Abstract
In 2010, the UN Secretary-General‟s Global Strategy for Women’s and Children’s Health highlighted the suffering of women and children around the world caused by lack of access to life-saving commodities. The Strategy called on the global community to work together to save 16 million lives by 2015 through increasing access to and appropriate use of essential medicines, medical devices and health supplies that effectively address leading avoidable causes of death during pregnancy, childbirth and childhood.
This challenge was taken up by the UN Commission on Life-Saving Commodities for Women and Children (the Commission), which is a part of the Every Woman, Every Child (EWEC) movement and has the overall goal to increase access to these life-saving commodities in 50 of the world‟s poorest countries. With a strong focus on the reproductive, maternal, newborn and child health (RMNCH) „Continuum of Care‟, the Commission identified and endorsed an initial list of 13 overlooked life-saving commodities that, if more widely accessed and properly used, could save the lives of more than 6 million women and children.
The Commission also identified key, interrelated barriers that prevent access to and use of the 13 commodities. These include severely under-resourced regulatory agencies in low-income countries, leading to delayed registration of commodities; lack of oversight of product quality and general inefficiencies; market failures, where return on investment is too low to encourage manufacturers to enter the market or produce sufficient quantities; and user supply and demand challenges such as limited demand for the product by end-users, local delivery problems and incorrect prescription and use.
To address these challenges and deliver on the promise of saving the lives of millions of women and children, the Commission recommended 10 time-bound actions. These focus on the need for improved global and local markets for life-saving commodities, innovative financing, quality strengthening, regulatory efficiency, improved national delivery of commodities and better integration of private sector and consumer needs.
The Commission estimated that an ambitious scaling up of these 13 commodities over five years would cost less than US$2.6 billion and would cumulatively save over 6 million lives including 230,000 maternal deaths averted through increased access to family planning. This would catalyse an accelerating reduction in deaths for women and children. Achieving these goals would save an extra 1.8 million child deaths a year, reducing the estimated 7.1 million deaths in 2010 to 5.3 million. Likewise, the estimated 287,000 maternal deaths in 2010 would be reduced to 213,000 by increased access to maternal health and family planning commodities. The estimated costs per lives saved are low and represent excellent global development investments. Thus, the scaling up of these commodities is not solely a moral obligation but one of the most effective ways of getting more health for the money invested. It would make a significant contribution to putting maternal and child health on a trajectory to end these preventable and tragic deaths.
A detailed plan for implementation has been developed with cross-cutting and commodity-specific actions and clearly stated national, regional and global activities and associated costs. In addition, national plans aimed at country-level implementation at scale will be developed and shaped during in-country stakeholder meetings, building on and linked to existing planning and costing processes and timelines.
Recognizing that many commodity-related obstacles are linked to financial and social barriers and rooted in broader health system challenges – such as poor governance, inadequate human resources, ineffective local supply chains and insufficient information systems – the Commission calls for further links between the identified solutions and priority actions and other global and national initiatives for strengthening health systems.
