A Framework for Assessing Import Costs of Medical Supplies and Results for a Tuberculosis Program in Karakalpakstan, Uzbekistan

Background. Import of medical supplies is common, but limited knowledge about import costs and their structure introduces uncertainty to budget planning, cost management, and cost-effectiveness analysis of health programs. We aimed to estimate the import costs of a tuberculosis (TB) program in Uzbekistan, including the import costs of specific imported items. Methods. We developed a framework that applies costing and cost accounting to import costs. First, transport costs, customs-related costs, cargo weight, unit weights, and quantities ordered were gathered for a major shipment of medical supplies from the Médecins Sans Frontières (MSF) Procurement Unit in Amsterdam, the Netherlands, to a TB program in Karakalpakstan, Uzbekistan, in 2016. Second, air freight, land freight, and customs clearance cost totals were estimated. Third, total import costs were allocated to different cargos (standard, cool, and frozen), items (e.g., TB drugs), and units (e.g., one tablet) based on imported weight and quantity. Data sources were order invoices, waybills, the local MSF logistics department, and an MSF standard product list. Results. The shipment contained 1.8 million units of 85 medical items of standard, cool, and frozen cargo. The average import cost for the TB program was 9.0% of the shipment value. Import cost varied substantially between cargos (8.9–28% of the cargo value) and items (interquartile range 4.5–35% of the item value). The largest portion of the total import cost was caused by transport (82–99% of the cargo import cost) and allocated based on imported weight. Ten (14%) of the 69 items imported as standard cargo were associated with 85% of the standard cargo import cost. Standard cargo items could be grouped based on contributing to import costs predominantly through unit weight (e.g., fluids), imported quantity (e.g., tablets), or the combination of unit weight and imported quantity (e.g., items in powder form). Conclusion. The cost of importing medical supplies to a TB program in Karakalpakstan, Uzbekistan, was sizable, variable, and driven by a subset of imported items. The framework used to measure and account import costs can be adapted to other health programs.

Analysis of Energy Crisis, Energy Security and Potential of Renewable Energy: Evidence from Pakistan

Over the last thirty years, Asian countries have become a chief player in the worldwide scene. Pakistan is facing an acute energy disaster since last decade that impacts on social and economic development. Sustainable energy supply is an essential feature for the economic growth of any society. From the last five years, Pakistan is facing a shortfall between 4,000-5,000 megawatt. This study inspects the association between energy security, energy crisis, energy demand, energy supply, and renewable potential in Pakistan. It also evaluates the final energy demand-supply gap, provincial renewable energy distribution, sectorial distribution, and policy recommendation for future energy. For this study, we applied renewable and non-renewable energy scenarios during 2014-2035 and Market-Allocation method to prove the energy situation in Pakistan. The outcomes show that renewable resources are the best option in reducing energy risk, import cost, and enhance environmental and economic sustainability. With the objectives of our key findings, targeted suggestions and policies are given.