Why leadership should be at the centre of workforce development

The next article in our thought leadership series – Stronger together: Health supply chain voices – comes from Stanley Chindove, supply chain manager at the Global Fund. In it he urges countries to invest in leadership.

 

Despite considerable investments in technology, infrastructure and operational delivery, challenges such as stockouts and last-mile delivery inefficiencies continue to plague health supply chains in Africa. Up to 40 percent of public health facilities in sub-Saharan Africa may experience stockouts of essential medicines at any given time. For critical health products, including antiretrovirals, antimalarials, contraceptives and vaccines, stockout rates can exceed 30 percent, particularly in rural health settings. 

The root of the problem often lies in the human systems that drive these initiatives. Health supply chains require dedicated and skilled personnel at all levels who can provide visionary leadership, engage stakeholders and facilitate sustainable reforms. Recognising and nurturing this leadership potential is essential for overcoming current challenges. Unfortunately, leadership in health supply chains is often underdeveloped, underfunded, undervalued and underleveraged. 

The sudden change in the supply chain donor funding landscape has revealed several hard truths and opportunities about leadership in African health systems, particularly in supply chain governance, exposing where leadership is strong and where it needs urgent development. In many African countries, where resources are often constrained and systems fragmented, strong visionary leadership is the most critical driver of health supply chain transformation. 

Over the past two decades, donor-driven supply chain initiatives have made substantial contributions to improving health supply chains in Africa, but in many cases, this external funding has unintentionally undermined local ownership. As we witness shifts in donor support, such as USAID scaling back, Gavi pushing for co-financing and the Global Fund's evolving focus, countries have an opportunity to reassess and strengthen their national leadership. In the absence of robust national leadership, health systems can struggle to adapt effectively, revealing the need for better planning for sustainability, local ownership and in-house expertise.

Fostering national supply chain leadership builds local ownership and decision-making to promote sustainable country-led programmes. Capable supply chain leaders play a crucial role in driving improvements in last-mile delivery, enhancing accountability and increasing system efficiency. Thus, investing in leadership development not only addresses immediate needs but also builds a legacy of capacity building by developing a pipeline of national experts. Africa needs leaders who can sustain the ongoing reforms and ensure long-term success and resilience in health systems.

Barriers to leadership in health supply chains

Despite its importance, leadership development in health supply chain management remains largely absent from health system planning in many African countries. Some of the key barriers include:

  • Lack of formal leadership training in health supply chain career paths, with a focus mainly on logistics and operational management, neglecting strategic thinking and people management skills.
  • Limited visibility and influence of health supply chain functions within ministries of health, leading to weak policy integration and insufficient budget allocations.
  • Donor-driven models that prioritise short-term technical outcomes over long-term leadership development and national ownership.
  • High turnover in key health supply chain leadership roles disrupts continuity and undermines institutional memory.

In many African countries, there are strong supply chain leaders within ministries of health, medical stores, health facilities and at the community level. However, many of these leaders often lack a clear platform, resources or political support to act. In some cases, leadership is often fragmented across government, implementing partners and donors with no unified direction. In addition, strategic leadership, covering policy, sustainable financing and long-term planning, is rarely developed in supply chain units. Technical leadership alone is not enough. What is needed is a constructive leadership model that brings together people who can align across sectors, manage complexity and advocate at the highest levels.

Fostering a constructive leadership model in health supply chains

Leadership in health supply chain transformation is not limited to high-level policymakers or directors of pharmaceutical services or central medical stores – it spans many professionals across the entire system. Political leadership is crucial, particularly from ministers who can prioritise the health supply chain as a strategic pillar of health advancement. 

The call for strong political leadership and mutually beneficial partnerships in health supply chains in African nations is both urgent and critical. Without prioritisation, resilience remains elusive and prior gains risk being eroded. 

