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Working Group on the Future of Global Health Procurement

Many low-and lower-middle-income countries currently procure a large portion of their health commodities—drugs, devices, diagnostics, and vector control tools—through centralized, donor-managed procurement mechanisms, and often at subsidized prices or as donations. Over the next several decades, however, the landscape of global health procurement will change dramatically as countries grow richer and lose aid eligibility; disease burdens shift; and technological breakthroughs change the portfolio of commodity needs. To consider how the global health community can ensure the medium- to long-term relevance, efficiency, quality, affordability, and security of global health procurement, the Center for Global Development (CGD) launched the Working Group on the Future of Global Health Procurement in July 2017. A final report is expected in late 2018. Throughout this process, CGD will engage key global health stakeholders—country representatives, procurement agents, funders, and industry partners—to reflect the range of views on these issues and encourage the adoption of proposed recommendations.

In recent decades, the world has made great strides toward improving global access to lifesaving health commodities, including medicines, diagnostics, medical devices, and vector control tools.* This increase in access has in large part resulted from the investments of international health partnerships such as UNICEF, UNFPA, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and bilateral aid programs such as PEPFAR, DFID, and USAID. To deliver these lifesaving global health commodities to where they are needed most, these funders have also set up centralized procurement mechanisms to purchase drugs, diagnostics, devices, and vector control tools from manufacturers, and to subsequently make them available to countries at subsidized prices or as donations.

Over the next decade, however, most low-income countries will become middle-income countries that are ineligible for aid under current rules, spend more domestic public monies on health, and self-procure most needed health commodities. At the same time, demographic and epidemiological changes will affect the size and composition of demand for health care and related products; infectious diseases will diminish in importance while non-communicable diseases increase. Other factors—such as growing drug resistance, the pace of economic growth and its impact on public spending, the trend towards increasing decentralization of procurement and service delivery, and the continual development of new technologies in the context of rising expectations for more comprehensive health benefits—will also put new pressures on global health procurement. In this context, policymakers should be prepared to take preemptive action to ensure the medium- to long-term relevance, efficiency, quality, affordability, and security of global health procurement. This Working Group considers how global health procurement mechanisms can adapt to this changing landscape.

Working group meetings were held on July 25, 2017 in Washington, DC and February 6-7, 2018 near Geneva, Switzerland. A supplementary technical workshop was hosted in April 2018 in Toulouse, France. The third meeting will be held on July 19-20, 2018 in London, England and a final report is expected in late 2018.

*Note: This working group does not consider vaccines.

Participants

Michael Anderson, CDC Group
Amie Batson, PATH
Francisco Blanco, World Health Organization
Christa Cepuch, MSF Access Campaign
Kalipso Chalkidou, Center for Global Development
Clinton De Souza, Imperial Logistics
John Crowley, USAID, Supply Chain for Health Division
Francesco Decarolis, Boston University and Einaudi Institute for Economics and Finance
Todd Dickens, PATH
James Droop, DFID
Rebecca Forman, Center for Global Development
Akthem Fourati, UNICEF
Amanda Glassman, Center for Global Development
Eduardo González-Pier, Mexican Institute of Social Security and Ministry of Health, Mexico
Lisa Hare, USAID, Malaria Division Supply Chain Branch
Jay Heavner, USAID Global Health Supply Chain – Procurement and Supply Management Project
Beverly Lorraine Ho, Department of Health, Philippines
Christine Jackson, Crown Agents
Sneha Kanneganti, World Bank
Navjot Khosa, Kerala Medical Service Corporation Ltd., India
Biljana Kozlovic, Consultant and formerly National Health Insurance Fund, Serbia
Wesley Kreft, Partnership for Supply Chain Management (PFSCM)
Neel Lakhani, Clinton Health Access Initiative
Beverly Lorraine Ho, Department of Health, Philippines
Janeen Madan Keller, Center for Global Development
Melissa Malhame, GAVI Alliance
Susan Nazzaro, Bill & Melinda Gates Foundation
Cassandra Nemzoff, Center for Global Development
Roxanne Oroxom, Center for Global Development
Ed Rose, NHS England
Daniel Rosen, AfRx Consulting Group
Rajeev Sadanandan, Government of Kerala
William Savedoff, Center for Global Development
Eugene Schneller, Arizona State University
Andreas Seiter, World Bank
Rachel Silverman, Center for Global Development
Paul Stannard, Population Services International
Netnapis Suchonwanich, National Health Security Office, Thailand
Mariatou Tala Jallow, Global Fund
Greg Vistnes, William Davidson Institute, University of Michigan
Brenda Waning, Global Drug Facility
Barnaby Wiles, World Bank
Tommy Wilkinson, PRICELESS SA
Hongwei Yang, National Health and Development Centre, China

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Janeen Madan Keller

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