Challenges and opportunities in managing the supply and availability of medicines in health facilities in latin america: A literature review
Article Sidebar
Main Article Content
Abstract
This literature review analyzes the challenges and opportunities of managing the supply and availability of medicines in healthcare facilities in Latin America. The study begins with the recognition that timely access to essential medicines remains a significant problem for healthcare systems, especially in contexts marked by territorial inequalities, budget constraints, logistical fragmentation, and limited capacity to respond to shortages. Methodologically, a qualitative review of scientific literature was conducted, guided by the PICO strategy and PRISMA guidelines, considering research published in high-impact databases such as Scopus, ScienceDirect, and SciELO. The findings show that the main challenges are related to deficiencies in demand planning, weaknesses in inventory management, a shortage of specialized personnel, opaque procurement processes, limited traceability, and dependence on external suppliers. However, significant opportunities are also identified, such as the implementation of digital platforms, real-time monitoring systems, traceability technologies, strengthening local production, centralized purchasing, training of pharmaceutical personnel, and the creation of strategic inventories. In conclusion, improving the management of the drug supply chain requires comprehensive public policies, technological innovation, inter-institutional cooperation, and control mechanisms that ensure the continuous, equitable, and safe availability of essential medicines in Latin American healthcare facilities
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
El contenido de los artículos es responsabilidad exclusiva de los autores.
Debe cumplir con los siguientes aspectos de la licencia CC BY NC ND :
- Atribución: debe otorgar el crédito correspondiente, proporcionar un enlace a la licencia e indicar si se realizó algún cambio. Puede hacerlo de cualquier manera razonable, pero no de ninguna manera que sugiera que el licenciante lo respalda a usted o su uso.
- No comercial: el material no se puede utilizar con fines comerciales.
- Sin derivados: si remezcla, transforma o construye sobre el material, no puede distribuir el material modificado.
- Sin restricciones adicionales: No se pueden aplicar términos legales o medidas tecnológicas que restrinjan legalmente a otros de hacer cualquier cosa que permita la licencia.
References
Ahmad, A., & Micieli, J. A. (2025). Cost and availability of high-dose oral prednisone for management of optic neuritis. Canadian Journal of Ophthalmology. Documento en línea. Disponible https://doi.org/10.1016/j.jcjo.2025.03.020
Akter, S., Debnath, B., & Bari, M. (2022). A grey decision-making trial and evaluation laboratory approach for evaluating the disruption risk factors in the Emergency Life-Saving Drugs supply chains. Healthcare Analytics, 2. Documento en línea. Disponible https://doi.org/10.1016/j.health.2022.100120
Aljohani, M., Mukkamala, R., & Olariu, S. (2025). Delivery of Medical Supplies to Remote Locations via Unmanned Aerial Vehicles: Approaches, Challenges, and Solutions. Transportation Research Procedia, 84, 73-80. Documento en línea. Disponible https://doi.org/10.1016/j.trpro.2025.03.047
Arantes, A., Alhais, A. F., & Ferreira, L. M. D. F. (2022). Application of a purchasing portfolio model to define medicine purchasing strategies: An empirical study. Socio-Economic Planning Sciences, 84. Documento en línea. Disponible https://doi.org/10.1016/j.seps.2022.101318
