Scott Dubin Calls for Delivery System Investment in Nigeria

To mark World Malaria Day 2026, Scott Dubin, convener of the Logistics Marketplace and global supply chain expert, has called for stronger investment in delivery systems and aligned incentive structures that can drive positive outcomes across Nigeria’s health sector and beyond in this exclusive interview with REBECCA EJIFOMA.

From your perspective, what is the most important shift needed to turn malaria prevention gains into routine care for every community?

I spent over 20 years working in humanitarian relief and then public health. Since I started in public health, much of my work has been in Nigeria and has focused on campaigns. We have seen that these campaigns have been successful; they show that the government is able to deliver at a very large scale in relation to malaria.

I think the priority now is ensuring that diagnosis and treatment are available consistently in every state, all year round, not just during mass campaigns. This is really about the scale we are dealing with. There are an estimated over 68 million malaria cases and close to 200,000 deaths in the latest 2023 statistics. The next phase is about making progress in routine care, and making it as dependable as the campaigns we have seen.

What key lesson from the government’s efforts, including large-scale prevention campaigns, should shape routine malaria responses in the country?

We talked a lot about the burden on Nigeria being quite significant. It is no small feat to address malaria, neglected tropical diseases, or any other health issue in a country as large and geographically diverse as Nigeria. There are many challenges in making these efforts successful, and a great deal of credit goes to the government for the progress made.

I think the biggest lesson is that Nigeria can coordinate and deliver at a massive scale, but this only happens when roles are clearly defined, data is available, funding is sufficient, and accountability is in place. All these elements must come together, as we have seen in mass campaigns. That same level of discipline, which has proven possible, now needs to shape routine delivery.

As I mentioned, the progress has been remarkable. Nearly 30 million children were reached in the latest statistics, which is significant. These campaigns demonstrate that the capacity exists to get this done. The real challenge is making this a continuous effort. In many ways, mass campaigns are like a sprint, while day-to-day delivery is more of a marathon.

In 2023, Seasonal Malaria Chemoprevention reached nearly 28.9 million children. What does this scale of success reveal about what effective delivery systems can achieve?

I think it is great to have these numbers because they show that when delivery systems work, tens of millions of children can be reached effectively. This makes it clear that the challenge is not whether the country can operate at this scale, but how to sustain that level of performance in routine care.

Across industries, countries, and even individuals, it is possible to succeed for a period of time, but the real test is consistency. That is where the next challenge lies; how to deliver strong performance continuously.

Reaching about 30 million children across 21 states is a remarkable achievement, especially given Nigeria’s size and complexity. It involves navigating conflict-affected areas, weak infrastructure, and diverse geographies. It shows what is possible when planning and coordination are aligned. The key question now is how to sustain that level of alignment consistently.

With over two decades of work across Nigeria and Africa, what lessons on consistency and sustainability could help Nigeria maintain and expand these efforts beyond current reach?

It takes investment in systems. It takes investment in people and in processes. I think what we have seen is that this applies for all health areas and all countries. It is not a matter of whether the tests or the medications or the materials exist. Those have been invented, procured, and have arrived into the country. The question is, are those reaching the people who need them consistently? Because these products, existing on their own, are not helpful. They have to be at the right place, delivered to the people who need them when they need them.

Ultimately, consistency is going to be around investment in what allows that to happen. And so that is around the logistics that need to be in place, around the data and information that needs to be moving within the system, the coordination amongst the stakeholders, the alignment of whatever incentives are necessary. So I would say it will take investment, which is not always as glamorous as other things that might be invested in. You could point to a hospital, but developing the necessary infrastructure, whether it is people, processes, or systems, those need to happen in order for this type of impact to be sustained, to exceed the impact that we have already seen, and to deliver the supplies, the tests, and the materials and pharmaceuticals that people need to respond to malaria and other health issues.

Despite the fact that 97 per cent of Nigeria’s population remains at risk, what are the biggest weaknesses in the current logistics chains?

I would say distribution is a critical one. As I mentioned, products existing in a warehouse do not mean anything; they have to be delivered. The system to move those commodities is quite important. Data visibility, what products are where, and what the needs are in different locations, is also critical. We often talk about last-mile delivery separately from distribution because, as you get closer to the last mile, it becomes much more difficult.

