Uganda — Uganda's National Medical Stores facility in Entebbe holds and distributes essential health commodities including medicines, diagnostics and 14 types of vaccines to more than 3,500 health facilities across the country.
It is the beating heart of Uganda's cold chain systems: the flow of temperature-sensitive medicines and vaccines from manufacturers to patients, including the tools needed to administer them.
The Global Fund works with Uganda's Ministry of Health and National Medical Stores to strengthen that cold chain, applying decades of expertise building systems to deliver HIV, TB and malaria medicines across countries and continents.
Gavi, the Vaccine Alliance (Gavi) provides more than half of the vaccines distributed by National Medical Stores, including vaccines for HPV (human papillomavirus), measles, rubella, yellow fever and more.
Type an optional group caption Matayo Gamutunu (above), Head of Logistics at National Medical Stores' location in Entebbe, checks vaccines in the facility's cold rooms daily to make sure they stay cool.
Every month, National Medical Stores sends medicine and health supplies to health facilities nationwide.
A fleet of more than 60 trucks and vans - purchased with support from the Global Fund and Gavi - are equipped with cold storage technology to safely carry and distribute vaccines across the country.
Four times per year, staff ride along on these resupply missions to remote towns and villages to monitor and assess equipment and train health workers to handle temperature-sensitive medicines and vaccines.
Mathias Mutagubya has been a driver for National Medical Stores since 2006, shuttling medicine, vaccines and more between warehouses, storage facilities and health facilities across Uganda: "Just mention the district, and I've been there," he says.
All told, Mathias has driven more than 600,000 kilometers, wearing out three trucks and meeting hundreds of health workers and the people they serve.
Type an optional group caption Left: Sister Jesca Agaba, nurse and head of the immunization department at Entebbe General Hospital, administers a yellow fever vaccine to Fosca Ainebyoona (age 35), a farmer.
In April 2024, the government of Uganda launched a campaign to encourage people to get the yellow fever vaccine. More than 20 million people were vaccinated in one week - a massive logistical and coordination effort nationwide.
Gavi supplies a range of vaccines administered at Entebbe General Hospital, while the Global Fund supports the infrastructure and facilities required to store, distribute and administer vaccines: refrigerated trucks, motorcycles, personal protective equipment and syringes - as well as training for health workers like nurse Rachel Nakaabale.
On the right, Rachel administers polio and rotavirus vaccines to 6-week-old Patrick.
Type an optional group caption In July 2024, National Medical Stores will transfer its entire vaccine supply to a new location: the New Kajjansi Warehouse, near Kampala.
In 2018 National Medical Stores broke ground on the warehouse: a US$18 million project, funded by the government of Uganda, the Global Fund and Gavi. The warehouse opened its doors in November 2022.
Today, it is the largest medical stores facility in East Africa: a purpose-built, state-of-the-art warehouse that can manage, store and distribute tons of commodities every day.
Solar panels provide 60% to 70% of the energy needed for daily operations - a key design element included to ensure the warehouse is powered largely by a clean, reliable energy source.
Type an optional group caption Paul Okware, Chief Stores and Operations Officer, has been with National Medical Stores for 10 years.
Paul says that when he started, National Medical Stores was moving about US$133 million of health commodities nationwide annually. In 2023, it moved nearly three times that.
This includes essential tools and medicines to prevent and treat infectious disease, procured with Global Fund support: malaria testing kits and medications, rapid HIV tests, reagents for GeneXpert machines and more.
When New Kajjansi Warehouse's large volume cold storage facility opens in July 2024, Entebbe's entire cold chain supply - vaccines, laboratory reagents and more - will fit easily into just two of its nine large-volume cold storage rooms.
"As demand increases, we must have the speed and capacity to serve," Paul says.
Paul is also a pharmacist. During a hospital internship in his 20s, he saw up-close how health challenges can shape people's lives - especially if they don't have access to the right tools and treatments.
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"The people should never worry about us, about what we're doing to provide commodities," he says. "We want to be the point of least resistance."
The COVID-19 pandemic showed the world that medical supply and cold chain operations matter. New diagnostic tools, tests and vaccines can prevent deadly emerging and re-emerging diseases - when people have access to them.
New Kajjansi Warehouse incorporates decades of wisdom from National Medical Stores and health officials in Uganda, including lessons learned from Uganda's COVID-19 pandemic response.
With support from the Global Fund and Gavi, National Medical Stores is realizing a vision for the future: strong, nimble, flexible supply chain operations that can help countries plan for whatever comes.
"New Kajjansi makes us future-proof," says Paul. "It gives us space to interpret, improvise and prepare for changing circumstances."
Written by Elise Walter. Photos by Brian Otieno. Drone imagery by Kasujja Asaph.