Benites, J., Pinedo, L., Cabanillas, M., Herrera, P., Mougenot, B., & Benites, V. (2023). Ethnic disparities in out–of–pocket expense on medicines in Peru: Evidence from a nationwide survey. Public Health in Practice, 6. Documento en línea. Disponible https://doi.org/10.1016/j.puhip.2023.100442
Blankart, K. E., & Felder, S. (2022). Do Medicine Shortages Reduce Access and Increase Pharmaceutical Expenditure? A Retrospective Analysis of Switzerland 2015-2020. Value in Health, 25(7), 1124-1132. Documento en línea. Disponible https://doi.org/10.1016/j.jval.2021.12.017
Ciceri, C., Borsani, C., Guida, M., Farinelli, M., & Caniato, F. (2025). Impact pathways: navigating risks in the pharmaceutical supply chain – a multi-actor perspective. International Journal of Operations and Production Management, 45(13), 53-62. Documento en línea. Disponible https://doi.org/10.1108/IJOPM-06-2024-0458
Du, D., Hu, X., Zuo, Q., Xu, D., Zhu, T., Fan, T., Yang, J., Xu, W., Wei, H., Baima, K., Zhang, Y., Gu, Y., Chen, L., Luo, F., Shen, Y., & Wen, F. (2025). The availability of drugs for stable COPD treatment in China: a cross-sectional survey. npj Primary Care Respiratory Medicine, 35(1). https://doi.org/10.1038/s41533-025-00413-1
Duarte, I., Mota, B., Pinto, T., & Barbosa, A. (2022). Pharmaceutical industry supply chains: How to sustainably improve access to vaccines? Chemical Engineering Research and Design, 182, 324-341. Documento en línea. Disponible https://doi.org/10.1016/j.cherd.2022.04.001
Dullaert, W., Ghiami, Y., Jagtenberg, C., Romero, R., Wissink, P., & Zsidisin, G. (2025). An investigation of Dutch pharmaceutical supply chains: insights from the theory of swift and even flow. The International Journal of Logistics Management, 36(7), 262-283. Documento en línea. Disponible https://doi.org/10.1108/IJLM-04-2024-0266
Freiberg, A., & Espin, J. (2022). Towards a taxonomy of judicialization for access to medicines in Latin America. Global Public Health, 17(6), 912-925. Documento en línea. Disponible https://doi.org/10.1080/17441692.2021.1892794
García, V., Prieto, I., Izquierdo, G., & Fernández, M. (2023). A propósito del estudio del nivel de acuerdo de los socios de SEMDOR sobre las recomendaciones de uso de fármacos opioides para el tratamiento del dolor crónico no oncológico. Multidisciplinary Pain Journal. Documento en línea. Disponible https://doi.org/10.20986/mpj.2023.1056/2023
Gorordo, M., Rojas, R., Carino, J., Zambrano, J., & Castro, J. (2024). Health alerts for substandard, falsified, and unregistered medical products at the onset of the COVID-19 pandemic in the Americas. Revista Panamericana de Salud Publica/Pan American Journal of Public Health, 48. Documento en línea. Disponible https://doi.org/10.26633/RPSP.2024.7
Günther, G., Guglielmetti, L., Leu, C., Lange, C., van Leth, F., Hasan Hafizi, Khachatryan, N., Aroyan, H., Kabasakalyan, E., Knappik, M., Skrahina, A., Klimuk, D., Nikolenka, A., Muylle, I., Milanov, V., Velkovska, D., Tarinska, N., Bachiyska, E., Jankovic, M., … Dudnyk, A. (2023). Availability and costs of medicines for the treatment of tuberculosis in Europe. Clinical Microbiology and Infection, 29(1), 77-84. Documento en línea. Disponible https://doi.org/10.1016/j.cmi.2022.07.026
Hemmeda, L., Koko, A., Mohamed, R., Mohammed, Y., Elabid, A., Omer, A., Hamida, A., Haiba, A., Ali, E. M., Abdelgadir, I., Al Fanob, R., Almahadi, S., Ali, S., & Mahgoub, S. (2023). Accessibility crisis of essential medicines at Sudanese primary healthcare facilities: a cross-sectional drugs’ dispensaries assessment and patients’ perspectives. International Journal for Equity in Health, 22(1). Documento en línea. Disponible https://doi.org/10.1186/s12939-023-02009-y
