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 chainsin Sub-Saharan Africa. Specifically, the authors 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 – The authors 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 – The authors derive six testable propositions from the analysis and offer a decision framework to support donorsin 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, they 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, they identify contexts in which each intervention is most effective.