un c ommissionon life saving commodities · utilized life-saving commodities across the rmnch...

RMNCH UN COMMISSION ON LIFE

SAVING COMMODITIES

Dr Paul Pronyk

RMNCH Strategy & Coordination Team

UNICEF

Expanding availability and access to life-saving commodities

RMNCHStrategy and Coordination Team

Overview

• UN Commission on Life Saving Commodities

• Strategies to implement UNCoLSC recommendations

• Progress to date and next steps

•Markets & manufacturers

1. Shaping global markets

2. Shaping local markets

3. Innovative Financing

4. Quality strengthening

5. Regulation efficiency

6. Supply and awareness

7. Demand and awareness

8. Reaching women and children

9. Performance and accountability

10. Product innovation

Reproductive

health

Female Condoms

Implants

Emergency

Contraception

Maternal

Health

Oxytocin

Misoprostol

Magnesium sulfate

Newborn

Health

Injectable antibiotics

Antenatal Corticosteroids

Chlorhexidine

Resuscitation Equip.

Child Health Amoxicillin

Oral Rehydration Salts

Zinc

Accelerate

achievement

of

MDGs 4 & 5

The Commission’s recommendations support clear objectives for under-

utilized life-saving commodities across the RMNCH Continuum of care




• Perspectives for markets & manufacturers

Two main strategies for implementing UNCoLSC recommendations

Strategy &

Coordination Team

RMNCH Trust Fund

Support for Country Plans

Supply chain

Markets–Regulation -

Quality

Demand-Access-

Performance

Family Planning

Maternal

Newborn

Child

Technical Resource

Teams

Manufacture Coverage

National

Commodity

Specific

UNCoLSC framework guides country plans


Commodity dashboard to identify key bottlenecks

Country support for system strengthening activities

Country Total

Nigeria $10,265,649

Senegal $5,513,964

Sierra Leone $5,320,040

Malawi $3,955,255

Uganda $3,877,359

DRC $3,496,404

Tanzania-Mainland $3,292,390

Tanzania-Zanzibar $750,070

Ethiopia $1,990,775

Grand Total $ 38,461,906

Budget split by UNCoLSC recommendationYear 1: Country budgets (US$)

Regulatory 7%

Innovative financing 2%

Year 2 support extends to a wider number of countries

• Nigeria

• DRC

• Ethiopia

• Additional catalytic, gap-filling and co-financing support from RMNCH Trust

Fund

• Benin

• Burkina Faso

• Cameroon

• RMNCH Country Engagement process on-going with teams in-

country

• Tanzania

• Uganda

• Burundi

• Haiti

• Pakistan

• Alignment of funding discussion well primed and could happen quickly

• Next priority countries

• Mali

• Niger

• Sierra Leone

• Somalia

• South Sudan

• RMNCH Trust Fund ready to support part of the gap, alongside other partners

• Kenya

• Liberia

• Zambia

• Zimbabwe• Discussion initiated

• Senegal

• Malawi

Commodity TRTs

Research and evidence

Product specification

New product innovation

Treatment guidelines

Manufacturing landscape

Input into job-aids and training

materials

Technical Resource Teams (TRTs) as a second strategy for

accelerating progress on the UNCoLSC recommendations

• Consortium of global experts: ~250 affiliated organizations• H4+, academics, implementing partners

• Often members of initial UN Co LSC process

• Draw from pre-existing initiatives where they exist• Diarrhoea-pneumonia working group

• Direct Technical Assistance to Countries through established partners

• 7 core groupings (plus Advocacy)• Commodities

• Recommendations

Supply chain

Markets–Regulation -

Quality

Demand-Access-

Performance

Family Planning

Maternal

Newborn

ChildRecommendation TRTs

Global catalytic activities

Dissemination to stakeholders

• Governments, agencies, partners

• Procurement and Supply Chain

• Regulatory agencies

• Private sector

• Health Providers and Professional bodies

• NGOs, CSOs


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

National EML

National Guidelines

Regulator Registration

National Tender

National Stock-out

Facilities Stock-out

Prescription Authority

Training

Job Aids

Demand Generation

No User Fees

Coverage

Re

gu

lato

rySu

pp

lyP

erf

orm

an

ceD

em

an

d &

Acc

ess

Good

Moderate

Low

No Data

N/A

TRTs address cross-cutting challenges to commodity-accessData from 6 countries, all commodities


Overview



• Perspectives for markets & manufacturers


• Essential Medicines List: All commodities on WHO EML

• Global Market Shaping: 50% price reduction for implantable contraceptives

• Pricing data, manufacturer mapping (22 countries), needs-based quantification conducted for all LSCs

• Local Markets: Market shaping primer for actionable private sector local market shaping interventions

• OTC status for ORS-Zinc in several countries

• Procurement: Quantification and Forecasting tools and guidance materials (needs-based forecasting for LSCs)

• Regulatory: Regional market shaping efforts conducted with the East African Community’s Pharmaceutical manufacturers

• Fast track registration process initiative in 15 countries

• Initial discussions on regulatory harmonization with regional blocs (EAC, ECOWAS)

• Direct support to Manufacturers: Manufacturer GMP certified in Nigeria (first in W Africa)

• TA to manufacturers in 5 additional countries

• Quality: Ten country quality survey of LSCs

TRT phase I deliverables for manufacturing and markets


• Market shaping

• Consolidate procurement and forecasting data for LSCs

• Identify potential price reduction deals

• Regional entry points to engage multiple countries: (EAC, SADC, ECOWAS)

• Develop procurement standards for LSCs

• Collate information on supply for high volume LSC; work with countries to consolidate demand

• Provide assistance to strengthen tender process for select high volume essential health products

• Implement consolidated procurement for LSCs;

• Streamline regulatory processes: Common regulatory pathways, joint inspections/dossier reviews

• Direct support to manufacturers: Develop business sustainability plans for GMP manufacturers

• Identify local manufacturing opportunities with engagement of manufacturers and potential buyers

• Provide TA to improve the quality production of LSCs:

• for non-PQd products – develop ERPs, monographs, bioequivalence studies 20 LSCs

TRT Phase II agenda focus on dissemination to countries


• Prescription authority: Ensure Registered products can be prescribed at the appropriate level

of care

• Supply chain: Identify and TA for addressing supply chain challenges

• Inter-agency Supply Chain group

• Health worker performance: Scale-up job-aids, check-lists and training materials to enhance

utilization by health workers

• Private sector: Work with regulators and private pharmacists to expand over-the-counter

access to ORS, Zinc, Emergency contraception

• Demand: Scale-up demand Generation Programs

• Financial access: Address financial access barriers/ user fees

Downstream work by other TRTs to improve availability and access


• 13 commodities as the ‘thin edge of the wedge’

• Growing needs: growing purchasing power,

expanding range of proven interventions,

shifting demographics, non-communicable

disease

• Draw attention to systems-level bottlenecks,

require systems-strengthening solutions

• Wider benefits for manufacturing and markets

across the full spectrum of commodities

Life saving commodities are just the starting point

un c ommissionon life saving commodities · utilized life-saving commodities across the rmnch...

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