"Even if we had free and unlimited supplies of ARVs and other essential HIV/AIDS commodities, they would still not be available to the majority of people who need them because of poor infrastructure." —Dr. Gordon Perkin, senior fellow, Bill & Melinda Gates Foundation

Efficient logistics systems for health save lives. A regular supply of HIV/AIDS commodities at service delivery points is especially critical to the success of antiretroviral (ARV) treatment programs, because supply interruptions endanger patients by introducing the risk of drug resistance. Resistance can develop when HIV replication is not fully suppressed.

Public health and international assistance organizations cannot successfully address HIV/AIDS unless the right products for prevention and treatment are delivered in the right quantities, in the right condition, to the right place, at the right time, and for the right cost. This is the role of logistics—a role often under-emphasized and under-funded in the planning of public health initiatives in the developing world. For a program to be efficient and to eventually function without outside assistance, donors must balance their participation between directly providing urgent commodities and services, and reinforcing the program’s infrastructure.

As new funding mechanisms and initiatives help to vastly increase the number of HIV/AIDS commodities that will be available to developing countries, logistics systems need to be strengthened to avoid costly wastage. A comprehensive HIV/AIDS program must manage more than 200 distinct products, including HIV tests and other laboratory reagents, ARV drugs, medicines for treating sexually transmitted infections and opportunistic infections, condoms, contraceptives, and consumable supplies. But many existing distribution systems, particularly in Africa, are unable to consistently provide even the most essential medicines to service delivery points.