How to prioritise leadership in health supply chains

To maximise the impact of available supply chain innovations and tools, it is essential to empower national leaders who can champion their adoption, integration and scaling. To effectively transform health supply chains in African countries, the global health community should prioritise leadership as a foundational element of health systems strengthening. This approach can be realised through the following actions: 

  1. Integrating leadership development into all health supply chain programmes, from global grants to national strategies. Successful initiatives like The Strategic Training Executive Programme (STEP 2.0) serve as models for enhancing leadership development across various levels of health supply chains.
  2. Establishing dedicated supply chain leadership tracks and roles within ministries of health. This ensures that health supply chain leaders can actively participate in decision-making processes and have a meaningful influence on outcomes.
  3. Investing in national or regional training academies and South-South learning platforms such as the Supply Chain Leaders Forum (SCLF). This investment aims to cultivate and elevate local and regional expertise, fostering a talent pool that can drive change.
  4. Encouraging cross-sector collaboration. By drawing on insights from the private sector and broader logistics ecosystems, health supply chain leaders can adopt the best practices that enhance efficiency and effectiveness. By taking these steps we can create a robust leadership framework that supports the sustainable transformation of health supply chains, and ultimately improve health outcomes across the continent.

Where strong leadership has made a difference

The transformation of health supply chains, driven by strong leadership, is not hypothetical. Several African countries have demonstrated that when leadership is prioritised, results follow. 

Rwanda has decisively integrated supply chain management into its national health strategy with robust government ownership. By empowering district-level logisticians and investing in performance management, Rwanda has increased the availability of essential health commodities, such as HIV test kits, antiretroviral treatment medicines and oral contraceptives. [JM1] Over 90 percent of health facilities consistently submit monthly reports and the national average for facility order fill rates stands at an impressive 90–95 percent. 

Ghana has successfully institutionalised leadership training within its public health supply chain system. Through structured, performance-based programmes and leadership fellowships, supply chain managers have emerged as vital strategic actors in health service delivery. This proactive approach has driven substantial supply chain performance enhancements, with stockout rates for antiretrovirals, family planning products and antimalarials averaging less than 10 percent nationally. Over 80 percent of health facilities reliably submit reports monthly, while order fill rates from central medical stores to districts consistently hover around 90 percent.

Nigeria is actively rolling out drug management agencies to streamline state-level procurement, warehousing and distribution of essential medicines to public facilities. The rollout of drug management agencies is decentralising supply chain leadership to states, contributing to driving policy implementation, strengthening governance and accountability structures, and enabling the mobilisation of state resources to secure financial, technical and human resources to support last-mile supply chain operations. While performance varies across states, some, including Lagos, have implemented effective reforms that allow semi-autonomous operations, established framework contracts with suppliers and strengthened last-mile delivery strategies. These initiatives, exemplifying strong, visionary and accountable leadership, have substantially improved the availability of essential medicines and enhanced the predictability of state-level budgeting.

Partnerships driving leadership development 

People that Deliver, a broad coalition that includes funders, technical partners, professional associations, academic institutions, and the private sector, has elevated supply chain workforce development as a strategic health investment. STEP 2.0 builds strategic leadership, communication and systems-thinking capacity for mid- to senior-level supply chain managers. Since 2016, over 900 public sector supply chain leaders have been trained across Africa and Asia, many of whom have transitioned into more senior roles.

In tandem, a group of funders, including the Global Fund, the Bill and Melinda Gates Foundation and the World Bank, is leveraging the SCLF as a strategic platform to engage and elevate national supply chain leadership. The SCLF brings together senior government officials, supply chain leaders and partners to discuss national priorities, challenges and innovations. It creates space for country-led discussions, enabling national leaders to voice needs and shape agendas, thereby strengthening government ownership.

By engaging ministries of health, finance and other national bodies, the SCLF helps align supply chain reforms with broader health sector strategies and national development plans. This encourages governments to embed health supply chain priorities into national budgets and policies. It is also used to highlight successful national supply chain leadership models, enabling cross-country learning and inspiring political will. 

Looking ahead

As African countries confront rising demand, shifting disease burdens, climate change pressures and the expectations of digital transformation, their health supply chains must become more agile, resilient, and client-centric. This will not happen without leaders who can think systemically, act strategically and inspire change across fragmented systems. The current global development funding landscape offers a great opportunity for African countries to reclaim and redefine leadership for their health supply chains.

Moving forward, African countries must prioritise bold, coordinated and visionary leadership in health supply chains or risk sliding backwards just when they most need resilience. The future of health supply chains and the health of millions of beneficiaries that we serve depend on it.

 

Stanley Chindove is a global health supply chain expert with over 20 years’ experience supporting health supply chain system strengthening in low and middle-income countries. He currently serves as a supply chain manager at the Global Fund. 

*The views expressed in this article are the author’s and do not reflect the views of any organisation(s) associated with the author

 

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