Resilience and Adaptability in Paracetamol Supply Chains: A Systems Perspective on COVID-19 Challenges and Responses in Ethiopia

Tsegaye Melaku (), Zeleke Mekonnen, Gudina Terefe Tucho, Joe Viana, Christine Årdal and Marianne Jahre
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Tsegaye Melaku: Institute of Health, Jimma University, Jimma 378, Ethiopia
Zeleke Mekonnen: Institute of Health, Jimma University, Jimma 378, Ethiopia
Gudina Terefe Tucho: Institute of Health, Jimma University, Jimma 378, Ethiopia
Joe Viana: Department of Industrial Economics and Technology Management, Faculty of Economics and Management, NTNU—Norwegian University of Science and Technology, 7491 Trondheim, Norway
Christine Årdal: Norwegian Institute of Public Health, 0213 Oslo, Norway
Marianne Jahre: Department of Strategy and Entrepreneurship, BI Norwegian Business School, 0484 Oslo, Norway

Logistics, 2025, vol. 9, issue 1, 1-21

Abstract: Background : The COVID-19 pandemic exposed vulnerabilities in global supply chains, including those for essential medicines like paracetamol. This study aimed to assess the resilience and adaptability of Ethiopia’s paracetamol supply chain during the pandemic. Methods : A mixed-methods approach was employed, combining semi-structured interviews with key stakeholders and analysis of secondary data on paracetamol availability and supply chain disruptions. The study employed systems thinking and supply chain resilience frameworks, utilizing causal loop diagrams to visualize system dynamics. Results : Eighteen stakeholders, representing seven pharmaceutical manufacturers, five import companies, and five wholesalers, participated in the study. These participants had between three and fourteen years of experience in their respective roles. The study revealed complex interactions within the paracetamol supply chain, highlighting both challenges and adaptive responses. While 500 mg paracetamol tablets were readily available, shortages of other formulations were observed due to a range of factors, including limited product diversification, political instability, inflation, and reduced production efficiency. Conclusions : The resilience and adaptability of stakeholders, particularly manufacturers and importers, were crucial in maintaining the supply of 500 mg paracetamol tablets. Key strategies included regional sourcing, increased production, and improved partnerships. Understanding the interconnectedness of factors within the supply chain is essential for developing effective strategies to enhance its resilience and ensure sustained access to paracetamol in the future.

Keywords: COVID-19; Ethiopia; healthcare supply chain during the COVID-19 crisis; manufacturer; paracetamol; supplier; systems thinking (search for similar items in EconPapers)
JEL-codes: L8 L80 L81 L86 L87 L9 L90 L91 L92 L93 L98 L99 M1 M10 M11 M16 M19 R4 R40 R41 R49 (search for similar items in EconPapers)
Date: 2025
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