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This case was based on both primary and secondary data. In-depth semidirected interviews were conducted in 2021–2022 after receiving the institutional research board approval. The interviews took an approximate time ranging from 90 to 120 min. They were recorded and transcribed. A thematic analysis was undertaken to identify the most relevant themes for the case. The secondary sources used included various websites, scholarly and trade journals, as well as specific databases, such as Statista.

The case exposes students in multiple disciplines to the challenges created by the COVID-19 crisis at Yale School of Medicine (YSM). It describes its remarkable effects on organizational and community members as they struggled to reimagine more inclusive and supportive spaces. As one of the most severe crises humanity has ever witnessed, COVID-19 exacerbated the existing struggles of the underrepresented communities, creating a double pandemic. It has also amplified inequities among marginalized groups including black, indigenous and people of color; women; immigrants; lesbian, gay, bisexual, transgender, queer/questioning; people with different abilities; working parents; single parents; religious minorities; and people with low income. When COVID-19 hit in 2020, Yale University School of Medicine (YSM), like other pioneering schools in the field of health care, doubled their efforts to face both the public health crisis and the substantial social turmoil (racial tensions after the death of George Floyd, food insecurity, vaccine resistance, social inequalities, etc.). Professor Marietta Vazquez, MD, who was the first Latina to be named Associate Dean for Medical Students Diversity at YSM, launched with Dr Latimore (Chief Diversity Officer) and her other colleagues many strategic initiatives aiming at improving the diversity, equity and inclusion of organizational and community members.

The case is an invitation to graduate students and students in executive education programs to reflect on the grand challenges leaders faced at YSM as well as in other institutions across the nation and the globe. It is also a call to reimagine ways leaders can accelerate the pace of change in their organizational ecosystems.

This case was written for use in graduate-level courses, including executive education dealing with Diversity, Equity, Inclusion and Belonging, Leadership and Change, Health-Care Equity/Policy, Health Sciences, Human Resource Management, Organizational Behavior, Crisis Management, Sustainability, Business and Society, Social Issues in Management, Strategy, etc. Faculty members can easily adapt the case to fit the content of the course they teach, the students’ context as well as the specific learning outcomes to be achieved.

After discussing this case, students will be able to understand the challenges faced by social entrepreneurs in starting a health-tech start-up in Africa; create and evaluate lean business models of health-tech companies as a social enterprise; evaluate how health-tech start-ups were developing innovative business models and supply chain networks to make prescription drugs accessible and available in Africa; understand how inorganic growth strategies can help health-tech start-ups scale up; and evaluate what promises investors were seeing while investing in social enterprises in the health-care sector in Africa and what social wealth they were creating.

In August 2022, Gregory Rockson (Rockson), social entrepreneur and founder of for-profit health technology (health-tech) social enterprise in Ghana, mPharma, stated that he had plans to replicate the company’s business model, which provided people access to drugs and at affordable prices, to other African nations, beyond the company’s existing footprint. However, analysts pointed out that the fragmented drug supply chain and poor regulation in the health-care market across Africa could act as a challenge for mPharma to replicate its business model successfully across the African continent. People in Africa were forced to pay higher prices to buy life-saving drugs due to the continent’s fragmented drug supply chain. To add to their woes, pharmacies struggled to keep life-saving and life-sustaining medicines in stock. Often, patients traveled miles to a pharmacy only to find out that the drugs they needed were not in stock. In addition to this, the markets were flooded with counterfeit drugs. And the Covid-19 pandemic only exacerbated the situation. mPharma managed the prescription drug inventory for pharmacies and drug suppliers using its proprietary vendor management information system. By using the technology infrastructure it had built, the company connected patients, pharmacies and hospitals through a cloud-based software. The system enabled doctors to track in real-time which drugs were available and at which location, thus giving patients reliable access to medicines. Patients registering with mPharma with their prescriptions and medical history received an alert on their mobile phones notifying them where the drugs they needed were available. mPharma bought drugs from major drug manufacturers such as Novartis International AG, Pfizer Inc. (Pfizer) and Bayer AG, on behalf of the pharmacies. This enabled the pharmacies to save on the up-front costs of stocking the drugs, reduced supply constraints and ensured availability of drugs to consumers in these underserved markets. The company had a consignment model wherein member pharmacies had to pay only for what they sold. Most pharmacies forecast the number of drugs they needed and purchased them from mPharma at pre-agreed rates. The company took the inventory liability to prevent pharmacies from going out of stock. As mPharma used its purchasing power to buy drugs in large quantities from drug manufacturers and suppliers, it was able to help patients realize cost savings of 30% to 60% in the purchase of medicines. mPharma was focusing on achieving its ambitious goal of dominating the health-care market in Africa in future. However, analysts felt that the company would face challenges related to poor regulation in the health-care market, high prices of drugs and the fragmented pharmacy retail market in the continent.

