# Strengthening supply chains for pathogen genomic surveillance in Asia

## TL;DR

This study examines the challenges in procuring and managing pathogen genomic sequencing tools in Asia and suggests coordinated efforts to improve supply chains for better disease surveillance.

## Contribution

The paper provides a novel assessment of supply chain challenges for pathogen genomics in South and Southeast Asia through surveys and interviews with stakeholders.

## Key findings

- High costs of equipment and consumables were reported by 85% of respondents.
- Reagent resupply times averaged 8 weeks, with 77% of countries reporting long re-supply times.
- Customs clearance and import procedures were identified as major barriers to effective supply chain management.

## Abstract

While pathogen genomics using next-generation sequencing (NGS) has been recommended by the WHO as an essential tool for national communicable disease surveillance programmes, procurement and supply chain management (PSM) systems for this new technology are still evolving. To assess the status of PSM systems for pathogen genomics, we examined perspectives from end-users and manufacturers across South and Southeast Asia.

Between 2022 and 2023, a cross-sectional survey was conducted among institutional partners supporting pathogen genomics among primarily low- and middle-income countries in South and Southeast Asia. This was complemented by qualitative interviews with the major regional NGS manufacturers. A PSM framework was employed to assess sales, procurement, production, distribution and post-sales support. Analyses are expressed as proportions and means or medians for continuous variables.

A total of 42 partners across 13 countries, 3 genomics manufacturers and 22 laboratory personnel contributed data to this assessment. PSM challenges were reported by all countries and for all sequencing platforms. High costs of equipment and consumables were identified by 85% of respondents. Long equipment purchasing lead times and reagent re-supply times were reported by 69% and 77% of countries, respectively, with reagent resupply times averaging 8 weeks (IQR 6.2–9.0). Additional barriers included customs clearance, variability of import procedures, taxes and duties. Manufacturers reported a range of strategies to respond to PSM bottlenecks, including establishing regional hubs, distributor networks and financing schemes.

Coordinated national and regional efforts are required to improve PSM systems for pathogen genomic sequencing to enhance timely early disease detection and response capacity in South and Southeast Asia.