Ebola and Operations Research

It is impossible not to be moved by the impact of the Ebola virus on communities in western Africa with the World Health Organization (WHO) reporting a death toll of over 1,200 people.  Two Americans, Dr. Kent Brantly and Nancy Writebol, who had contracted Ebola while doing healthcare and missionary work in Liberia are now recovering at  special isolation wards at the Emory University Hospital in Atlanta, Georgia. Both were treated with the experimental drug ZMapp  and 3 doctors in Liberia, who were also given this drug, seem to be recovering.

There is no cure for Ebola and the fatality rate ranges from 50%-90%.

You may have seen the transport provided for both Brantly and Writebol from Africa to the US, with each traveling in white suits that enveloped their bodies on a specially equipped plane and being then transferred to the isolation facility by specially dressed workers in white "hazmat suits."

One of my colleagues was in Sierra Leone in June and this country had had the greatest number of cases. I saw him in mid-July and, thankfully, and with great relief,  he seemed fine. The incubation period is 2 to 21 days.

Last spring I taught a course on Humanitarian Logistics and Healthcare at the Isenberg School of Management and will be teaching it again in the Spring of 2015.  This healthcare crisis I will certainly be covering since, as I read the news, I keep on thinking of the complexity of the situation and when the problems and challenges are extra difficult, then my discipline of Operations Research may be able to contribute.

One of the issues which is so startling is the low level of many of the hospitals and healthcare facilities in western Africa with some hospitals not even having water and the healthcare workers not having access even to plastic gloves. Some are being offered extra pay for the hazardous duty associated with treating and taking care of Ebola victims. Having the proper medical supplies is essential for stemming the spread of this contagious disease, which supposedly does not spread through the air but, rather, through the exchange of fluids. I was reminded of a paper that we wrote: Supply Chain Network Design for Critical Needs with Outsourcing, Anna Nagurney, Min Yu, and Qiang Qiang, Papers in Regional Science 90: (2011) pp 123-142. By “critical needs” we mean products that are essential to the survival of the population, which can include, for example, vaccines, medicine, food, etc., depending upon the particular application. “Critical” implies that the demand for the product should be met as nearly as possible since otherwise there may be additional loss of life. We also studied the multiproduct aspects in the paper: Multiproduct Humanitarian Healthcare Supply Chains: A Network Modeling and Computational Framework,  Anna Nagurney, Min Yu, and Qiang Qiang, in the Proceedings of the 23rd Annual POMS Conference, Chicago, Illinois, April 20-23, 2012.

There are also ongoing disruptions to the supply chains of the affected countries, since some suppliers and freight service providers are reluctant to take the risk of possibly contracting the disease, which is truly horrific. The economies of these countries may also be affected. Our paper,  A Bi-Criteria Indicator to Assess Supply Chain Network Performance for Critical Needs Under Capacity and Demand Disruptions, Qiang Qiang and Anna Nagurney, Transportation Research A 46(5): (2012) pp 801-812, provides metrics to enhance decision-making in disaster situations and can even be applied to assess the delivery of food and medicines.

Moreover, there are policies such as the cordon sanitaire being implemented in parts to isolate the communities where Ebola is rampant to minimize its spread to other communities.  I thought about the research on "cliques" that our Operations Research community is a leader in.

Finally, this healthcare humanitarian crisis also has aspects of hazmat transportation, but with new challenges, since we are no longer transporting hazardous materials (we have done work on medical nuclear supply chains, for example) but people, who, in effect, are hazardous since they have Ebola.

As the new academic year begins, I know that certain colleges in the US are taking precautions since they have students coming from the affected countries. Also, many of us travel alot via air and I am sure that we will be a bit anxious in flying.

Given that there is no cure, but that ZMapp appears to have had very positive effects in those who have been lucky to acquire it, it is imperative to assist the company in its production, especially that the supply has now been exhausted.  And, here again, through analytics and Operations Research, I believe that our models and algorithms can be helpful: Pharmaceutical Supply Chain Networks with Outsourcing Under Price and Quality Competition, Anna Nagurney, Dong Li, and Ladimer S. Nagurney, International Transactions in Operational Research 20(6): (2013) pp 859-888.

In conclusion, I would like to thank the selfless, truly courageous healthcare workers battling Ebola, under such difficult circumstances.  Our hearts go out to the families who are suffering so much.  Organizations need to team up to battle this scourge.

Global Healthcare Supply Chains and Good Job News

I have been writing in this blog about our latest research on supply chain network design for critical needs products from vaccines to medicines and on hospital supply chains.

I was delighted to read in the Boston Globe that Sanofi-Aventis, one of the world's largest drug makers, is expanding its operations in Massachusetts and that this will mean more jobs -- jobs of importance and meaning.

According to the article: Sanofi-Aventis SA, is planning a $65 million expansion in Cambridge that will create about 300 jobs, making it the latest foreign pharmaceutical giant to invest in Massachusetts. The Paris-based drug maker is in the process of leasing space in Cambridgeport, where it will establish a joint headquarters for a new cancer division.

As you may recall (what a feeling of deja vu) last summer, at this time, the world was battling the H1N1 virus from Argentina (coincidentally, my most recent international trip in the summer of 2010) to China to the United States.

Sanofi-Aventis was one of only a handful of H1N1 vaccine producers and, given the low number of vaccine manufacturers, and the various challenges with the production of this vaccine, my research group began a study on multiproduct supply chain network design with applications to healthcare. Clearly, with fixed capacities, some of the vaccine producers had to switch from production of the annual flu vaccine to the challenging H1N1 vaccine.

We are pleased that the study has resulted in a paper/report, "Multiproduct Supply Chain Network Design with Applications to Healthcare," which, given the timeliness of the topic, we are making available to our readers through the Virtual Center for Supernetworks. The research allows pharmaceutical firms to redesign their supply chains in an optimal way to enable the cost-minimizing production of multiple vaccines and medicines with demand satisfaction.

Research at Business Schools is increasingly focusing not only on how wealth can be created but also how it can be done in a socially responsible way.

Supply Chain Network Design for Critical Needs at NetSci2010

I will be at MIT for the NetSci2010 Conference over the next couple of days and will be presenting the paper, "Supply Chain Network Design for Critical Needs with Outsourcing." The paper has been accepted for publication in the journal, Papers in Regional Science. The presentation may be downloaded here. I will be going with one of my doctoral students, Min Yu, who is a co-author with me of the paper, along with Dr. Qiang "Patrick" Qiang.

The conference should be very interesting and the venue of the Media Lab should be perfect. I am looking forward to seeing many colleagues there.