• ,

    Tuberculosis has a last-mile delivery problem in Africa. A new logistics platform is trying to fix it.

    Tuberculosis has a last-mile delivery problem in Africa. A new logistics platform is trying to fix it.
    Forklift truck with boxes on pallet. Aid cargo concept.

    Share

    Share

    Tuberculosis is curable. Yet,  for many patients across developing countries, survival depends less on medicine and more on logistics.

    In 2024, the disease became the world’s leading infectious disease killer, with  10.7 million people falling ill globally, according to the World Health Organisation. Africa accounts for a significant share of cases and deaths.

    Weak infrastructure, paper-based systems, and fragmented logistics often disrupt the supply of essential health products, leaving frontline facilities underserved.

    As the world marks World Tuberculosis Day 2026, health experts are turning to innovative solutions to address these gaps. One such initiative is the Logistics Marketplace, a platform that connects governments, humanitarian organisations, and health partners with local logistics providers in emerging markets. By centralising provider discovery, streamlining procurement, and improving visibility into the movement of medicines and diagnostics, the platform aims to reduce the long-standing bottlenecks in treatment delivery.

    Scott Dubin

    For Scott Dubin, a global health supply chain expert involved in the initiative, the goal is simple: ensure that treatment tools reach those who need them most.

    The last mile problem

    Medicines and diagnostics are available. What consistently fails, Dubin says, is last-mile delivery. “The issues are around forecasting, visibility of where the product is, how it can be redistributed between oversupply and undersupply, transportation planning, and weak coordination across the system,” he said.

    To address these gap, several African countries have turned to drone technology. In Rwanda, Zipline drones deliver blood products and essential medicines to remote facilities in minutes, replacing road journeys that once took hours by road.  The programme has expanded across Nigeria, Kenya, Ghana, and Côte d’Ivoire, reaching more than  5,000 health facilities.

    However, Dubin cautioned that drones are only a part of a broader solution. “Drones can solve some geographic barriers, but without strong management and oversight, technology only goes so far. It’s usually a mix of systems working together.”

    Tuberculosis highlights this complexity. Unlike malaria, where testing can often be done on the spot, TB diagnosis depends on a chain of equipment, samples, and data moving in multiple directions. Supplies move downstream to facilities; specimens travel upstream to laboratories; and results—often still paper-based—return downstream.

     “Anytime you’re moving something, it becomes a chance for disruption,” he said.

     Those disruptions are not isolated incidents. The Africa CDC notes that fragmented logistics and limited real-time data continue to slow delivery, a problem compounded by projected declines in development aid for TB of 30 to 40% in 2025. As Dubin put it, “there’s less room for error.”

    Funding is only part of the problem. Dubin explained that Disease control is always a combination of factors, including Clinical capacity, diagnostics, community engagement, and health-seeking behaviour. But logistics, he said, remains an underestimated piece of the puzzle.

    It is fragmented and largely invisible to buyers, Dubin explained, making it difficult for governments and health partners to identify reliable providers. As a result, procurement often defaults to large international firms, which then subcontract to local operators while taking a significant cut. Those local providers, he notes, are left underpaid and unable to scale, keeping the market immature.

    It is this gap between what exists and what actually works on the ground that the Logistics Marketplace is trying to close.

    A Platform Built for the Problem

    Image Source: Logistics Marketplace

    Backed by the Global Fund in partnership with the Gates Foundation, the Logistics Marketplace is a Software-as-a-Service platform that connects health logistics buyers, governments, humanitarian organisations, and global health partners with local logistics providers across Africa at no cost to eligible organisations. It is what the global health community calls a global good.

    The platform, launched in July 2025, operates on both sides of the market simultaneously. For logistics providers, the most significant feature is visibility. Firms create detailed profiles that show what services they offer, where they operate, what assets they carry, and what experience they bring, making them discoverable to buyers. 

    For buyers, the platform allows them to search for providers by country and service type, compare capabilities across multiple firms, and post procurement opportunities directly to the market. 

    “If you want to make a request from the market to ask about pricing, right now you don’t have a mechanism for that without the marketplace,” Dubin said. 

    Beyond searching and posting, buyers can also engage providers directly through the platform, request bids, and manage the tendering process within a single, secure interface, removing the manual back-and-forth that has historically slowed procurement to a crawl.

    “It really reduces the time and effort required to identify providers and engage with logistics firms,” he said. “And it helps local providers to be more visible.”

    That visibility is already translating into real use. In Nigeria, where the platform was first launched, MEBS, a logistics provider, has onboarded its subcontractors and begun running procurements through the system. 

    In Kenya, a provider called Freight in Time has used it to identify subcontractors in markets where it had no existing relationships, cutting down weeks of networking to a matter of searches. Ethiopia is next in line for a full rollout.

     Dubin said that core services will remain free, with premium features planned over time to generate the revenue needed to keep the platform running without ongoing donor injections.

    “The priority is really making logistics less of an invisible bottleneck,” he remarked.

    What Still Needs to Change

    Image Source: Logistics Marketplace

    While the Logistics Marketplace and other innovative solutions are beginning to address the chronic weaknesses in Africa’s health supply chain, Dubin is cautious about how much ground has actually been covered. Technology and infrastructure, he says, are only as effective as the systems that connect and sustain them.

    Globally, the net reduction in TB incidence from 2015 to 2024 was just 12.3%, far short of the WHO’s target of a 50% reduction by 2025. The gap is not scientific. It is logistical, structural, and increasingly political.

    The next phase of progress, he notes, depends less on new technology and more on governments deciding to treat logistics as a core function of public health rather than a background consideration. “It’s not a side thing,” he said. “It is core to the success of the public health work that we’re doing.” 

    That means proper forecasting, investment in warehousing and transport capacity, and clear thinking about what governments should run themselves versus what they should coordinate through the private sector.

    Governments are beginning to move in that direction. In Rwanda, the government launched the National Health Intelligence Centre in 2025, integrating data from various health systems to improve real-time coordination across its supply chain. The country also rolled out e-Ubuzima to eliminate paper medical records across all public health facilities. Ghana developed a National Electronic Pharmacy Platform to digitise access to medicines. Nigeria, through its Digital in Health Initiative, is working to improve healthcare delivery through data-driven analytics and supply chain tracking. 

    “We see governments interested in asking a lot of the right questions and wanting to improve performance,” Dubin said.

    But as donor funding contracts and countries absorb more responsibility for their own health systems, the margin for poorly managed logistics is shrinking fast. “It’s probably happening a bit more rapidly than anyone had expected,” he said, “but it’s important they look at that.”

    What that looks like in practice is a health system genuinely oriented around the people it serves, one that works backwards from the patient rather than forwards from a central warehouse. Faster rollout of point-of-care diagnostics closer to communities. Better specimen collection and result return systems.

    As the world marked World Tuberculosis Day yesterday, March 24, 2026, under the theme “Yes! We Can End TB,” that ambition will only be achievable if the systems that deliver medicines and diagnostics to the people who need them are treated with the same urgency as the science that produced them. For Dubin, the path forward is simple. “Fewer emergency fixes,” he said, “and more predictable routine delivery.”