focus of dfid’s current research identify the market characteristics and determinants of...
TRANSCRIPT
Focus of DFID’s Current Research
Identify the market characteristics and determinants of reproductive health commodity supply,
Determine whether and in what way international finance and procurement systems play a role in securing commodity security, and
Through selected country case studies, explore county level architecture and systems that influence RH commodity security
Focus of the Country Level Studies
Understanding how continuing inefficiencies in demand estimation, financing and procurement systems at country level are contributing to the RH supply security problem
Identifying how these problems have been overcome in some circumstances, and
Knowing whether and how commodity security has been affected by the introduction of aid instruments like SWAPs or budgetary support
International study – emerging conclusions
For most reproductive health commodity products, supplier markets are sufficiently deep to enable supply security, without active donor intervention. In fact, the rise of generic Southern suppliers is beginning to enable major cost efficiencies – though a number of issues remain
International procurement efforts are hampered by a lack of coordination between donors and by short term funding horizons
There is evidence that international procurement efforts have been improving in efficiency and effectiveness, though evidence is patchy and there are concerns over service quality
The main issue for donors seem to be a relative lack of capability building results at country level. This issue will be pursued further during the country level study, but there is clear evidence of a lack of a coordinated, long-term strategic effort on this front
There is clearly potential for improved coordination between donors on the strategic capability building level. Real success for such an effort is likely to require:
– Clear agreement between donor stakeholders on overall direction and strategy
– Strong, committed leadership and dedicated, but lean, resource– An appropriate organisational form – whether as stand-alone organisation
or fitting into existing organisational structures
World contraceptive commodity supply markets
11,000
Source: UNFPA, Global Consultants
Donor-funded and operated
Government-operated, may be partly donor
funded
Private sector/ other
Total, developing country
World totalDeveloped countries
15,000
4,000
300224
~3,500
$m, 2002
Includes:•Oral contraceptives (60%+ of market)•Male condoms (25% + of market)•Implants/ injectibles•IUDs•Female condoms•Emergency contraceptives
•Does not include sterilization products/ services
Rise of generic suppliers
Source: Interviews
•For reasons of IPR or technology capabilities, only “Northern” manufacturers supply market
•Limited number of suppliers
•No/ few quality issues
•High prices, except where products given away at discount
“Northern”* suppliers only
Entry of “Southern”* suppliers [Transition phase]
Maturity of “Southern” suppliers
•“Southern” suppliers enter market
•Much lower production costs enables much lower prices
•However, major quality and reliability issues with new entrants
•Use of certification and quality control procedures is key
•New entrants mature and resolve quality and reliability issues
•Donors will have a large pool of qualified producers, enabling highly competitive sourcing
*”Northern” suppliers: manufacturers in developed countries. “Southern” suppliers: manufacturers in developing countries/ emerging markets, e.g. Brazil, India, China
Bangladesh Southern sourcing case study
Source: Interviews
•Over the last 4 years, the Bangladeshi Government procurement function (all local staff) have managed to reduce reproductive commodity procurement cost by 1/3 (from $60 to $40m) with no loss in quality or adverse product mix
•This has been done purely by using best practice procurement techniques, including pushing for generic products and using a “Southern” supplier base
•Following some initial quality problems, “Southern” suppliers are now performing very well
•Anecdotally, “Southern” suppliers were able to offer oral contraceptives for 10 cents/ cycle; half the 20 cents/ cycle offered by “Northern” manufacturers
•Anecdotally, Wyeth upset about these low prices – “we can never match this”
Entry barriers becoming lower
Source: Interviews; Gujarat Business Council, WHO
Oral contraceptives
Male condoms
Injectable contraceptives
Capital cost of plant
Other resources required
Minimum efficient scale/ turnover*
•$4-$6m •Skilled latex/ chemical engineers•Skilled labour
•500,000 gross @ 144 condoms (70m)•$2-$3m
•$3-$5m •Skilled chemical engineers•Skilled labour
•5-10 million doses•$5-$9m
•$2.5-$6m •Skilled chemical engineers•Skilled labour
•15 million cycles•$3-$4m
Need for donor intervention to build market capacity
Source: Interviews
•Donor demand is a large fraction of total demand (or even all of it)•Long ramp-up times for production; no slack in system•Few suppliers (or none)
•Example: ACT
•Donor demand is a low proportion of total demand•Short ramp-up times for production/ slack in systems•Many suppliers
•Example: Most contraceptives
High Low
-
50,000
100,000
150,000
200,000
250,000
Others
IPPF
DFID
BMZ/KFW
World Bank
PSI
UNFPA
USAID
Donor procurement of contraceptive commodities
Source: UNFPA
$’000
Efficiency of donor condom procurement
Source: UNFPA
$/gross (144) – real 2002 prices
7.74 8.04 8.15 8.14
6.73 6.527.01
6.396.90
6.05
7.22
4.904.43
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
$4.44
$2.57
UNFPA target range
2001-2002:boost in donor procurement spend
Country level issues
Source: Interviews
Government/Regional authorities
Donors•Fragmented, short term funding, focusing on commodity buying, not capability building (tactical, not strategic)
•Low quality supply chains, and management information systems
•Multiple, overlapping supply chains (agencies, governments)
•Low priority
•Governance
•Generally weak procurement capabilities
•Lack of coordination between agencies and governments
•Low priority
•Governance
$$$ $
Procurement Supply chain
Recommendations
Continue to expand the supplier base– Some work on certification and quality control measures required– Improve international procurement– Consider options to smooth fund flows and make them more predictable, to
facilitate procurement– Improve donor coordination– Improve information flows (e.g. why only detailed information available on
condom procurement?) Improve donor support for country level implementation
– This seems to be the biggest issue– Substantially increased strategic focus on long-term capability building
required, across procurement and supply chains – increased funding clearly required, but not just a money issue
– Strongly improved donor coordination Creation of a strategic implementation vehicle
– Clearly benefits from a coordinating vehicle between donors– Needs to provide strong leadership and resources on strategy and capability
building issues– May also help facilitate regional procurement pooling, possibly channelling
through UNFPA– Not clear whether better housed inside existing organizations or as a stand-
alone entity – benefits and drawbacks to both models