USD 252 million budget committed (2015-2017)
Up to 45% budgetary savings for some cancer drugs
$18 million of savings in 2017, 13% of the budget
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.
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 programe to provide this treatment for free, available resources were enough to cover a third of patients and he 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.
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 US$9.5 trillion each year, with US$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. The United Nations Office on Drugs and Crime (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 population’s 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. Developing human capacity and strengthening of the national procurement system in Ukraine are generating guidance and examples, together with lessons learnt, that can contribute to strengthening capacity in other countries.