In many cases, these commodities exist somewhere in the system, but they are not where patients need them or when they need them. To address this, there must be investment in those systems. These are typically the weakest points, and they are not always prioritised because they are less visible. As you noted, 97 per cent of the population is at risk. While there has been progress, there are still major stockouts of malaria tests and treatments, especially in facilities across the seven southern states.

So there is still significant work to be done. As you mentioned, distribution, visibility, and last-mile delivery are the key areas that require focused attention.

How can private-sector logistics help ensure malaria commodities reach the right places, at the right time, in the right quantities, and without waste?

When distribution and last-mile delivery are critical, private sector logistics can help strengthen execution because of their experience. They have invested in systems, processes, and people, enabling better transport planning, more efficient warehousing, higher service levels, and ultimately accountability, since they operate under contracts to deliver specific outcomes.

There is a clear level of accountability when engaging the private sector. This does not mean replacing public systems, but rather complementing them by leveraging private-sector strengths to make routine delivery more reliable. These same logistics providers already distribute consumer goods across the country, working with companies like Coca-Cola and Unilever to move products across Nigeria, ensure availability, and maintain proper conditions. This reflects a depth of knowledge and sustained investment in people, processes, and systems that can be difficult for governments to replicate at scale.

There is significant opportunity to draw on this capacity to improve routine delivery. Evidence from northern Nigeria, for example, shows that when third-party logistics providers are engaged, stockout rates tend to be lower. In essence, the private sector can help ensure that products are not just stored in warehouses, but are consistently delivered to where they are needed most.

You mentioned knowledge and investment as strengths in the private sector. What other strengths do they bring to the table?

Their investments in systems, people and processes. It takes time and a lot of money to do that. Not every provider is at the same level, but you will find the ones that have done that to attract business. They have responsibility contractually they have to meet, and if they don’t, they don’t get paid. There is an incentive structure. They are able to leverage experience, either in health products or other sectors, moving products at large scale, high value, incorporating technology to keep that secure.

Even when selecting a private sector provider, you look at their experience and capabilities. Typically, infrastructure, incentive structure and experience are what we rely on when we say the private sector has benefits for engagement on distribution and warehousing.

What practical difference can providers like Logistics Marketplace make in improving equity, efficiency, and accountability in malaria supply chains?

Logistics Marketplace was developed to make it free and accessible to everybody, with no profit motive. I spent over 20 years in logistics, and many issues come down to logistics. I used to work in humanitarian relief, where disaster response is based on logistics capabilities. Nothing works without logistics functioning.

Products can be in Nigeria or at the central warehouse, but if they are not in the hands of a parent to give to their child, they are meaningless. The biggest issue we see is logistics, because products don’t get where they need to go and are then thrown away after they expire. So we have a stock-out in a health facility, but not in the country, and that is a result of poor logistics.

What we have seen is that you can’t just Google what logistics providers are available. Nigeria has a more mature market than others, but it is still challenging. So, the platform helps you identify logistics providers in the market. Buyers can be governments, international organisations, NGOs, pharma distributors, anybody looking to use logistics services.

The platform reduces the challenge in finding providers. It improves competition, lowers prices, improves service, and makes coordination faster and more efficient. And that has a big impact on how well we can identify providers for the movement of health products in Nigeria and across Africa.

What must governments, donors, and private sector partners do to ensure prevention campaigns are matched with consistent year-round access to treatment and diagnostics?

They really need to invest in the delivery system that keeps all of this flowing, which allows for improved movement, better visibility, stronger ability to resupply health facilities when needed, and accountability in the system.

And this happens everywhere. You need to have the incentive structure aligned so that things are done as they need to be done. Ultimately, this will cause more reliable routine distribution. It may be less glamorous to invest in systems, but we need to invest in delivery systems that keep commodities flowing and allow us to know where products are.

If you waste product or overspend, that means there is less money in the system. Improving competition allows for lower costs and higher performance. Not wasting funds on poor systems is important, especially when funding is limited.

So, if you fix the system, you don’t just fix malaria, you fix the health system. And the impact goes beyond health into economic outcomes, affecting productivity, education, and GDP. And that is why the investment matters.