Procurement for health
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UNDP is taking a lead globally to support countries in the procurement of health products in some of the most challenging operating environments. The expertise built through decades of supporting Global Fund procurement in such contexts is being used to deliver value for money, quality assurance and reliability for domestically funded health procurement.
36 countries supported with Global Fund Grants and Government Financing Agreements
US$310 million of procurement expenditure delivered in 2017
US$65 million of procurement savings in HIV medicines (TLE/ARVs) from 2014-2017
Source: The Global Fund
Zimbabwe: creating value for money in HIV treatment
Price negotiations between UNDP and suppliers have achieved a cost for ARVs of less than US$70 per patient per year for the one-pill combination of the three HIV medicines known as TLE (Tenofovir, Lamivudine and Efavirenz). Because of this, UNDP was able to purchase 7.4 million packs of medicines for US$46 million for Zimbabwe in 2017—resulting in efficiencies of over US$29 million compared to previous orders. With the help of these efficiencies, the Ministry of Health and Child Care has now put over 1 million people on HIV treatment with support from the Global Fund, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the UK Department for International Development (DFID), UNDP and other partners.
Sustainable Health Procurement - saving more lives sustainably
Sustainable health systems
UNDP provides dedicated support for countries to implement large-scale health programmes and to strengthen institutions to deliver essential services in challenging and high-risk country contexts. While it is essential for UNDP to help deliver on health programmes in accordance with the HIV, Health and Development Strategy 2016-2021 and the SDGs, this also includes addressing the rising social and environmental challenges that are a part of a sustainable health system.
Total Gross Weight of TLE/ARV Shipped by transportation mode 2015-2017
As specified by the Lancet, climate change is the biggest global health threat in the 21st history and yet it is evident that the health sector is also paradoxically contributing towards climate change, with the environmental problems caused by health product production, consumption practices and the incredible scale of the global health procurement footprint.
While UNDP has identified this as a health procurement challenge, it has taken a new organizational model and business approach within its procurement practices by working in partnership with manufacturers and freight forwarders as part of the procurement and contract management process. This makes it possible to further assess, measure and provide dedicated support for the innovation and gradual adoption of sustainable health manufacturing and procurement practices. The main sustainable health procurement programme milestones include the following:
- manufacturer participation in the UNDP Environmental Scorecard Assessment and Criteria Implementation to enhance social and environmental due diligence
- eradicating the impacts on public health and climate change through CO2 data collection and monitoring of freight emissions
- health packaging reduction and innovation to reduce waste and optimize shipments
- conduct the UNDP Sustainable Health Procurement programme in partnership with the United Nations Interagency Sustainable Procurement in the Health Sector (UN-SPHS) Secretariat
The UNDP Sustainable Health Procurement programme is conducted in partnership with the United Nations Interagency Sustainable Procurement in the Health Sector (UN-SPHS) Secretariat.
Spotlight: Reducing emissions through health procurement planning and packaging optimization
UNDP is committed to reducing its C02 footprint as it is evident that health procurement is contributing to climate change. Therefore, UNDP in partnership with Kuehne Nagel is collecting data to measure, monitor and reduce C02 impacts on specified UNDP heath procurement trade lanes.
Average of CO2 Emission per Kg of TLE/ARV 2015-2017
UNDP also leverages the procurement volume presently channelled through its heath procurement architecture to facilitate the reduction of unnecessary product waste through packaging reduction and optimization. This not only improves environmental aspects and helps to reduce C02 emissions but also leads to substantial cost savings and resource efficiencies—which can essentially save more lives.
As an example, for the TLE/ARV Framework, carbon emissions per pack were reduced by 67% for units shipped by sea as opposed to air from Mumbai to Zimbabwe, which represents 86% of total procurement volume. Therefore, for 26 million packs that were prioritized and delivered via sea freight versus air, this represents a calculated savings of over US$5.85 million.
Ukraine: Ivan's fight for free cancer treatment
When he was 34, Ivan Zelenskiy, a power plant engineer in the Poltava region of Ukraine, was diagnosed with myeloid leukemia. To add to the shock of the diagnosis, he soon discovered that the treatment he now needed daily would cost him up to US$1,000 per month. While there was a state programme to provide this treatment for free, available resources were sufficient to cover only a third of patients. He was not covered.
“It was difficult for us to understand who bought medicines, at what price, and how the number of patients that could be covered was calculated.” -Ivan
Agreements between the Ministry of Health and pharmaceutical companies were not transparent. The patient community came up with an idea: why not shift the procurement to international organizations, which would ensure higher transparency and a more efficient use of resources?
UNDP is one of the international organizations now procuring medicines on behalf of the Government. With this support, almost 100% of the patients requiring Imatinib, the treatment Ivan follows, now have access to free, state-purchased treatment.
Innovation in Procurement
Solar for Health
Saving lives, saving money, saving the environment
UNDP provides dedicated support for countries to implement large-scale health programmes and to strengthen institutions to deliver essential services in challenging and high-risk country contexts. While it is essential for UNDP to help deliver on health programmes in accordance with the HIV, Health and Development Strategy 2016-2021 and the SDGs, this includes addressing the rising social and environmental challenges that are a part of a sustainable health system.
Clinics, maternity wards, operating rooms, medical warehouses, and laboratories rely on electricity to power the lights, refrigerate vaccines, and operate life-saving medical devices. An inability to carry out these basic functions puts lives at risk. A recent review by WHO shows that between a quarter and a third of health facilities lack a reliable supply of power.
UNDP’s Solar for Health initiative supports governments to increase access to quality health services through the installation of solar energy photo-voltaic systems (PV), ensuring constant and cost-eﬀective access to electricity, while also mitigating the impact of climate change and advancing multiple Sustainable Development Goals. The installation of solar systems under the current phase of the Solar for Health initiative is estimated to be saving 250,000 tons/year of carbon.
UNDP is currently working to install solar systems in health facilities across Africa, the Arab States and Central Asia. See the link below for further information.
Electronic Vaccine Intelligence Network (eVIN)
Robust technology for low-resource environments
In 2015, India launched eVIN, or electronic vaccine intelligence network—an easy to use mobile- and cloud-based technology that enables last mile management of the supply chain. The project, run in partnership with Gavi, the Vaccine Alliance, the Indian Ministry of Health and Family Welfare and Logistimo (the technical partner) has effectively digitized the entire supply chain for vaccine distribution across, India meeting the needs of the country’s ambitious vaccination programme.
Once in use it allows cold chain handlers to update information on vaccine stocks after every immunization session. These updates are stored on a cloud server that gives health officials an immediate look at vaccine stocks and flows. It helps officials course correct, reducing wastage and empowering health workers.
UNDP support in implementing eVIN goes beyond just the technology in addressing the three ingredients critical to any successful service delivery transformation: people, processes and technology. At the forefront of India’s immunization efforts are thousands of cold chain handlers. Each roll-out of the technology is accompanied by training.