Supply Chain

It's 3 a.m. in Kampala, and a delivery truck is making its way out of the city. Inside are boxes of malaria medicines and tests, each labeled with a unique code. By the time the sun comes up, they'll reach a community pharmacy and, eventually, a child who spiked a fever the night before.

When people think of supply chains, they often picture warehouses and spreadsheets. But I see it as a very human story. When our own inventory reached its millionth malaria patient, what that meant to me was a million times someone walked into a pharmacy, the right medicine was there, and they could afford it.

Supply chains are always working behind the scenes to make our health programs possible. It's like the engine of a car: You don't usually look under the hood, but nothing moves without it.

We've spent years building our supply chains using proven private-sector practices, designed to be resilient without relying on any single manufacturer, country, or funding stream. That approach is what kept essential products moving in early 2025, even as parts of the global health system faced disruptions.

Our journey starts long before a patient walks in. We negotiate directly with manufacturers to purchase quality-assured medicines in bulk. We bring these through customs and store them in our warehouses. And we serialize them ourselves, giving each box a unique identity we can track down to the pin on a map.

Then we wait for a pharmacy to place an order.

When a pharmacy in our network needs to restock, they open Shopify—the same platform millions of online stores use worldwide. For our partners, it means an ordering experience that feels familiar and modern.

That order flows through our system until we pack and hand it off to local delivery partners. In our malaria program, drug shops, pharmacies, and clinics go from placing an order to receiving stock in less than 24 hours.

To make that possible across four countries, we've built a network of hubs and spokes. Each country has a central hub. But geography doesn't always cooperate. Nigeria has high demand in northern regions like Kano and Kaduna, far from Lagos. Zanzibar is an island off the Tanzanian mainland. So we position smaller "spokes" closer to where they're needed, with stock ready to deploy.

By the end of 2025, we had four hubs and three spokes across our four countries of operation, with more planned for 2026. And we do it without a massive fleet or sprawling infrastructure. By partnering with local logistics providers who know the terrain and in some cases live within these communities, we keep our costs low so more resources go toward patient care.

When a delivery arrives at a pharmacy, the story isn't over. It's just entering a new chapter.

Our supply chain is one piece of a larger model: We keep quality products on shelves, while our software guides care and captures data. Meanwhile, our reimbursements ensure that the most effective treatment remains profitable for providers and affordable for patients.

Historically, once medicines entered the private sector, tracking what happened to them was a constant challenge. This made large-scale health programs difficult, especially when they needed to reimburse providers while ensuring medicines were used as intended.

Our model solves these challenges. Through serialization, app-based tracking, and automated verification, we've created a level of transparency into our supply chain that's never existed at this scale among independent providers.

And this isn't just about protecting the integrity of our own program. It's about protecting pharmacies, too. For many business owners, inventory loss, unclear records, and unpredictable cash flow are constant risks. So, when they join our malaria program and place a deposit to receive medicines, it's about more than just growing their revenues. They're plugging into a system that helps prevent losses and makes every transaction easier to account for. Meanwhile, patients who benefit from lower prices and reliable care come back. It's a positive feedback loop, but it only works if everyone can see and trust what's happening.

We didn't start with a perfect system. We started with a pilot.

In the early days of Maisha Meds, we printed alphanumeric codes on product boxes and asked pharmacies to photograph them as they were being dispensed. On our end, team members manually matched each photo to a master list. It worked, but it didn't scale. The volume quickly outpaced what humans could review.

So we iterated. We generated codes that were unique to each pharmacy, so we already knew where in our records to look. We added tamper-proof stickers that break apart if someone tries to peel and reapply them. We moved to QR codes for faster scanning, with a typed backup for phones and tablets that have lower-quality cameras. We built automated flags that prevent duplicates and reuse.

And at the end of each patient visit, we were ultimately able to link the product code to a verified patient record automatically, with strong privacy safeguards in place—closing the loop from port to patient. That level of end-to-end traceability even caught the attention of a major global pharmaceutical partner that donated medicines to our program, which came to us wanting to understand how we'd built what had been an ongoing challenge for them.

At the end of the day, patients have reliable access to quality medicines. Pharmacies don't worry about stockouts. Owners have real visibility into their inventory. And the governments, insurers, and donors who finance this care only pay when it's verified.

We're constantly iterating on new ways to keep our team lean, stay ahead of risks, and adapt as we grow.

For example, we're working on forecasting models that help pharmacies predict what they'll need based on their own sales history, seasonality, and local trends—like rainy seasons when malaria spikes. We're building improved dashboards so we can better monitor what's in stock in real time. And we're refining our serialization process with better printing technology and easy-to-use authentication codes for receiving shipments.

Most importantly, our supply chain isn't just for malaria. It has allowed us to scale and expand into new health areas without having to build everything from scratch each time. All of this infrastructure now supports HIV medicines, eyeglasses for near-vision loss, and more.

Supply chain might not seem glamorous at first. Yes, it's a lot of trucks moving through the night, codes being scanned, supply being tracked, and issues being addressed before they reach patients. But when I think about what we've built across four countries so far, I'm not always thinking about numbers or speed or scale. I'm thinking about keeping a promise we've made to the people we serve: that the health system will have what it needs to do its job when it matters.