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As more money is made available for the development and purchase of products that are needed to diagnose, prevent and treat leading causes of death and disability in developing countries, the need to improve demand forecasting comes into sharp relief. Shortcomings in demand forecasting increase the risks for suppliers, resulting in higher costs, supply shortages and concerns about the long-term viability of investing in R&D for health products that would benefit the developing world. Demand forecasting also limits the ability of donors and national health programs to spend dollars effectively to save lives. Developing better demand forecasts for critical medical technologies in the developing world requires collaboration and investment from all of the key stakeholders in the value chain for these products, and it will also benefit each of them in turn.
To address this important issues, CGD convened the Global Health Forecasting Working Group in early 2006 to examine the ways in which better forecasting could contribute to improved short- and long-term access; develop an understanding of market-related risks for global health products that combines a conceptualization of risk from economics with a focus on steps in the value chain; identify the ways in the asymmetrical burden of risk across funders, regulatory and purchasing intermediaries and suppliers results in misaligned incentives with respect to producing optimal demand forecasts and broad access; and advance a set of specific recommendations for actions by donors and technical agencies that would help to reduce overall risk and correct those misalignments.
The Working Group found that forecasting challenges can be understood only by looking at the nature and distribution of underlying risks faced by the pharmaceutical industry, regulatory and purchasing intermediaries and funders, particularly in light of the new global health environment of more money, new products and a more complex international market. They recognized early on that the solutions - not only to the narrow technical issue of better forecasting, but to the big-picture concerns about reliable and expanded access to essential products - lie in strategies that reduce and share risk.
The Working Group focused attention on aggregate demand forecasts, which seek to capture global demand and are used for high-level planning by manufacturers, procurement intermediaries and funders, and looked specifically at the challenges of forecasting for "new products and new markets" - that is, those products that are newly licensed and/or are new entrants into use in developing countries. Their findings and recommendations to 1) improve the capacity to develop credible forecasts by taking forecasting seriously; 2) mobilize and share information in a coordinated way through the establishment of an information clearinghouse, or infomediary; and 3) share risks through the adoption of broader contractual arrangements are laid out in A Risky Business: Saving Money and Improving Global Health through Better Demand Forecasts and the accompanying policy brief, which were launched in May 2007.
Working Group Composition
The Global Health Forecasting Working Group was led by Ruth Levine ame> and consisted of 26 members, including relevant experts from developing country governments, the pharmaceutical industry, procurement agencies, non-governmental organizations, market research, forecasting, game theory and other relevant fields of economics, funding and technical agencies, and disease- and/or product-based partnership initiatives.
Deborah Atherly, PATH Rotavirus Vaccine Program
Jorge Carrion, Pan American Health Organization
Robert Chisholm, Consultant
Renia Coghlan, Medicines for Malaria Venture
Peter Evans, Consultant
Gian Gandhi, International AIDS Vaccine Initiative
John Hurvitz, Covington & Burling
Steve Jarrett, UNICEF Supply Division
Andrew Jones, GAVI Alliance
Steve Kinzett, PATH Reproductive Health Supplies Coalition
Ruth Levine, Center for Global Development
Andrea Longhi, UK National Health Service
Elisabetta Molari, Global Fund to Fight AIDS, TB & Malaria
Morgan Musongole, Zambia National Malaria Control Program
Angeline Nanni, PneumoADIP
Donné Newbury, Bristol-Myers Squibb
Hans Rietveld, Novartis Pharma AG
Mark Rilling, U.S. Agency for International Development
Nina Schwalbe, Global Alliance for TB Drug Development
Neelam Sekhri, The Healthcare Redesign Group, Inc.
Anil Soni, Clinton Foundation HIV/AIDS Initiative
Jeffrey Sturchio, Merck & Co., Inc.
Krista Thompson, Becton Dickinson
Christine Tonkin, UN Inter-Agency Procurement Services Office
Saul Walker, International Partnership for Microbicides
Edward Wilson, John Snow, Inc
Members of the Working Group were invited to join in a personal capacity and on a voluntary basis.