Advancing Supply Chain Resilience for Canadian Health Systems

Every government leader and health-system leader knew, or should have known, that a pandemic was inevitable. Yet, when the COVID-19 pandemic arrived, the Canadian health-care supply chain was not ready. Critical supplies were held up by lockdowns in China and disruptions in transportation networks. Competition between provinces for emergency supplies meant places with the greatest needs were not prioritized. Healthcare professionals were given top-down orders on the supplies they were to use, denied the autonomy to make infection-control decisions applicable to their specific situations. With no direct involvement by health-care workers in procurement decisions, governments bought many unnecessary, poor-quality or counterfeit supplies that were wasted. Shortages drove a “hospital-first†approach, which resulted in supplies being diverted away from non-hospital settings experiencing critical need, such as long-term care homes, sometimes with devastating consequences. To ensure a more resilient health-care supply chain that will withstand future disruptions, shortages and crises, policy-makers need to learn from the problems encountered during the COVID-19 pandemic. A more sustainable supply chain requires data standards and digital infrastructure that enable the tracking of supply inventories and product usage in near real time. It is critical that this information is consistent across all provinces, and at the federal level, to provide true visibility that monitors supplies and needs, while identifying risks of shortages early. It is also vital that the health-care workforce is involved in the management and maintenance of supplies, so that they can inform decisions that serve patients and feel confident in the safety of their own workplaces. Canada also needs to ensure it no longer pursues a supply-chain strategy that prioritizes lowest-cost producers, which resulted in our overdependence on a single region. Resilience in the supply chain will require diversification of product sources. It will also benefit from policies that support domestic manufacturers, including by providing them privileged access to provincial health-care markets, allowing Canadian suppliers to grow to sufficient scale so they can become reliable sources for the domestic market and also profit from international sales. The fragility of the supply chain that was exposed by the COVID-19 pandemic revealed just how important the supply chain is. Human lives depend on 100-per-cent supply availability. Accurate, timely, automated and interoperable supply data, and the involvement of frontline health-care workers in procurement decisions, make datadriven and collaborative leadership possible, while mitigating the risks of future supply disruptions. The COVID-19 pandemic will not be the last health-care supply crisis that Canada will face, but the lessons learned from this crisis about supply-chain fragility will allow us to become much better prepared for the next one.