Effective purchasing and supply lines for getting emergency aid supplies to the projects are critical for MSF to be able to provide effective medical aid. Our supply lines are organised such that they guarantee as much as possible that medicines, vaccines, specialised nutritional supplies and logistical materials arrive in the right place at the right time. We also have strict quality standards for the supplies and materials we use.

Purchasing growth

In 2013, more than 40,000 orders were handled by the MSF Amsterdam Procurement Unit. This was in excess of 4,000 more orders than in 2012. The value of the purchases amounted to €28.2 million (2012: €24.0 million). The volume and value of the purchases supplied to our projects is growing because we are providing large-scale aid in a number of countries, such as South Sudan and Myanmar, and because we are treating more and more complex diseases such as multidrug-resistant tuberculosis. To treat this disease, for example, more laboratory materials are required, the medicines are more expensive and the courses of treatment prescribed to the patients take longer.

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Guaranteed availability

It is of the utmost importance to MSF’s medical work that the stocks are always maintained and that our medical staff never lack the medicines they need. In 2013, we delivered 1,485 shipments of supplies (2012: 1,384) and succeeded in getting 84per cent of the orders to the projects in time (2012: 88per cent). Delays in deliveries and transport are usually due to general import restrictions imposed in the countries where we work and are thus regrettably unavoidable. This means that it can take a long time to import medicines and emergency aid supplies. The extended chain of ordering, purchasing, delivery and import means that orders must be placed 3 to 4 months in advance, while the reality in our projects is that conditions can change very rapidly. In 2013, we sent 60per cent of the goods tonnage by sea and over the road, while the rest was sent by aeroplane. By planning the shipments efficiently, we can cut costs and at the same time try to decrease our carbon footprint. This year, we deployed refrigerated containers extensively for the first time in order to improve the shelf life of certain medicines.

Our greatest challenge in 2013: South Sudan

The greatest logistical challenge for MSF in 2013 was once again South Sudan. The country as good as completely lacks a paved road network, so that we had to transport much of our supplies by aeroplane. MSF works at an average of 6 project locations in South Sudan simultaneously, in areas that are relatively far apart or remote. In addition to the basic health problems in those areas, in 2013 our teams also had to deal with outbreaks of hepatitis E and kala-azar. We also had to set up a widespread vaccination campaign against cholera. MSF had to build practically all the medical facilities in South Sudan itself and supply these with water and electricity. Various facilities were thoroughly refurbished in 2013. Towards the end of the year, there was a large-scale outbreak of violence that resulted in thousands of people killed or put to flight. Unfortunately, a number of our facilities were destroyed in this violent outbreak. In 2013, we shipped 154 tonnes of supplies to our projects in South Sudan (2012: 360 tonnes).

Stock management

We book the costs of medicines and emergency aid supplies to the projects as soon as they are dispatched. Due to the long supply lines, our projects maintain, on average, a 6 month supply of stocks that must be managed locally. At the end of 2013, the value of these stocks was about €16.5 million. The efficient management of local stocks is an ongoing challenge that we continually try to improve, not in the last place because our policy is geared to preventing shortages. The recent growth in volumes, the increase in the number of products, and the sometimes short shelf life of specific medicines means that we need to invest in better stock management systems that are tailored to the local conditions. Various projects are currently underway to improve stock administration and management. Because of the nature of our projects, we accept that medicines and supplies sometimes need to be written off. Patient numbers can prove to be lower than expected, clinical pictures can turn out differently or access to our clinics may be limited due to a local conflict. In 2013, we were forced to write off a lot more supplies than in the previous years. More than 7.5per cent of the value of our purchases was not actually used in our projects in that year. In 2012, this was about 3per cent. All write-offs are followed up by our logistics department so that we can try to prevent similar problems from occurring in the future. We made good progress in 2013 with an inventory of the stocks at risk of reaching the end of their shelf life in the short term and we try to plan exchanges of surplus supplies between projects where this is affordable.

Plans for 2014

In 2013, we started a programme to improve joint purchasing with MSF-Belgium and MSF-France, both of which have access to large distribution warehouses. In 2014, we will negotiate new purchase contracts with selected suppliers that will apply to MSF worldwide.

We will also continue to work on improving our purchasing and stock management systems in the project countries. We expect the information system that we are building to this end will be completed in 2014 so that we can deploy it in 2015. In addition, we will continue to monitor local and international purchasers’ and stock managers’ compliance with our procedures and codes of conduct within the framework of our integrity policy. See also Accountability Statement.