The penultimate article in our thought leadership series – Stronger together: Health supply chain voices – comes from Transaid’s Edward O' Connor. He draws attention to low safety standards for supply chain workers and asks how we can better support them.
When the COVID-19 pandemic took hold, the world began to notice the people who kept commodities moving: delivery drivers, heavy goods vehicle (HGV) drivers, motorcycle couriers and forklift operators were seen, although maybe not always officially recognised, as essential workers.
Five years later, the global landscape has shifted again. Overseas development assistance is rapidly shrinking, recognition of these essential workers has faded and fresh challenges are arising while others remain unresolved. Yet these transport and distribution workers remain the backbone of resilient and efficient supply chains. If their work is disrupted, health systems stall and lives are lost.
Drivers and operators move vaccines from ports to central medical stores and onwards to hubs and clinics. They deliver lifesaving treatments to remote health facilities and ensure that warehouses stay stocked and communities stay supplied. Every link in the health supply chain – from pharmacists and warehouse managers to stock controllers and community health workers – relies on their work. Yet, too often, their needs are overlooked in policy, planning and funding.
How can we best support these supply chain workers in the long term? Employers, governments and donors need to move beyond compliance to champion meaningful training, uphold strong professional standards and direct resources toward the areas where they can create the greatest, most long-lasting impact.
Driver training is often unregulated
Globally, in 2021 there was a five percent drop in the estimated number of traffic deaths when compared with 2010, according to the World Health Organization. However, there was an overall increase of 17 percent in the number of fatalities across the 28 countries in the African region.
Many transport and distribution workers are still treated as casual or informal labour. In Africa, the area of focus for Transaid, a lack of trained HGV drivers means many young men move from assistant to driver roles informally and, at times, illegally, without structured training. This keeps goods moving and ensures a level of supply in the labour market, but puts drivers, other road users and cargo at risk.
Driving standards vary widely across regions and refresher training, where mandated, is often given by the least expensive provider rather than the best. Training content is not regulated. The operation of HGVs, forklifts and motorcycles requires specialised skills, but operators often learn on the job without any formal instruction and often without adequate licence testing to accurately assess skills and knowledge.
Truck drivers in Sub-Saharan Africa often spend weeks at a time on the road, making it difficult for them to access timely and adequate healthcare. Supporting their welfare is crucial, as the demanding conditions of long-haul journeys can take a serious toll on their health and wellbeing. Many drivers are at risk of being exposed to infectious diseases, report increases in non-communicable diseases (NCDs) such as hypertension and diabetes, lack regular eye tests or glasses and have little or no consideration for their mental wellbeing.
During COVID-19, when all other movement was restricted, some drivers transporting essential commodities were stigmatised as spreaders of the virus and faced hostility from communities. This is a reminder that social attitudes towards these vital workers can be as damaging as the physical risks.
The rapid growth of the motorcycle delivery sector, for both urban environments and rural areas, brings new safety concerns. In many countries, one of many issues is that helmets are of poor quality and there’s little testing or enforcement of safety standards.
Countries and organisations must usher in higher standards
Governments, training institutions and the private sector can work together to lift and standardise driving standards. “Master trainer” programmes can help build capacity within countries, ensuring training is relevant and sustainable.
Training drivers isn’t enough though: buy-in from employers – both government and the private sector – is vital. This means:
- Equipping drivers with quality safety equipment
- Strengthening enforcement through policy and legislative frameworks, and improving the skills of police and other authorities
- Scheduling work to avoid excess driving/operating hours
- Using transport management systems (TMS) to help managers champion driver welfare and performance
Authorities can enforce helmet and road safety standards and invest in structured national training systems, such as Ghana’s new HGV curriculum.
With less funding available globally, efficiency matters. Partnerships between governments, the private sector and transport associations can help target resources where they have the greatest impact. Investments in driver training and welfare aren’t just ethical but also economically sound, paying for themselves through reduced crashes, increased reliability and stronger supply chain performance.
Supported supply chain workers ensure health products reach patients
Without competent drivers, medicines don't arrive, vaccines don't reach clinics and those most in need – the communities – can be left without the health products they need.
- Employers must go beyond compliance to invest in meaningful training, quality equipment, and health and welfare programmes. They should actively drive positive change in the sector.
- Governments must establish and enforce clear professional standards, ensure safety regulations are upheld and prioritise driver welfare in transport policy.
- Donors must target resources where they deliver the most significant impact, strengthening the people who keep the system moving.
This is not just a workforce issue; it is a health system issue.
A supply chain is only as strong as its workforce. We must protect and invest in these transport and distribution workers.
Edward O' Connor is a programme support manager at Transaid.
References
https://iris.who.int/bitstream/handle/10665/375016/9789240086517-eng.pdf?sequence=1
