Sarah Andersson

With JSI since 2007

Senior Technical Advisor for Center for Health Logistics

What attracted you to pharmaceutical work and international health?

Sarah Andersson in Malawi

When I finished university I realized I liked people and chemistry–pharmacy seemed to have both. Once I qualified, I found that in fact, it turns out that pharmacy, especially retail pharmacy, was more about the money than the customer.

So I went backpacking to Africa. Two months in I broke my ankle and had to MedEvac to Australia for surgery. While recovering in sunny Oz, a pharmacist friend of mine rang me from a remote and beautiful town in Northwestern Australia and said, “There is another pharmacist position. You should come.” So I went and worked with aboriginal communities. At the time the Australian government was assessing the access and distribution of medicines to remote aboriginal communities, and we were asked to collect data in the communities that we supplied. So began my interest in working in more challenging environments.

From there I moved around to other parts of Australia; remote, but beautiful places. Then, I met a pharmacist who had just come back from Vanuatu where he had been an Australian Youth Ambassador for Development (volunteer) for a year. He was very excited and told me I should apply to be his replacement. So I ended up in the South Pacific building capacity in pharmaceutical management in yet another remote and beautiful place. Much better than being in a pharmacy in a shopping mall!

Can you help the rest of us understand more specifically what role pharmacy plays in the supply chain management process?

In terms of pharmacy and the supply chain,  despite never learning formally about supply chains, every pharmacist becomes involved in one way or another. I probably became even more involved than most pharmacists in my work in Vanuatu and with Australian aboriginal communities. I was always looking for ways to make things easier and more efficient. Even in well-resourced settings, such as Australia, the supply chain can really affect your day-to-day work and the effectiveness of health services. Working for JSI on projects like the USAID | DELIVER PROJECT or SC4CCM has given me a lot of answers, and I often think about going back to share those answers with some of my past workplaces.

After DELIVER what did you work on?

From 2010 to 2015 I worked on a project called “Improving Supply Chains for Community Case Management of Pneumonia and Other Common Disease of Childhood” project— the SC4CCM project—which was funded by the Bill & Melinda Gates Foundation. The project worked in Ethiopia, Malawi, and Rwanda, with community health workers to ensure they had the medicines needed to treat sick children in their villages. It was an exciting project in which we had the opportunity to test innovative ideas and then try and make them work across the whole program.

Since then I have moved to being a Senior Technical Advisor for JSI’s Center for Health Logistics working on many supply chain projects big and small.

What have you been working on these days that’s exciting you?

I have been doing a lot of work around using data for decision-making: how can we get people to use analytics and visualize their data and use that for making decisions around their supply chains? It’s mostly stock-level datamonitoring stock outs, monitoring coverage of vaccines, tracking how many vaccines are being wasted. It’s exciting because we’re getting more data, using systems that have nice visuals, and building people’s skills to use data on the ground. We’ve created “Impact Teams” comprised of Ministry of Health staff in the different countries to problem solve using the available data.

You’re also the activity manager for a new project–Track and Trace. What’s that about?

Track and Trace brought together JSI’s supply chain logistics expertise with our partner, World Education’s work in schools. We entered the All Children Reading Grand Challenge with a proposal to build a system that tracks the delivery of school books to primary schools in developing countries.

There’s a lot of evidence that many books don’t make it into the hands of kids because they get diverted through various means. The goal of the program is to make sure that books get to schools in remote villages. Teachers and parents register for the system using their mobile phones and then receive information that their books are coming. They can then follow up and make sure the books are actually getting to the schools. Education department staff can also track the books on the website and monitor when the books left the warehouse and when they will arrive at the school. The books are tracked using a combination of SMS, barcodes, and the Salesforce software.

Using the All Children Reading grant, we piloted a feasibility test in Malawi in November 2016 in a couple schools. They found the system very useful–and it was easy to use and train on. So now World Education and JSI together are looking for opportunities to use the program in other countries. We’ve seen that the approach increases transparency and accountability in the distribution of textbooks so that more books reach classrooms and more kids have access to school books. The importance of getting reading materials to kids in schools so they can actually sit and read a book is essential. I think the project has the potential to contribute to improving literacy. Obviously, there are other factors at play, like the quality of the teaching, which World Education is working on, but this is an important first step toward improving literacy.

What do you think is one of the most critical issues facing international public health right now? What’s a top public health priority?

It’s complicated because there are so many different things. I think that antimicrobial drug resistance is going to become a big issue. Bacterias are not responding to antibiotics, due to poor prescribing by doctors, patients not understanding how to use their medications, or pharmacies running out of stock. We’re seeing some infectious diseases that cannot be cured by the antibiotics we have, and I think it’s going to become more of a problem for us. Being able to improve the way antibiotics are used and to monitor that is going to be a big challenge.

I also think climate change is going to become more of a problem, how we respond to natural disasters and changes in climate will most certainly affect disease patterns.

A Project to Remember

The SC4CCM project helped strengthen the supply chains for community health workers who were working to treat pneumonia, diarrhea, and malaria, with a focus on child health. We had a small team of about 25 people working in Kenya, Malawi, Rwanda, and Ethiopia. Everyone was very dedicated and worked hard to do quality work. It was just a really close, dedicated team, very supportive. We had some highly successful interventions. We created a mobile health tool for community health workers. That was where we came up with the impact teams, and we’ve gone on to do that in other countries. We’ve seen a decrease in the number of stock-outs and an increase in the number of medicines available.