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1. CLICK TO ADD TITLE The 5th Global Health Supply Chain Summit November 14 -16, 2012Kigali, Rwanda Supply Chain Design to Mitigate Risk Ryan Purcell – MD, LLamasoft Africa + Indian Rim [SPEAKERS NAMES] [DATE]

2. Supply Chain Design • A process that attempts to optimize the supply chain’s structure and policies in order to make the best uses of the resources available, as defined by a holistic, end to end view of all the relevant metrics of interest • Process, not an outcome • End to end, cross functional, network structure AND policies • A supply chain’s design can make it easier, harder, or impossible to plan, manage, and execute

3. Antipaludiques Contra- ceptifs MEG ARVs M.T.Nég TB IO ARVs Ped REACTIFS VACCINS Dispositifs Médicaux Systèmes d'approvisionnement des produits pharmaceutiques en HAITI, Octobre 2011 Etat P. Privé Bailleurs bilatéraux Bailleurs multilatéraux ONG G S K U S A I D ETAT (Secteur Privé) U N I C E F PROMESS (Population) O P S F N U A P F M S C M S U N I T A I D A M E R I C M M B P I H D R I Sources de Financement Structure d'appro- visionnement Importateurs privés PIH PROMESS (OPS WDC) AMERICARES GSK PNUD UNICEF SCMS JSI CMMB DRI FNUAP 1er point de stockage Grossistes privés UNICEF LMS PSI CMMB DRI SCMS PIH AMERICARES PROMESS 2ème point de stockage Grossistes privés CDAI Officines CS privés confessionnel Structure dispensatrice Cliniques privées CHU CHD CHC CS Dispensaires ONG/Association PATIENT

4. Supply Chain Design: Service Metrics On time delivery In stock rate Order fulfillment lead time Percent of demand satisfied Proximity: How close are we? Others?

5. Supply Chain Design: Financial Metrics Income Statement Revenue Expense (EBITDA) D&A Taxes Profit Balance Sheet Assets Liabilities Debt and Equity Capital Cash Flow Payback period Interest Financial Sustainability Time Horizon! Do we need to recover costs THIS year???

6. Supply Chain Design: Logistics Metrics Number of Facilities Factory/Warehouse space Inventory Assets and Equipment Labor Complexity

7. Supply Chain Design: Sustainability Metrics CO2 / Carbon footprint Water usage Solid waste Hazardous waste Social Externalities Can this supply chain operate “as designed” for the medium to long term? Is that necessary?

8. Supply Chain Design Metrics Natural Disasters Infrastructure Challenges Supply Disruption Demand Volatility Political Instability • What % of population can be served • effectively? Service R I S K • Total costs of serving population • Fixed and Variable Operating Costs • Trade-offs between costs Financials • Capacity Requirements • Complexity Supply Chain • Countryplans for expansion • Expected growth trends • Security Sustainability

9. Refining the SCG solution • Expansion and Growth • USG, Haiti, and other countries investing heavily in the Cap-Haitien region • Expecting population migration • Security • Greenfield chooses Gonaives, an area the client called “Bandit country”, as closest city in solution Long-term sustainability

10. Refining the SCG solution • Road Factors (Traffic & Flooding) • Seasonal Road obstructions due to landslides and flooding • Heavy traffic in and around PAP • Natural Disaster • Port Au Prince goes down affecting • Inbound supply from overseas • Inland distribution Accounting for Risk Seasonal Road Obstructions due to flooding and landslides Source: WFP Log Cluster, Haiti

11. Proposed Warehouse and Distribution Structure Percentage of population within 3 hours: 77% 5 Hours: 94% • Additional Warehouses in Cap-Haitien and Les Cayes, to serve population in the north/north-west and south-west, respectively • Cap-Haitien to act as a secondary port for inbound supplies