Henao, C., Lis, J., & Lis, M. (2023). Inequality in Access to Healthcare: A Latin American Perspective. Salud, Ciencia y Tecnología, 3. Documento en línea. Disponible https://doi.org/10.56294/saludcyt2023355
Janvrin, M. L., Kanagaratnam, A., Suarez, V. A., Light, D. Y., Lucki, I., & Koehlmoos, T. P. (2025). A comparison of the essential medicines lists of the U.S. Department of Health and Human Services, the U.S. Department of Defense, the U.S. Food and Drug Administration, and the World Health Organization. Journal of the American Pharmacists Association, 65(5). Documento en línea. Disponible https://doi.org/10.1016/j.japh.2025.102427
Javarayee, P., Meylor, J., Shahrukh, S., Pollock, S., Andrade, R., Sah, J., & Patel, H. (2024). US Generic Antiseizure Medication Supply Chain: Observations from Analysis of US Government Databases. Seizure, 117, 83-89. Documento en línea. Disponible https://doi.org/10.1016/j.seizure.2024.02.003
Jifar, W., Geneti, G., & Dinssa, S. (2022). The Impact of COVID-19 on Pharmaceutical Shortages and Supply Disruptions for Non-Communicable Diseases Among Public Hospitals of South West, Oromia, Ethiopia. Journal of Multidisciplinary Healthcare, 15, 1933-1943. Documento en línea. Disponible https://doi.org/10.2147/JMDH.S377319
Kabera, J., & Mukanyangezi, M. (2024). Influence of inventory management practices on the availability of emergency obstetric drugs in Rwandan public hospitals: a case of Rwanda Southern Province. BMC Health Services Research, 24(1). Documento en línea. Disponible https://doi.org/10.1186/s12913-023-10459-x
Kritchanchai, D., Srinon, R., Kietdumrongwong, P., Jansuwan, J., Phanuphak, N., & Chanpuypetch, W. (2024). Enhancing home delivery of emergency medicine and medical supplies through clustering and simulation techniques: A case study of COVID-19 home isolation in Bangkok. Heliyon, 10(12). Documento en línea. Disponible https://doi.org/10.1016/j.heliyon.2024.e33177
Kunwar, A., Kaur, P., Durgad, K., Parasuraman, G., Sharma, M., Gupta, S., Bhargava, B., Bangar, S., Bharadwaj, V., Bharadwaj, R., Bitragunta, S., Chintala, S., Chakma, T., Chavan, T., Dar, S., Das, B., Dhaliwal, R., Gill, S., Jain, T., … Wankhede, A. B. (2023). Improving the availability of antihypertensive drugs in the India Hypertension Control Initiative, India, 2019-2020. PLoS ONE, 18(12 December). Documento en línea. Disponible https://doi.org/10.1371/journal.pone.0295338
Lan, Y., Lu, P., Pan, C., Kar, S., & Li, W. (2022). The effects of medical insurance and patients’ preference on manufacturer encroachment in a pharmaceutical supply chain. Journal of Management Science and Engineering, 7(2), 243-265. Documento en línea. Disponible https://doi.org/10.1016/j.jmse.2021.09.001
Langebrake, C., Gottfried, K., Dadkhah, A., Eggert, J., Gutowski, T., Rosch, M., Schönbeck, N., Gundler, C., Nürnberg, S., Ückert, F., & Baehr, M. (2023). Patient-individual 3D-printing of drugs within a machine-learning-assisted closed-loop medication management – Design and first results of a feasibility study. Clinical eHealth, 6, 3-9. Documento en línea. Disponible https://doi.org/10.1016/j.ceh.2023.05.001
León, M., Sánchez, M., Rodríguez, L., Moyano, J., Velasco, A., Garay, O., Buitrago, L., & De Lima, L. (2022). Availability and accessibility of opioids for pain and palliative care in Colombia: A survey study. Colombian Journal of Anesthesiology, 50(1). Documento en línea. Disponible https://doi.org/10.5554/22562087.e1011
