This paper examines donor interventions aimed at improving the performance of underdeveloped Pathogen Genomic Sequencing (PGS) supply chains in Sub-Saharan Africa. Specifically, we investigate in-kind donations and supply chain management (SCM) capability-building at laboratories performing PGS. In-kind donations have historically been the primary tool used by donor-led initiatives to scale up PGS capacity, while SCM capability-building represents a more recent, complementary strategy.
We develop a system dynamics model of the PGS supply chain, grounded in extensive empirical data, to analyze the short- and long-term impacts of each type of intervention.
The results reveal a core trade-off: while in-kind donations can mitigate acute shortages, frequent use risks creating dependency and suppressing learning. In contrast, SCM capability-building supports sustainable improvements, particularly when targeted at labs that are unlikely to improve without external support.
We derive six testable propositions from the analysis and offer a decision framework to support donors in allocating resources more effectively, balancing immediate shortage mitigation with longer-term supply chain improvements.
By applying a system dynamic modeling approach tailored to the development of PGS supply chains, we capture the nuanced interactions between donor interventions and lab performance, that is: the ability of labs to timely meet disease surveillance needs in their catchment areas. By evaluating both short- and long-term performance impacts of donor interventions, we identify contexts in which each intervention is most effective.
