Regional procurement policies and access to

medicines - lessons from the SADC Pooled

Procurement project

Wilbert Bannenbergwilbert@sarpam.net

SARPAM

Situational Analysis: Key Challenges• Limited transparency and poor availability of information

• Prices, quality, sources of medicines• Use of TRIPS flexibilities• Reluctance to disclose information

• Varying availability of selected medicines• Lack of standardisation on procurement and pricing information

• difficult to compare between countries

• Various levels of development of medicines regulatory systems – no MRAs in some countries

• Shortages of qualified staff in fields of specialisation• No coordination in efforts to strengthen PSM systems• Demographic and economic differences among countries

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Percentage of NMPA prices below the international MSH benchmark

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SADC Pharmaceutical Business Plan: 4.1.5 Promoting joint procurement

1. Evaluate options for pooled procurement for priority medicines and harmonize procurement regulations

2. Identify the priority essential medicines which can bring about the largest savings from pooled procurement or price negotiations

3. Identify and facilitate access to funding sources and finance mechanisms for joint procurement

4. Establish a regional mechanism for pooled procurement of medicines

5. Assess and strengthen national procurement agencies and supply chain management systems

SARPAM Pooled Procurement project• Based on SADC Pharmaceutical Business Plan• SADC Health Ministers wanted PP since 1997!

• Efforts did not work due to Drug Regulatory and Procurement system differences

• SARPAM developed proposal to start with information exchange between Procurement Agencies• 11 countries now sharing information

• At same time, SARPAM started Drug Regulatory harmonisation project • Common Technical Document approved last month

• SADC PP Strategy developed in 2012

SADC Pooled Procurement Strategy• Developed by a working group from SADC Member

States and partners WHO, UNDP, MSH with technical assistance from SARPAM• Discussed and approved by SADC Ministers of Health

and HIV/AIDS – Nov 2012• SARPAM facilitating implementation of the strategy• Member States choose taking a step-wise approach:• Recognition of challenges – 14 sovereign states vs region• Prioritise information and work sharing first• Group contracting in a later phase

The 4 Pooled Procurement models (Adapted from MSH, 2012)

Informed Buying Member States share information about prices and suppliers but undertake individual procurement.

Coordinated Informed Buying Member States undertake joint market research, share supplier performance information and monitor prices. Countries undertake individual procurement.

Group Contracting Member States jointly negotiate prices and select suppliers.

Countries agree to purchase, individually, from selected suppliers.

Central Contracting and purchasing

Member States jointly conduct tenders and awards contracts through an organisation acting on their behalf.

Central buying unit manages the purchase on behalf of countries

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PP Strategic Objectives

• To establish a mechanism for regional procurement of medicines and related commodities.• To mobilise resources for the SADC regional

procurement for Essential Medicines and Commodities• To develop and harmonise policies and guidelines for

procurement of Essential medicines and Commodities.• To facilitate trade and movement of Essential

Medicines and Commodities in the region • This includes working on using TRIPS flexibilities!

Intersectoral Cooperation

• Between the Health sector and• Trade (and customs): increased medicines’ trade

among MS• Finance: ensure resources• Procurement: procurement guidelines• Legal affairs: legislation and regulations

•While including development partners, private sector (SAGMA) and Civil Society

Main Responsible Parties

• SADC Pharmaceutical Procurement Services (SPPS)• SADC Secretariat• MOH Pharmaceutical Departments• Procurement Agencies (e.g., NatPharm)• Regulators (e.g., MCAZ)• Partners• Suppliers• Ministries of Trade, Finance, Justice

Pooled Procurement Benefits• Considerable savings by applying information and work

sharing among procurement agencies• Leading to improved access to essential medicines

• Development and implementation of regional standards and procedures will lead to increased efficiency• Quality assured medicines through regulatory

harmonisation• Functional regional pharmaceutical procurement agency

(SPPS) offering procurement services like• information sharing, work sharing , coordination, (e-)

procurement services including group contracting

Information & Work Sharing Platform

1. To make available to stakeholders in SADC Member States all key information on medicines that are on the market in the region• information on prices, sources and quality of at least 50

essential medicines and other difficult to source products

2. To make available information on ‘good practices’ in SADC Member States on pharmaceutical Procurement and Supply Management (PSM) systems including• procedures and tools used• a database of expert staff in Member States that apply

these practices.

ACT prices on SADC e-platform

http://sadc.meddb.medicinesinfohub.net/

Finally...• SADC member states last week: • Pooled Procurement implementation plan approved• Options paper for SPPS approved (@ SADC Secretariat)• agreed to establish the information sharing e-platform• SADC medicines database established

• Acknowledgement - based on a presentation by :• Geoffrey Ngwira, SARPAM Pooled Procurement Officer• Phone: +265 994 608 005• Email: geoffrey@sarpam.net