Lugada, E., Ochola, I., Kirunda, A., Sembatya, M., Mwebaze, S., Olowo, M., Ladwar, D. O., & Komakech, H. (2022). Health supply chain system in Uganda: assessment of status and of performance of health facilities. Journal of Pharmaceutical Policy and Practice, 15(1). Documento en línea. Disponible https://doi.org/10.1186/s40545-022-00452-w
Luka, M. M., Ferguson, E. A., Rees, E., Hoffu, H., Changalucha, J., Lushasi, K., Sikana, L., Mutunga, M., Thumbi, S. M., & Hampson, K. (2025). Optimising human rabies vaccine supply chains: A modelling study. Vaccine, 54. Documento en línea. Disponible https://doi.org/10.1016/j.vaccine.2025.127108
Maciel, B., & Macfarland, C. (2022). Access To Medicines. The Human Right Forhead Pharmaceutical Monopolies. Boletin Mexicano de Derecho Comparado, 55(163). Documento en línea. Disponible https://doi.org/10.22201/iij.24484873e.2022.163.17498
Mbonane, H., Sibanda, M., Godman, B., Meyer, J. C., & Matlala, M. (2023). Knowledge, attitudes and practices of healthcare professionals on the use of an electronic stock visibility and management tool in a middle-income country: Implications for access to medicines. Exploratory Research in Clinical and Social Pharmacy, 9. Documento en línea. Disponible https://doi.org/10.1016/j.rcsop.2023.100233
Mekonnen, Z., Melaku, T., Tucho, G., Mecha, M., Årdal, C., & Jahre, M. (2023). The knock-on effects of COVID-19 pandemic on the supply and availability of generic medicines in Ethiopia: mixed methods study. BMC Health Services Research, 23(1). Documento en línea. Disponible https://doi.org/10.1186/s12913-023-09535-z
Melaku, T., Mekonnen, Z., Terefe, G., Mecha, M., Årdal, C., & Jahre, M. (2024). Availability of essential, generic medicines before and during COVID-19 at selected public pharmaceutical supply agencies in Ethiopia: a comparative cross-sectional study. BMJ Open, 14(3). Documento en línea. Disponible https://doi.org/10.1136/bmjopen-2023-077545
Ministerio de Salud. (2022, noviembre 22). Minsa alista medidas para mejorar el abastecimiento de medicamentos en establecimientos del sector público. Documento en línea. Disponible https://www.gob.pe/institucion/minsa/noticias/672907-minsa-alista-medidas-para-mejorar-el-abastecimiento-de-medicamentos-en-establecimientos-del-sector-publico
MINSA. (2023). Documento técnico: Petitorio Nacional Único de Medicamentos esenciales para Sector Salud.
Nascimento, M. E. B. do, Brandão, A. L. do A. P., Santos, D. M. dos, Silva, R. B. da, Tavares, B. A., Freire, I. C., Cecilio, M. J. C. R., Melo, M. C. de A., Cardoso, L. C., Melo, D. A. de, Liberato, B. T. G., & Magalhães, E. T. P. (2024). Efeitos do isolamento social na saúde mental durante a pandemia. Brazilian Journal of Implantology and Health Sciences, 6(12), 94-103. Documento en línea. Disponible https://doi.org/10.36557/2674-8169.2024v6n12p94-103
Nemoto, K., Hayashi, Y., & Sugiyama, H. (2024). Indicator-based assessment of potential supply risks for pharmaceutical excipients: Method and application. International Journal of Pharmaceutics, 663. Documento en línea. Disponible https://doi.org/10.1016/j.ijpharm.2024.124498
Nievas, C., Gandini, J., & Tapia, A. (2021). Desigualdades en el acceso a medicamentos y gasto de bolsillo, realidades del subsistema público de salud en el interior argentino. Revista de la Facultad de Ciencias Médicas de Córdoba, 78(2), 147-152. Documento en línea. Disponible https://doi.org/10.31053/1853.0605.v78.n2.30652
Núñez, S., & Martínez, L. (2023). Latin American Strategies to Improve the Fight Against Drugs. Journal of Leadership, Accountability and Ethics, 20(3), 2023.
