World Customs Day, observed each year on 26 January under the auspices of the World Customs Organization (WCO), is an opportunity to recognize the essential role that customs administrations play in enabling trade, protecting borders, and supporting economic and social development. For the global health and humanitarian community, World Customs Day is also a moment to reflect on how customs processes directly affect people’s access to lifesaving medicines, diagnostics, and health technologies.
In low- and middle-income countries (LMICs), public health supply chains operate in demanding environments shaped by complex importation requirements, fragmented regulatory frameworks, and constrained institutional capacity. Donated health products play a critical role in these settings, enabling governments and health programs to expand access to lifesaving health products for populations that might otherwise be left behind. While such products are typically eligible for exemptions from taxes, duties, or product registration requirements, the administrative processes required to secure these waivers can be intricate and time-consuming. When not well aligned with the urgency of public health needs, these processes can unintentionally slow the delivery of essential products—highlighting the importance of thoughtful coordination, clear procedures, and collaborative solutions.
The Partnership for Supply Chain Management (PFSCM), a nonprofit procurement services agent and supply chain solutions provider, has worked at this intersection of health, logistics, and customs for over two decades. Since 2005, PFSCM has supported ministries of health and global health programs in more than 120 countries, coordinating thousands of shipments of essential health products—many of them cold chain, time‑ and temperature‑sensitive, and urgently needed.
In recognition of World Customs Day 2026, this blog highlights how PFSCM collaborates with customs authorities, ministries of health, freight forwarders, and clearing agents to simplify and accelerate the importation of donated health products or those procured with donated funds. It emphasizes practical solutions, shared accountability, and real‑world examples of how coordinated action can reduce delays, protect product integrity, and ultimately save lives.
The unique nature of products imported for humanitarian health programs
Health products procured with donated or grant funding occupy a unique space in international trade. Unlike commercial goods, these products are procured by recipient countries using donated funds for public benefit. As such, most governments have policies that allow for exemptions from import duties, value‑added tax (VAT), and, in some cases, product registration requirements.
However, while the principle of exemption is widely accepted, the practical implementation is often complex. Waiver processes typically involve multiple government entities, including ministries of health, finance, and trade, as well as customs authorities. Documentation requirements vary by country and by product type, and approval timelines can range from a few days to several months.
For products with long shelf lives, extended waiver timelines may be inconvenient but manageable. For diagnostics, reagents, and other cold chain products, delays can be critical. Every additional day spent waiting for clearance reduces usable shelf life and increases the risk of spoilage, stock‑outs, or emergency redistribution.
PFSCM’s internal analysis of shipment data consistently shows that importation activities—particularly tax and product registration waivers—are among the most significant contributors to extended delivery lead times. Addressing these challenges requires not only technical knowledge of regulations but also close coordination among all stakeholders involved in the end‑to‑end supply chain.
PFSCM’s orchestrating role helps keep stakeholders connected
PFSCM operates in a unique orchestrating position within global health supply chains. As a procurement services agent and fourth‑party logistics (4PL) provider, we oversee and coordinate a broad network of actors, including suppliers, freight forwarders, customs clearing agents, and in‑country recipients.
This “bird’s‑eye view” of the supply chain allows us to identify risks, anticipate bottlenecks, and intervene early when issues arise. Importantly, PFSCM does not replace the responsibilities of national authorities or commercial partners. Instead, we support them by improving visibility, clarifying roles, and strengthening communication across institutional boundaries.
Over the years, we have learned that accountability in complex supply chains does not emerge automatically. Dedicated oversight, clear documentation, and proactive follow‑up are essential—particularly for waiver processes that involve multiple handovers and approvals. By serving as a central coordination point, we help ensure that no single stakeholder unknowingly delays another and that critical actions are completed in the right sequence and at the right time.
Initiating waivers earlier: using proforma invoices to reduce lead times
One of PFSCM’s most impactful recent initiatives to reduce waiver‑related delays has been the use of proforma invoice (PFI) documentation to initiate waiver applications earlier in the procurement cycle.
Traditionally, many countries begin the waiver process only after a final commercial invoice is issued and the goods are ready to ship. By that stage, certain lead times or milestones may already have elapsed, and any delay in waiver approval will directly add to delivery timelines.
To mitigate this risk, we began advocating for countries to apply for waivers using proforma documents. This approach allows clients, mainly government counterparts, to process waivers in parallel with product production lead times, substantially reducing overall delivery timelines.
After consulting with freight forwarders, suppliers, and in‑country partners, we identified several countries where this approach was feasible based on regulatory frameworks, past performance, and data reliability. Several countries are now initiating waivers in parallel with supplier lead times, and PFSCM intends to expand this approach where possible.
The results have been significant. Uganda achieved a 50% reduction in waiver processing time, Mozambique a 60% reduction, and Burkina Faso led with a 64% decrease in waiver processing days.
This initiative has highlighted additional opportunities for improvement, and PFSCM will continue refining it to reduce administrative friction while maintaining compliance and transparency.
