How a project to digitize pharmaceutical management in Sudan won the Lynn C. Fritz Medal

South Sudan is not a tourist stop. Conflict and instability do not attract visitors. Rather, the drought-stricken, poor country is a destination for humanitarian organizations. Some 4.9 million people are in need of humanitarian aid. Food, medicine, clean water — everything is lacking.

Dispensing medicines using the PIMS software: The humanitarian organization International Medical Corps receives an award for its project to control the last mile in the pharmaceutical supply chain. Photo: International Medical Corps

One of the humanitarian organizations active in this country is US-based International Medical Corps. Its approximately 8,000 employees have provided disaster relief in more than 80 countries since its founding in 1984. South Sudan is currently a priority country for the organization.

And there, where living conditions are extremely poor and the infrastructure particularly dilapidated, International Medical Corps has tested an internally developed software, the Pharmaceutical Information Management System (PIMS), for the last mile of supply chain management and attracted worldwide attention with the results.

The results also attracted the attention of the 16-member jury of the Lynn C. Fritz Medal for Excellence in Humanitarian Logistics. The medal is awarded by the Logistics Hall of Fame and sponsored by the San Francisco-based Fritz Institute.

International Medical Corps is the first organization in the world to be awarded this medal, which was established in 2023. That’s because it is using PIMS to solve a key problem for all humanitarian organizations: the procurement, tracking and dispensing of medicines, steps that until now have been documented and managed primarily on paper.

Before the tool was developed, the last mile of the pharmaceutical supply chain was producing mountains of paper. For example, consider a pharmacy that serves 500 patients a day. For each prescription, more than 40 pieces of information must be recorded. That means that from the time the medication is received at the warehouse to the day it is dispensed to 500 patients, 20,000 pieces of data would be recorded.

The mammoth task for the pharmacists? All that data must be digitized and forwarded to a central location for analysis and replenishment.

“This takes weeks, and it’s impossible to quickly gain insights from this data to reduce costs or improve performance,” said David Alarcon, vice-president of corporate finance at International Medical Corps. “Managing supply chains with paper and Excel is like driving a car while looking in the rearview mirror.”

In 2015, International Medical Corps decided that the time of paper mountains must end. A team searched for solutions on the market—in vain. The software tools it found were either very expensive or unsuitable for use in disaster relief.

So in 2018, the organization made the decision to develop a solution internally. Unlike other organizations or companies in which a manager delegates a project from the top down, International Medical Corps chose a bottom-up approach: in concrete terms, this means that employees from the entire organization participate—pharmacists, logisticians, doctors, technicians and experts from the finance and legal departments.

The advantage of this approach is that the combined knowledge of everyone involved in the process is used in product development. “We developed PIMS to meet the diverse organizational needs that cover the lifecycle of a product, from planning, procurement, transportation and storage, to dispensing to beneficiaries,” Alarcon explained.

From his perspective, the ability to ensure that the right medicines were available at health facilities in the right quantities, properly prescribed and dispensed, was overdue. All of these factors can significantly affect the quality of health services for patients. Better outcomes strengthen trust in the health system and ultimately lead to lower mortality.

International Medical Corps relied on proven technologies to develop the system. Scanners capture barcodes on the medicines to transfer basic information about the items and transactions into the system. PIMS uses simple interfaces so that users can easily enter relevant supply-chain information and basic patient data while the system uses preset algorithms in the background to augment the collected data. This enables the system to provide real-time statistical data and generate alerts so that supply-chain managers can take timely action and run their projects more efficiently.

The results are impressive. PIMS has many unique features. One of PIMS’ key differentiators is its ability to manage all types of goods from the central warehouse to the end-user, providing full visibility of all movements of goods within the supply chain in the last mile. Time-consuming practices and procedures dominated by manual spreadsheets are eliminated, resulting in greater efficiency and accuracy as well as streamlined operations.

Because PIMS enables accurate and efficient data collection and timely, flexible reporting, it increases process transparency for physicians, supply-chain managers and other staff, ministries of health and funders. Importantly, it frees up healthcare professionals to focus on patient care. PIMS also helps users with quantification, pharmacovigilance and drug-utilization review when dispensing medications.

Another plus is that the tool, which runs in the cloud but also locally, can be easily adapted to any language needed. PIMS currently runs in Arabic, English, French and Somali. It is compatible with other supply-chain systems and can be connected to complementary software via an integrated application programming interface (API). The software also can be easily adapted to any context and is adaptable to existing processes in the humanitarian and development sectors.

When International Medical Corps presents its new system to experts from the humanitarian sector, the reactions are “overwhelmingly positive,” according to Alarcon. He recalls a pharmacist saying after the software presentation, “For us, using PIMS would be like going from a cave to a spaceship.”

The Directorate-General for European Civil Protection and Humanitarian Aid Operations of the European Commission (DG ECHO) in Brussels has also commended PIMS, including the software in its thematic strategy paper as an “example of the best use of digital solutions in the use of track and trace technology.”

The highlight in 2023 was winning the Lynn C. Fritz Medal for Excellence in Humanitarian Logistics.

The 16-member jury was particularly impressed by the “bottom-up approach and the interdisciplinary teams that have created a cost-effective system that establishes maximum transparency and efficiency in the pharmaceutical supply chain.”

The international judges were also impressed by the rapid spread of the system. As of mid-2023, PIMS was in use at 165 sites in 16 countries. More than 1.7 million prescriptions have now been processed in the software and around three million items have been distributed to those in need.

Also contributing to the judges’ vote are the results evaluated in Jordan, South Sudan and Yemen:

• PIMS reduces out-of-stocks and overstocks to less than three percent.
• Inventory accuracy increases to 99.8 percent in the first month of use.
• Prescription time drops from an average of four to five minutes to 41 seconds.
• Waiting time for those in need is reduced from an average of 85 minutes to 16 minutes.
• Dynamic, proactive alert system results in 100 percent elimination of drug interactions and
  incorrect dosing.

Recognition, pats on the back, a medal: International Medical Corps is not keeping its success to itself. The system is being offered to other organizations. Alarcon says: “We firmly believe that PIMS is revolutionizing the way the last mile is managed.”