In over ten countries, the USAID | DELIVER PROJECT has worked to find innovative solutions to address the unique supply chain challenges posed laboratory commodities, including:

• Laboratory systems pose a unique challenge to ensuring a continuous supply because of the considerable number of commodities that must be managed. For example, a comprehensive HIV/AIDS program can require hundreds of commodities for complete and quality service delivery systems (see Figure 1). In addition, laboratory commodities often come in a variety of preparation, including dry powders, liquids, and kits, and have a relatively short shelf-life.
  
  

  Figure 1

  
  Approaches: Designing and implementing logistics systems that can effectively deliver hundreds or thousands of commodities without compromising the continuous availability of products that have a short shelf life or require cold chain storage.
  
  
• In most laboratory systems multiple stakeholders involved in supply and operations (e.g., governments and donors), pose a challenge to program management.
  
  Approaches: Establishing a central coordinating body to bring together multiple stakeholders, empower them to make decisions and task this body with overseeing laboratory system operations.
  
  
• The multiplicity of techniques and procedures, and brand proliferation of laboratory instrumentation results in a large number of laboratory supplies for which forecasts must be prepared.
  
  Approaches: Standardizing testing protocols, instrumentation, and procedures—and, therefore, the commodities managed in the laboratory system—are essential to ensure efficient and effective management of laboratory supplies. However, the actual implementation of standardization can be quite difficult, particularly when managing legacy supplies and instrumentation donation.
  
  
• Lack of logistics information to determine order quantities or forecast national requirements.
  
  Approaches: Developing and strengthening a logistics management information systems (LMIS) to collect accurate, reliable, and consistent logistics information on laboratory commodities, currently unavailable in most settings.
  
  
• Uncoordinated funding and limited commitment to procure a wide-range of laboratory commodities required to provide comprehensive laboratory services.
  
  Approaches: Securing funding for the long-term, uninterrupted procurement of laboratory commodities; Coordinating procurement of laboratory commodities among donors.
  
  
• Laboratory commodities are bulky and require special storage (including cold chain) to ensure product integrity.
  
  Approaches: Securing warehousing and distribution of laboratory commodities, to ensure proper storage, and to reduce wastage and expiry. Identify laboratory specialists to oversee the storage of laboratory commodities in central and regional storage facilities and during distribution.
  
  
• Balancing the need to immediately implement effective logistics systems with the long-term need to strengthen existing systems.
  
  Approaches: Design, implement, and monitor laboratory logistics system, with a view of the long-term integration within existing supply chains.