This case is intended for use in MBA/MS level programs as part of a course on Social Entrepreneurship, Sustainability, Business Model Innovation, Disruptive Business Models, and Supply Chain Management in the Drug Industry.

Teaching notes are available for educators only.

CSS 3: Entrepreneurship.

This paper aims to highlight the implications of financial planning for public procurement process for medicine purchase. The purpose of this case is also to understand how the choice of contract type in public procurement impacts medicine inventory levels and availability. It finally highlights the appropriate configuration of framework procurement contract for procurement of discrete goods in the context of public sector procurement.

Primary and Secondary Healthcare Department (P&SHD), Government of the Punjab provides free public health-care services in the Punjab province. Public health-care services of P&SHD are organised in a tiered manner with almost 3,000 primary and secondary medical facilities dispersed throughout the Punjab province. P&SHD maintains inventories of approximately 300 medicines to support medical service provision.

This case can be taught in procurement and inventory management module of MBA level operations management course. It can also be used in executive course on public sector procurement management. The case aims to highlight the interrelation between inventory planning and procurement management process. Hence, it should be used after participants have understood inventory models, procurement process and procurement contract types. Standard readings or cases on inventory and procurement management that cover topics such economic order quantity, procurement process steps and procurement contracts can be used to develop this understanding.

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

CSS 9: Operations and logistics.

This case study will allow students to critically analyse and develop entry strategies into untapped foreign markets. The case study was designed to introduce students to identifying and analysing information related to target markets for expansions in international business.

The main objectives of this case are to evaluate and make the “Go Global” decision for the company; to take a position on entry timing for a company for entering an overseas market; to select a country for entry based on cultural, administrative, geographic and economic analysis and other relevant factors; and to evaluate a firm’s readiness for exports.

This case study on Satya Pharmaceuticals presents a typical dilemma faced by small and medium enterprises (SMEs) in emerging markets such as India while exploring the untapped overseas markets to expand their business. Satya Pharmaceuticals produced over-the-counter Ayurvedic medicines. With the onset of the COVID-19 pandemic, the consumer preference for Ayurvedic products had increased globally. Home country governments’ emphasis on exports and conducive consumer preferences created an opportune time for such SMEs to explore uncharted markets with a propensity for herbal medicines. Amidst strict regulations regarding safety, efficacy, labelling and packaging norms, along with a subjective understanding of the consumers’ sentiments regarding alternate medicines, SMEs had to select their target market carefully for their products to be successful overseas. This case study presents the basic information that entrepreneurs needed to explore the foreign markets. It revolved around checking firms’ preparedness to explore foreign markets, identifying target markets, timing the entry and entering those markets.

This case is appropriate for graduate-level courses in management that offer subjects such as international business.

Teaching notes are available for educators only.

CSS 5: International business.

This case describes the teaching and learning processes in Ayurveda, the ancient Indian system of medicine as explained by Vaidya Hardikar. He practised the system of diagnosis through ‘Nadi Nidan’, pulse reading and treated patients according to the principles of Ayurveda, the ancient Indian system of Medicine. The transfer of knowledge happened through formal and informal processes where he assisted his father and other practitioners in preparing medicines, interrogating the patients and pronouncing diagnosis. The participants can identify and analyze the various processes in the transfer of tacit and explicit knowledge.

