Last week's discussion was the futuristic dream of the 'decentralization=democratization' paradigm of health-care. In this model,supplies are manufactured in the places where people need them. But stepping back into the reality of the present, there must be some things we can improve in logistics to overcome the plight of, say, a polio vaccine getting to a rural child in Pakistan (painstakingly articulated by NPR) or the inability to get necessary medicines into Haiti post-earthquake.
Perhaps two of the big four technology companies can give us insight: Apple and Amazon (the other two of the four being Facebook and Google, though they are still mainly in the computing/internet business). Apple is a singularly vertical company which produces all its own components and software to manufacture a final product to which users ascribe a 'halo effect.' Its ability to negotiate with its suppliers comes from its scale and from its customers strange proclivity to be completely inelastic to price or supply shocks (a google nexus 7 isn't that inferior to an ipad mini!). It's unclear if any international health organization has the financial clout to impose Apple-like rules of procurement on its suppliers. Perhaps consortiums or individual organizations can negotiate improved access using the shield of 'humanitarianism' into conflict areas? In reality - these organizations already try pretty hard to get access and it's not clear logistic lessons from Apple have anything to offer.
On the other hand, Amazon is a polyamorous giant, sprawling multiple supply vectors and financial models. It sells products directly. It sells products for other companies. It supplies physical products and also 'clouded' products. It competes with Apple and Microsoft and Google. But it also competes with Fedex. It has huge warehouses of server farms and also buys robots for its fulfillment centers. In short, it does a lot of things, all of them having logistical implication.
There are many lessons to be learned from Amazon for international health organizations - how to maintain warehouses, how to rapidly fulfill field orders, how to ensure product quality, how to track feedback, etc. But perhaps, as this article discusses on the nature itself of Amazon, international health organizations need to continue thinking through how much of a vertical versus horizontal organization they'd like to be versus just divesting non-health related entities, like this one. Does an NGO want to manufacture medications, warehouse them, buy planes for transport, and then actually treat patients also? Or would it rather buy medications from a pharmaceutical, pay a logistics company to transport and house them and then finally when the supplies are in the field, treat the patients?