Change, champion or charity? Designing effective interventions in Pathogen Genomic Sequencing supply chains

Purpose
This paper examines donor interventions aimed at improving the performance of underdeveloped Pathogen Genomic Sequencing (PGS) supply chains in Sub-Saharan Africa. Specifically, we investigate in-kind donations and supply chain management (SCM) capability-building at laboratories performing PGS. In-kind donations have historically been the primary tool used by donor-led initiatives to scale up PGS capacity, while SCM capability-building represents a more recent, complementary strategy.

Design/methodology/approach
We develop a system dynamics model of the PGS supply chain, grounded in extensive empirical data, to analyze the short- and long-term impacts of each type of intervention.

Findings
The results reveal a core trade-off: while in-kind donations can mitigate acute shortages, frequent use risks creating dependency and suppressing learning. In contrast, SCM capability-building supports sustainable improvements, particularly when targeted at labs that are unlikely to improve without external support.

Research limitations/implications
We derive six testable propositions from the analysis and offer a decision framework to support donors in allocating resources more effectively, balancing immediate shortage mitigation with longer-term supply chain improvements.

Originality/value
By applying a system dynamic modeling approach tailored to the development of PGS supply chains, we capture the nuanced interactions between donor interventions and lab performance, that is: the ability of labs to timely meet disease surveillance needs in their catchment areas. By evaluating both short- and long-term performance impacts of donor interventions, we identify contexts in which each intervention is most effective.