars to strengthen health systems and make affordable medicines available. However, government supply chains often struggle to get medicines and supplies the last mile to the health facilities and people who need them most.

Key health Last Mile delivery challenges in developing countries include:

• Over-simplification of customer service strategies to health facilities with “one size fits all” approach
• Poor information systems and inventory management from point-of-care back through the supply chain, making it difficult for reliable supply and demand planning of medicine
• Unclear program and commodity portfolio with little prioritization by health facility segment
• Poor execution of storage guidelines and space management at point-of-care health facilities
• Lack of appropriate equipment and maintenance for storage and handling of products, including cold chain equipment
• Inadequate and poorly configured “one size fits all” transport between regional warehouses and health facilities due to poor storage and delivery infrastructure planning, exacerbated by poor roads and seasonal flooding
• Shortage of trained personnel to set up and manage efficient public health supply chains, caused by a limited talent pool of trained logisticians and insufficient human resources
• Fragmented and siloed programs addressing different medical priorities, each of which has separate public financing, supply chains, organizational structure, infrastructure and reporting, with a goal to reach the same point-of-care, which leads to inefficient use of funds and resources
• Limited engagement with private sector entities and their approaches to increase efficiencies and best practices

Our response

Almost every person around the world is a few steps away from a Coca-Cola product. Imagine life-saving medicines were as accessible. To help make that a reality, The United States Agency for International Development (USAID), The Global Fund to fight AIDS, Tuberculosis and Malaria (The Global Fund) and the Bill & Melinda Gates Foundation, The Coca-Cola Company and its Foundation, formed Project Last Mile – a partnership working to make life-saving medicines available to those who need them most. Project Last Mile shares and applies the supply chain expertise of The Coca-Cola system with Ministries of Health to build capability in this area.

Our current supply chain solutions include sharing The Coca-Cola Company’s best practice in leadership development, logistics, business planning and franchise management to better serve patient needs, expand access to life-saving medicines and reduce unnecessary burdens on health systems through:

• Supply chain and Last Mile delivery holistic assessment, gap analysis and benchmarking versus best-in-class African distribution models, including fact-based analysis of key supply chain and last mile delivery performance and process indicators from point-of-care back through to central warehousing and management
• Strategy development and design of segmented Last Mile delivery models customized to local conditions, in line with the Ministry of Health’s vision for the future and its short and long-term deliverables, to ensure the effective and efficient delivery and management of essential medicines right through to point-of-care
• Facilitation of commodity portfolio segmentation by health facility classification
• Capability and process development to enable localized planning and execution of end-to-end Last Mile delivery models, including supporting infrastructure, organization design, role profiling, compensation and benefit modeling, and performance dashboard implementation for sustainability
• Real data collection, analysis and management, developing clear routines and quality checks to ensure real data accuracy, inventory management, demand creation and fulfillment in transitioning from commodity push to informed pull replenishment systems

Our Last Mile delivery solutions

Many countries in Africa face challenges in Last Mile delivery of medicines and medical supplies caused by decades of suboptimal performance, parallel distribution systems, active conflict or health crises.

Project Last Mile works with countries and local Coca-Cola bottlers to develop tailored, Last Mile delivery solutions to strengthen public sector ability to reliably get life-saving medicines to people when and where they are needed most.

This may involve:

• Differentiated Service Delivery (DSD) models developed from existing Coca-Cola best practice in servicing territories across Africa, including urban and hard to reach rural areas;
• Identification of critical performance metrics to optimize effectiveness and efficiency of the supporting supply chain with consequent system and routine design to support data capture and manage performance through development of key insights;
• Routing optimization and warehouse placement to ensure efficiencies in distributing medications to health facilities;
• Optimized fleet configuration and management for appropriate fit to variable local transport environments using third-party contractors where relevant;
• Organizational development to reinvigorate supply chain agencies with a shared vision and

Project Last Mile is part of improving supply chain and demand creation in eight African countries, including Liberia, Sierra Leone, Nigeria, Ghana, eSwatini, Mozambique, South Africa, and Tanzania.

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