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Ukraine

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Since 2015 UNDP, on behalf of the government, has procured $252 million worth of medicines and health products, covering 26 programmes and saving $18 million in 2017 alone.

Project Summary

Public health spending in Ukraine has been amongst the lowest in Europe. Historically the Ministry of Health in Ukraine has faced challenges of accountability and transparency that have affected its public procurement and supply programmes. These and other challenges resulted in a gap of available medicines in the country from 2013-2015. Read more...
Following changes in 2014, the Government of Ukraine introduced an anticorruption policy, together with legal and institutional reforms, including the state health procurement arrangements. Consequently, the Ministry of Health requested support from international organizations, including UNDP, for the procurement of medicines. Since 2015, UNDP in Ukraine has procured a range of medicines and related medical products funded by the state budget, as an emergency measure, while working with the government to build a transparent and cost-effective public procurement system.

USD 252 million budget committed (2015-2017)

Source: UNDP

Up to 45% budgetary savings for some cancer drugs

Source: UNDP

$18 million of savings in 2017, 13% of the budget

Source: UNDP

Focus on capacity development: Building a transparent and cost-effective national procurement system

In addition to direct procurement support, UNDP Ukraine is also working with the government to build a transparent and cost-effective national procurement system. The support aims to help reform healthcare sector procurement for the period beyond 2019, with the creation of a national procurement agency, the Central Procurement Agency (CPA). The CPA will be established with the necessary structural and human resource capacity for selecting quality assured products, forecasting needs, defining processes for transparent and cost-effective procurement, including planning, monitoring and evaluation of procurement operations.

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Ivan’s Story

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 1,000 USD per month. While there was a state program to provide this treatment for free, resources allowed to cover only one of three 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 Zelenskiy

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, who 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 now almost 100% of the patients requiring Imatinib, the treatment Ivan follows, have access to free, state-purchased treatment.

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Working towards the Sustainable Development Goals (SDGs)

Public procurement and health procurement in particular, are critical issues for achieving all the SDGs, but with specific relevance to SDG 3: Ensure healthy lives and promote well-being for all. The global public procurement market is estimated at USD 9.5 trillion each year, with USD 1.66 trillion spent on procuring medicines. At the same time, public procurement is vulnerable to corruption, influence peddling and favouritism between state agencies and private companies. UNODC estimates that corruption may reduce the value of a public contract by an average of 10-25%.

Addressing these challenges and creating a resilient procurement system that provides for the populations needs, through good value for money, whilst ensuring procurement is sustainable, is essential to meeting the targets set out under SDG 3. In particular, to achieve universal health coverage (UHC) including; i) financial risk protection; ii) access to good quality essential health-care services; and iii) access to safe, effective, quality assured and affordable essential medicines and vaccines. The developing of human capacity and the strengthening of the national procurement system in Ukraine, is generating guidance and examples, together with lessons learnt that can contribute to strengthening the capacity of other countries.

The achievement of targets in SDG 3 also plays a huge part in delivering objectives of the other SDGs. The diagram highlights some of the key linkages with SDG 3.