This case describes the innovations of a medical practitioner over six decades of practice. It provides an opportunity to the participants to analyse the motivation, processes, constraints and outcomes or innovating efforts of individuals as opposed to corporates. During his career Dr. Shah has experimented with novel methods of treatment, applications of known solutions and new product formulations. At the fag end of his career Dr. Shah is wondering whether the innovating efforts were worth their white.

This case provides an opportunity to identify and discuss issues in sustenance of an incumbent's strategy in the changing environment. The context is the practice of Nadi Nidan (pulse diagnosis) and treatment of disorders based on this according to Ayurveda, the ancient system of Indian medicine. It describes the functioning of Bharadwaj Aushadhalay, an Ayurveda clinic run by Vaidyaji since 1955 and presents the history of the clinic, the process by which Vaidyaji learnt the practice of Nadi Nidan, the profile of the patients, the mode of treatment, restrictions imposed by Vaidyaji on the patients, their response and competitive pressures on the system. The case also provides a brief sketch of Ayurveda, its principles, currents trends in the education and research in Ayurveda, and recent advances in diagnostic tools and techniques. The case can be used in courses of Strategic Management in the module on Strategies for Sustainable Competitive Advantage and Knowledge Management.

Pharmaceutical marketing, brand protection.

It could be used with the pharmaceutical marketing students and MBA students for analysing counterfeit medicines' menace in developing countries and positioning of a disruptive technology. The case could be used for marketing consultants, Brand managers and executive development programmes to explore issues such as protecting brands through technology, pharmaceutical packaging marketing, competitiveness of counterfeit drugs, global harmonisation.

Against the backdrop of rising menace of counterfeit drugs in developing countries, the case talks in particular about an innovative pharmaceutical packaging company. The company has developed a unique security technology called non-ClonableID™ which can enable products to be authenticated throughout the supply chain, thus protecting brands and preventing misuse. Despite a promising technology, it poses challenges regarding its adoption and commercial success.

Counterfeiting as an inevitable result of Globalization has become a global nuisance and has to be dealt at global level. Brand protection could be one of the lowest cost tools for pharmaceutical companies to restore public confidence in their products and themselves. While all methods for anti-counterfeiting are known to have short lives the menace still must be dealt with. For this, companies need to deploy anti-counterfeiting strategies that set up various layers of security.

Teaching note.

Public Health; Leadership; Organisational Development; Organisational Behaviour; Public Administration Management.

Postgraduate level for honours or masters programmes in courses on public health; executive leadership and management programmes; MBA level.

The case unpacks decentralisation as a means to promote and improve local decision-making and accountability through community participation and engagements. Ayanda Nkele was a programme manager in a health district in South Africa. He was faced with many challenges when trying to implement his programme, most of which were related to local authority, responsibilities and decision-making abilities at his level. This case describes briefly the South African health system. and how it functions. It describes the proposed changes to the health system and its transformation towards Universal Health Coverage. The decision space analysis as discussed in the case illustrates the types of decentralisation in the country and how this also applies to Nkele’s level.

Understanding the concepts and principles of decentralisation within the context of strengthening district health services, the re-engineering of primary health care (PHC) and rolling out a National Health Insurance in South Africa. Applying the “decision space” approach to analyse the extent of decentralisation. Grasping the requirement of leaders to be “contextually intelligent” and identify the important contextual variables to take into account when analysing public health care.

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

CSS 7: Management Science.

Prayas is a unique healthcare initiative, launched in India by Sanofi-Aventis, a French multinational pharmaceutical company, with the objectives of updating the medical knowledge of doctors in semi-urban and rural areas, bridging the gap between diagnosis and treatment, and making available quality medicines at affordable prices. This case discusses the evolution of the Prayas model from its inception to its current state, and the company's business strategies around it. Cognizant of the success of Prayas, many competitors of Sanofi-Aventis are actively developing and implementing similar models. The company's top management team has to respond to the competitive threat.