Movement restrictions and lockdowns in response to the COVID-19 pandemic affected stock management procedures, procurement processes, and competitive supplier bidding, resulting in price increases and health system disruptions.

Manufacturing constraints and restrictions of exports from other countries resulted in shortages of medicines and some commodities, supply chain delays, and increased freight costs, which, in turn, significantly increased the cost of certain medical products and impacted access to medicines not related to COVID-19.

Programmatic and operational shifts within the health system to focus on the COVID-19 pandemic response led to the diversion of human and financial resources from other essential health areas and a decrease in procurement of medicines and commodities that were not related to COVID-19.

Policymakers should craft policies and interventions to ensure that the supply chain of medical products is resilient for future pandemics and other shocks.

Policymakers and other health system stakeholders should apply lessons from the COVID-19 supply chain disruptions toward broader health system strengthening efforts.

The COVID-19 pandemic has disrupted global health supply chains including manufacturing, storage, and delivery of essential medicines, testing kits, personal protective equipment, and laboratory reagents. We sought to document how pandemic impacted the procurement, prices, and supply chain of medical products in Zimbabwe.

We conducted semistructured in-depth key informant interviews with 36 health system stakeholders in Zimbabwe involved in medicine procurement. Respondents included pharmacists, regulatory officers, and procurement and supply chain management professionals from public and private sectors.

Before the COVID-19 pandemic, respondents described experiencing long-standing resource constraints, medicine shortages, foreign currency shortages, and supply chain inefficiencies. The pandemic exacerbated this situation due to supply constraints, export restrictions, medicine shortages, and movement restrictions that disrupted logistical and stock management systems. Competitive bidding and tendering processes experienced reduced participation by international suppliers. Significant price increases were initially observed among internationally shipped medicines and for personal protective equipment to cover additional freight costs. COVID-19 pandemic impacts were moderated by reduced patient demand and lower health services utilization, resulting in fewer supply shocks and less price volatility. Further, health system adaptations such as switching treatment regimens, modifying dispensing schedules based on stock availability, redistributing stock of medicines among facilities, and new service delivery models such as integrated outreach services helped ensure continued patient access to medicines.

Our findings highlight the need for policies that ensure continuity in access to health services and medical products, even during a pandemic, by avoiding blanket restrictions on medical product exports and imports. Pooled procurement, especially at regional and global levels, with long-term service agreements may help achieve greater resiliency to supply and price shocks from supply chain disruptions. Interventions across manufacturing, trade, and regulatory policy and service delivery models are also needed for supply chain resiliency.

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