Protecting cold chain products through direct exit and emergency clearance
For time‑ and temperature‑sensitive health products, airport clearance delays pose a direct risk to product quality. In response, PFSCM has worked closely with freight forwarders and customs clearing agents to implement direct exit or emergency removal solutions where permitted.
Under these arrangements, shipments are released immediately upon arrival and transferred to approved pharmaceutical or cold chain storage facilities, rather than remaining at the airport during documentation finalization. Physical inspections and administrative checks are conducted later at an agreed location and time.
This approach minimizes exposure to temperature excursions, reduces congestion at ports of entry, and protects valuable donated products. While not suitable for all contexts, direct exit has proven particularly effective for reagents used in HIV, tuberculosis, malaria, and genomic surveillance programs.
Standardizing classification: Harmonized System Codes as an enabler
Inconsistent or incorrect classification of health products under the Harmonized System (HS) is an occasional cause of customs delays and unexpected charges. Reagents, for example, may be classified as industrial chemicals rather than medical or diagnostic supplies, triggering duties that contradict public health exemption policies.
PFSCM actively works with suppliers, clients, freight forwarders, customs agents, and ministries to align HS codes across documentation and stakeholders. In Guinea, for example, we coordinated a multi‑stakeholder effort to resolve HS code discrepancies that were delaying large shipments of health products originating from Asia.
Beyond individual cases, we advocate for greater standardization of HS codes for health products at regional and global levels, working alongside partners such as the Africa Centers for Disease Control, the World Health Organization, and the WCO. Clearer classification guidance reduces disputes and accelerates clearance without compromising revenue collection or regulatory oversight.
Digital tools, visibility, and accountability
Many waiver and clearance delays are not caused by policy constraints but by manual processes, missing signatures, or limited visibility into the status of a document in the approval chain. PFSCM supports the use of digital tools—where available—to address these challenges.
Digital trackers, shared document repositories, and automated alerts help stakeholders monitor progress, identify bottlenecks, and take corrective action early. In countries transitioning from paper‑based systems to electronic platforms, we help partners adapt workflows and build confidence in new tools.
Equally important is the use of clear checklists, standardized shipping instructions, and documented process maps. These tools reduce human error, support continuity during staff turnover or crises, and enable faster onboarding of new stakeholders.
Mapping processes to remove waste: lessons from Nigeria
Process mapping has proven to be a powerful tool for identifying inefficiencies and eliminating unnecessary steps in importation workflows. A notable example comes from Nigeria, PFSCM’s largest country program.
Several years ago, PFSCM and its partners identified that completing the e‑Form M—a legacy import document—added up to eight weeks to the importation timeline for donated health products, despite offering no additional regulatory value for these transactions. Through careful analysis and stakeholder consultation, it was determined that the form was redundant for PFSCM‑supported shipments and could be omitted.
Removing this single step significantly reduced lead times, improved shelf-life outcomes, and lowered the risk of stockouts. It also demonstrated how collaborative, evidence‑based dialogue can lead to meaningful reform without undermining regulatory intent.
Country examples of collaborative problem‑solving
Across its portfolio, PFSCM has supported countries in navigating sudden regulatory changes, infrastructure disruptions, and emergency conditions.
In the Dominican Republic, PFSCM helped resolve an unexpected reclassification of condoms that temporarily removed their blanket tax waiver. In Sierra Leone and Gambia, PFSCM coordinated rapid responses to abrupt changes in waiver and registration policies, ensuring continuity of supply.
In Tanzania, PFSCM worked with stakeholders to remap importation processes following major regulatory reforms, restoring clearance timelines to under ten days. In Uganda, PFSCM supported overland logistics by using a transit warehouse, staggering deliveries, and closely monitoring documentation to avoid compounding delays.
These examples underscore a consistent lesson: importation challenges are rarely solved by a single actor. Success depends on shared understanding, trust, and a willingness to adapt processes collaboratively.
Recognizing the role of customs and clearing agents
On World Customs Day, it is particularly important to acknowledge the critical role played by customs officers and clearing agents. Operating at the frontline of trade facilitation, these professionals balance the need for compliance, revenue protection, and security with the urgency of humanitarian and public health demands.
PFSCM’s experience has shown that when customs agents and regulatory authorities are engaged early, informed about the public health context, and supported with accurate documentation, they become powerful partners in accelerating clearance. Ongoing dialogue, training, and mutual respect are essential to sustaining these relationships.
Collaboration as the path forward
The importation of donated health products sits at the crossroads of trade, regulation, and public health. While the challenges are real—ranging from complex waiver processes to infrastructure constraints—they are not insurmountable.
PFSCM’s experience demonstrates that meaningful improvements are possible through early planning, process simplification, digital tools, and, above all, collaboration. By aligning freight forwarders, customs authorities, and ministries of health around shared goals, supply chain stakeholders can reduce lead times, protect product quality, and ensure that life‑saving health products reach the people who need them most.
As we mark World Customs Day 2026, PFSCM reaffirms its commitment to working alongside customs administrations and supply chain partners to build more efficient, resilient, and responsive health supply chains—at the border and beyond.
