Abstract
The purpose of this DFiD- funded study is to describe the current international system for securing Reproductive Health (RH) commodity supplies, to identify weaknesses and issues and suggest possible ways of rectifying them. This study will later be supplemented with a country-level study, investigating issues at country level.
The study is based on desk research, supplemented by structured interviews (30-90 minute) phone interviews with representatives of key international RH community stakeholders (see list at end of report). Data collection has been hampered by the relative scarcity of detailed, comprehensive, recent, high-quality statistics on RH procurement.
The context within which this study operates is 40 years of international investment in and donor support for developing country RH issues. While very considerable success has been achieved in some areas, it is clear that considerable gaps remain in realizing the 1994 Cairo ICPD goals, particularly in Sub-Saharan Africa, where 25% or more of married women have unmet RH needs, and where contraceptive prevalence in some countries remain in single % figures.
A key reason for this is a lack of funding, where a very considerable gap has opened between ICPD spend plans and actual donor funding provided (a cumulative shortfall of nearly 2/3 by 2001, the latest year for which figures are available).
The remit of this study was to investigate other possible non-funding issues around RH supply effectiveness and efficiency at the international level.
Eliminating issues may be as important as identifying them, and one of the key conclusions of this study is that the supplier architecture itself (i.e. availability of RH commodities from the private sector) is generally not a major constraint on RH commodity supply. This is in marked contrast to the situation within a number of niche medicines, e.g artemisinin-based (ACT) anti-malarial compounds, where substantial donor intervention has proved necessary to encourage sufficient R&D and production capacity investment.
