For most Malawians, 85% of whom are rural farmers, the rural healthcenter is the only accessible source of primary health care. A majorchallenge is a reliable supply of essential medical supplies which include malaria treatments, antibiotics, and contraceptives. In the past, medicalsupplies were transported from regional medical stores to hospitals, andfrom there to rural health centers. Many rural centers reported receiving less than their required medicines, often months late, or not at all.

In 2003, USAID funded the Malawi government to test a new distribution system in which medicines are pre-packed at the regional store and trucked directly to the rural centers. The new delivery system bypasses the stopover at district hospitals, thereby saving human and transport costs. The regional medical stores pre-pack supplies and drugs, and prepare them for delivery in a sealed box. Using a new radio system, delivery staff notify the health center of the pending arrival. The delivery is also observed by a volunteer from a local health committee.

In the test district, rural clinics now report that they receive essential drugs on time. A common problem – shortage of a malaria-prevention drug for pregnant women – was solved. According to Nurse Banda, this drug saves hundreds of lives of mothers and babies at her health center. With USAID support, the Malawi government has already begun to implement the new distribution system nationwide.