The year was 1996 and Christmas was around the corner. Thousands of children in the UK had asked Santa Claus for one precious item — a Buzz Lightyear action figure from the Toy Story movie. 25,000 Buzzes had been packed and loaded onto a freight ship bound for England. But just a few weeks before Christmas, the container with this precious cargo fell off the ship, threatening to leave in its wake 25,000 devastated end-users, plus parents.
At the time, I was leading a team in commercial supply chain at the time and was called to troubleshoot. Working with the supplier my team and I tracked down a surplus consignment of Buzz Lightyears available in Singapore and asked for them be dispatched to the UK with expedited delivery. We even went down to the snowy Southampton quayside bundled up in coats and hats. It would have been festive had it not been so stressful, but we received safe delivery of the shipment. Yes, that was a happy ending. But 30 years on, with so much more experience in the field, I cannot help but think, “if only supply issues were that simple to resolve”.
Over the past 30 years healthcare supply chains have gone from dispersed national systems to highly globalized, cost-optimized networks. Yes, that optimization has produced high quality and lower prices but also greater fragility: We now see regular drug shortages, too much dependence on a few geographic locations producing active pharmaceutical ingredients, counterfeit medicines on the market, and significant disruptions during pandemics.
The pandemic’s blow to healthcare supply chains
COVID-19, of course, led to clinic closures, travel restrictions, diverted health staff, and overwhelmed facilities, making it harder to get both short-term and long-acting contraceptive methods. 12 million women in 115 low-and -middle-income countries experienced disruptions in family planning services, leading to about 1.4 million unintended pregnancies. [i] The most heavily affected areas were low- and middle-income countries (LMICs) with weaker health infrastructure and more fragile supply chains.
RHSC commissioned work to study solutions applied by the community, and to make recommendations on future proofing reproductive health supply chains. With our partners, we looked at the regionalization of supply chains, making recommendations on strengthening our financing landscape, and learning from the resourceful workarounds our partners made in those desperate times.
But the reproductive health community was not prepared for January 2025, when the U.S. government made a shock announcement that it would freeze nearly all foreign aid through USAID — including programs supporting reproductive health. By the end of a 90-day review period, nearly 12 million women and girls are thought to have been denied essential reproductive healthcare.[ii]
How do we weather such shocks? What solutions can we reach for? The Freight Expectations storytellers share experiences from the frontlines of reproductive health supply logistics — stories of shock, disbelief, and despair that are steadily evolving into innovation, solidarity, and ultimately — hope.
[i] https://www.unfpa.org/press/new-unfpa-data-reveals-nearly-12-million-women-lost-access-contraception-due-disruptions
[ii] https://www.guttmacher.org/2025/01/family-planning-impact-trump-foreign-assistance-freeze