Strengthening Healthcare Systems and Last Mile Challenges in Sub-Saharan Africa

Strengthening Healthcare Systems and Last Mile Challenges in Sub-Saharan Africa

Over a year into the global response to the COVID-19 pandemic, the international logistics community continues to gather lessons learned in delivering critical personal protective equipment (PPE), medical supplies and equipment, and now vaccines.

The scale of logistics needs is extensive when responding to the same emergency in almost every country in the world. Infrastructure capacity and transport procedures will vary by country, some posing more challenges than others. Each commodity has unique shipping requirements and related challenges, making it even more important for Airlink to coordinate with its freight forwarding and airline partners, and learn from their expertise. These logistics partnerships are vital to timely and cost-efficient cargo deliveries on behalf of Airlink’s nonprofit partners.

At the onset of the pandemic and the travel restrictions that followed, airlines around the world were forced to substantially reduce the number of planes in the sky. This drastically limited the available routes for shipments of lifesaving supplies required for the COVID-19 response.

Limited capacity meant increased rates and a competitive environment to secure cargo space for supplies. Airlink’s airline partners continued to provide humanitarian support for our nonprofit partners’ cargo requests at discounted or no cost, truly showcasing the integral role the airline community continues to have in responding to COVID-19.

Delivering PPE, hygiene products, medical supplies, and equipment can become increasingly challenging when the destination’s last-mile infrastructure is poor or the country’s import requirements fall outside the norm. A shipment’s last-mile transit may only require delivery a few miles from a port or airport, but in other cases it requires trucking across countries’ borders – as we’ve found many times in the response to COVID-19 in Southern Africa. With unique obstacles and potential bottlenecks, remaining flexible has proved to be the core requirement for getting cargo to its final destination.

Hygiene Supplies to Botswana & Namibia

“When a donor asked for our help to procure and ship 500,000 bars of soap for the indigenous in Botswana and Namibia, we immediately turned to Airlink for transportation support. Our amazing partnership has enabled millions of people, in rural areas, to practice COVID preventive measures with safe hand washing. The impact here was a significant one in two nations!!” – Afya Foundation CEO and Founder, Danielle Butin

In the summer of 2020, Airlink and its partners at worked together to move nearly half a million bars of soap on behalf of our partners at Afya Foundation to local partners in Botswana and Namibia thanks to free of charge airlift on Qatar Airways. The Sir Ketumile Masire Foundation and The Palms for Life Fund, distributed the shipments of soap to communities in Botswana and Namibia, respectively. Moving such a large amount of cargo brings its own challenges; these two shipments not only took up a lot of space, but they were also dense, weighing 127,540 pounds – roughly the weight of 32 pickup trucks.

“The donation of 250,000 good quality bars of soap by Afya will enable many marginalized families in Namibia to access a basic product that they often have difficulties accessing. More than ever, they will have the wonderful experience that somewhere in the world, we have been thinking about them and their needs. COVID-19 has truly created new bridges of generosity and solidarity.” – Hannah Laufer Rottman, Founder and Executive Director of Palms for Life

Due to restricted space for cargo movement, Qatar Airways split the cargo over several flights into Johannesburg where a Flexport partner loaded the cargo onto trucks for final delivery to Botswana and Namibia. The final trucking required a great deal of coordination as the shipments would need to be customs cleared at the Botswana and Namibia borders, which was particularly difficult given that the cargo was arriving over the course of multiple days after being split onto multiple flights.

As Dave Hartman, Operations Manager at, shared, “Our success in delivering this soap to communities in need is a great reminder of the power of partnerships. By leveraging the strengths of both nonprofit and for-profit companies we were able to do far more than any of us could have individually.”

A logistics move of this magnitude and complexity can only happen if all parties are flexible and focused on the ultimate goal, helping those in need get essential hygiene supplies. With the support of those involved in these movements, all 488,640 bars of soap were delivered to those in need, increasing capacity of handwashing and hygiene practices critical to preventing the spread of COVID-19.

“We are delighted to have received this generous donation of soap facilitated by the Afya Foundation. It will go a long way in sustaining efforts to support communities in need across Botswana with humanitarian response programming related to the COVID-19 pandemic.” – Matshidiso Masire, Chief Executive of the Sir Ketumile Masire Foundation

Healthcare Systems Strengthening in Lesotho

In regions where last-mile delivery challenges are a significant obstacle to cargo movement, local populations experience similar challenges in accessing medical services. Many of Airlink’s nonprofit partners have initiated programming to create a link between underserved populations and access to medical services.

In Lesotho, for example, Airlink supports Partners In Health’s programs there in collaboration with the Ministry of Health to strengthen health systems, particularly in rural areas where the nearest medical facility can be hours away. Partners In Health has launched numerous initiatives to provide individuals with reliable primary care, including access to medical oxygen, a treatment critical to caring for COVID-19 patients. This effort resulted in the opening of the first oxygen plant in Lesotho in December 2020.

As the COVID-19 pandemic continues, health systems around the world remain overwhelmed with patients in need of treatment, while providers continue to require additional protections to prevent further transmission of the virus. When Airlink received a request from Partners In Health to support the transport of over 7,500 pounds of PPE and medical supplies, Airlink was able to leverage its partnerships with and Qatar Airways to provide airlift to Lesotho free of charge to Partners In Health, alleviating the financial burden of securing transportation for the critical supplies.

Unable to fly directly into Lesotho for cargo delivery, the shipment arrived in South Africa for last-mile ground transport with Flexport’s local partners. Throughout the pandemic, tighter regulations and import restrictions have meant that only those goods deemed essential items have been able to cross-borders in some locations, adding an additional layer of required planning for those transporting goods. Through the support of our network of expert logistics practitioners, the critical stocks of PPE and medical supplies were delivered to their destination for use at facilities supported by Partners In Health.

The past year has been a learning experience for the sector and has required constant engagement throughout partner networks to move lifesaving cargo around the world. Airlink is grateful for its partners who helped coordinate movement for more than 528,000 pounds of relief supplies in 2020, and provided $2.93 million in transportation savings to its nonprofit partners. Airlink will continue to work with airlines and logistics companies across global partner networks to increase its nonprofit partners’ capacity to respond where they are needed most and assist communities in crisis.

Picture of Bethany Holland

Bethany Holland

Bethany Holland is the Humanitarian Programs Manager at Airlink. Her role includes managing and expanding Airlink's NGO partnerships, building Airlink's capacity in disaster-prone regions around the world, and coordinating the mobilization of passengers and cargo in support of humanitarian emergencies around the world.

Related Stories

Making the Impossible Possible: The Haiti Humanitarian Airbridge

Airlink frequently makes the impossible possible. The Haiti Airbridge is a great example. This month Airlink was a finalist in the Concordia P3 Awards highlighting the power of public and private sector partnerships to change peoples lives. Find out more on this unique program.