Research spotlight: Improving HIV Early Infant Diagnosis Supply Chains in Mozambique

Using the lessons of operations management to improve population health

Researcher: Jónas Jónasson

According to the latest UNAIDS data, 150,000 children are infected with HIV in sub-Saharan Africa annually. A third of those infected and left without treatment die before their first birthdays. As administering lifesaving treatment depends on timely testing and diagnosis, therein lies the root of the challenge—HIV tests have historically depended on a complex and inefficient supply chain, with time lags extending for months.

Through a landmark study in Mozambique, Jónasson and his colleagues have recently investigated ways to speed up not only lab procedures, but also the supply chain itself. By shaving precious days, weeks, and even months off diagnostic turnaround times, infants infected with HIV are able to get treatment quicker.

Testing has traditionally been distributed through a network of clinics and labs throughout the country, leading to misused resources and unacceptable delays. In general, shorter turnaround times can be achieved by improving the clinic-to-lab supply chain, through increasing the number of vehicles equipped to transport samples, hiring enough drivers, training enough medical personnel, buying the right type of diagnostic equipment, and improving communication systems. But, their study indicates that improving the day-to-day operations of clinic-to-lab supply chains is simply not enough: sometimes the opportunities lie in the structure of the supply chain itself. Jónasson and his colleagues modeled the operational, medical, and behavioral aspects of the system and concluded that consolidating all diagnostics into a single lab destination could decrease average turnaround times by an estimated 22 percent. This would increase the number of infected babies initiating treatment by 7 percent, potentially saving the lives of up to 50–60 children per year in Mozambique.

1. “Improving HIV Early Infant Diagnosis Supply Chains in Sub-Saharan Africa: Models and Application to Mozambique.” Jónasson, Jónas Oddur, Sarang Deo, and Jérémie Gallien. Operations Research Vol. 65, No. 6 (2017): 1479-1493.