Oldfield, L., Penm, J., Mirzaei, A., Oldfield, L., Penm, J., Mirzaei, A., & Moles, R. (2025). Prices, availability, and affordability of adult medicines in 54 low-income and middle-income countries: evidence based on a secondary analysis. En Articles Lancet Glob Health (Vol. 13). Documento en línea. Disponible www.thelancet.com/lancetgh
Oldfield, L., Penm, J., & Moles, R. (2024). Exploring access to essential medicines in the South Pacific: insights from a multi-country cross-sectional study. The Lancet Regional Health. Documento en línea. Disponible www.thelancet.com
Organización Mundial de la Salud. (2023, septiembre 5). Cobertura sanitaria universal (CSU). Documento en línea. Disponible https://www.who.int/es/news-room/fact-sheets/detail/universal-health-coverage-(uhc)
Organización Mundial de la Salud. (2024, septiembre 25). Medicamentos esenciales. Documento en línea. Disponible https://www.who.int/es/news-room/fact-sheets/detail/essential-medicines
Ramirez, L., Cárdenas, J., & Rojas, W. (2022). Blockchain apply to the supply chain of essential medicines for the treatment of Covid-19 in Colombia. Informatics in Medicine Unlocked, 33. Documento en línea. Disponible https://doi.org/10.1016/j.imu.2022.101100
Ramírez, M., & Argotti, U. (2022). Regulation of Drug Prescribing Information in Latin America and the Caribbean. En Therapeutic Innovation and Regulatory Science (Vol. 56, Número 4, pp. 536-551). Springer Science and Business Media Deutschland GmbH. Documento en línea. Disponible https://doi.org/10.1007/s43441-022-00396-y
Roberti, J., Leslie, H., Doubova, S., Ranilla, J., Mazzoni, A., Espinoza, L., Calderón, R., Arsenault, C., García, E., & García, P. (2024). Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries. The Lancet Global Health, 12(1), e145-e155. Documento en línea. Disponible https://doi.org/10.1016/S2214-109X(23)00488-6
Romero, A., Alfonso, I., & Álvarez, G. (2024). Access to higher education in Latin America. Myth or reality? Health Leadership and Quality of Life, 3. Documento en línea. Disponible https://doi.org/10.56294/hl2024.571
Sánchez, A. (2023). Public Health Professionals in Latin America Should Play a More Active Role in Tackling Drug Violence. International Journal of Public Health, 68. Documento en línea. Disponible https://doi.org/10.3389/ijph.2023.1605245
Sangwan, K., Choudhary, D., Poonia, V., Kulshrestha, R., Shah, J., & Iyer, C. (2025). Blockchain-enabled Solution for Transparency and Waste Minimization in Pharmaceutical Supply Chains. Procedia CIRP, 135, 1064-1069. Documento en línea. Disponible https://doi.org/10.1016/j.procir.2025.01.083
Schurer, J. M., Murara, E., van, J., & Ooms, G. (2023). Antivenom for sale? Availability and affordability of snakebite medicines across public and private health facilities in Rwanda. Toxicon, 234. Documento en línea. Disponible https://doi.org/10.1016/j.toxicon.2023.107292
Téllez, S. C., Torres, R., Marmolejo, J. A., & Rodríguez, R. (2025). Sales predictive analysis for improving supply chain drug sample. Procedia Computer Science, 253, 1712-1719. Documento en línea. Disponible https://doi.org/10.1016/j.procs.2025.01.233
Toledo, H. (2023). Gestión de suministro de productos médicos esenciales y calidad de servicio en un hospital público de Trujillo, 2022. Ciencia Latina Revista Científica Multidisciplinar, 7(1), 5779-5801. Documento en línea. Disponible https://doi.org/10.37811/cl_rcm.v7i1.4884
Vahos, J., Rojas-, R., Daza, D., Osorio, L. C., Macias, D., Pastrana, T., Munoz, S., Fitzgerald, J., Porras, A., Luciani, S., & Castro, J. L. (2023). Barriers of Access to Opioid Medicines within the Context of Palliative Care in Latin America: The Perception of Health Professionals. Journal of Palliative Medicine, 26(2), 199-209. Documento en línea. Disponible https://doi.org/10.1089/jpm.2022.0122
Vann, E., Quinn, G., & Breen, L. (2024). Medicines Shortages Reporting Systems (MSRS): An exploratory review of access and sustainability. Research in Social and Administrative Pharmacy, 20(6), 72-83. Documento en línea. Disponible https://doi.org/10.1016/j.sapharm.2024.02.010
Villalobos, J., Zavaleta, E., Serrano, B., Hernandez, Y., & Diaz, J. (2022). Implementation of supply management strategies by the pharmacy service in a general hospital during the COVID-19 pandemic. Exploratory Research in Clinical and Social Pharmacy, 7. Documento en línea. Disponible https://doi.org/10.1016/j.rcsop.2022.100161
Zuma, S. (2022). Pharmacist Assistants’ role in medicine supply management at a primary healthcare setting. Health SA Gesondheid, 27. Documento en línea. Disponible https://doi.org/10.4102/hsag.v27i0.2041