Greenstar Commodity Security Reproductive Health Supply Coalition Meeting June

Pakistan Facts Demographics Total Population: 167 m Per capita income : $1,085 Population below poverty line : 35% Literacy Rate : 54%

Pakistan Facts Health Total Fertility : 4.1 CPR : 30% (22% modern) Population growth rate : 2% MMR: 276/100,000 Govt. Expenditure on Social Sector : 0.75% of GDP

Note TFR stagnation in last 7 years

Note: Modern contraceptive prevalence rate stagnation in last 7 years

Pakistan Greenstar Others

Greenstar CYP Contribution Source: Ministry of Population Welfare / Key Social Marketing / Greenstar reports (2003)

GOP Commodity Security GOP MOF allocates funding for commodities to MPW and MOH Draft outline of contraceptive security plan prepared but not yet available 2006 PDHS shows that women obtain contraceptives from the following sources –Public sector 48% –Private sector 52% 82% of condom users report using a social marketing brand and 74% of pill users GOP budgets for provision of minimal supplies to FPAP, but currently not for MSS due to shrinking budget MPW No government budgetary support to Greenstar

Greenstar Historical Commodity Support Since 1991, the following donors have supported contraceptive commodities to Greenstar –KfW (early 90s until 98, and again from 2007) –DFID (from ) –UNFPA(late 90s – to date) –Packard Foundation (late 90s until 2003) –Other private foundation (2007 to date)

Projected Commodity Requirements Jan 2009 – Jun 2012 (put in updated figures) 600m condoms 15m cycles OCs 5.7m injections 1.3m IUDs Growth projected at 10%-20% annually

Greenstar CYP Projection

GS’s Funding Gap for Upcoming Years Greenstar faces a $14.6m commodity shortfall from May 09-Jun 2012 –UNFPA continues to donate $1.5m annually –KfW has been contributing $1m annually and might continue until 2013 –Private foundation supports $2m annually through 2010 In current USAID FP grant there is no commodity support ( ). Assumption was that other donors would continue commodity support Based on the principles of the Paris Declaration, in 2008 DFID replaced its commodity support to GreenStar by Budget Support.

Implications from July 2010 Greenstar will face a stock out situation in mid 2010, unless new funding commitments are made by GOP or a donor Due to lead times in procurement funding commitments need to be made in before the end of 2009 In the absence of new funding Greenstar will have to raise prices to cost recovery, making them unaffordable to lower income people Greenstar CYPs may decline by up to 70% Government CYPs may decline by 30% 2 million couples currently using Greenstar contraceptives will no longer have access to them as the public sector system is not set up to cope with additional demand

Projected Greenstar CYP Decline CYPs in Million

Projected National Impact CYPs in Million National Growth Projected at +8 %

GreenStar’s Dilemma GreenStar fully supports the process of the Paris Declaration of Aid Effectiveness GreenStar is committed support GOPs Reproductive Health policies Greenstar is the largest contributor to MDG 5 and Contraceptive Security outside the public sector GreenStar’s contribution to achieving the GOP goals are widely recognized GreenStar has approached GOP in multiple ways to ensure continued funding of its commodity needs. However, GOP has not yet made commitments to funding GS’s commodity requirements

What can be done? National contraceptive security plan to incorporate NGO requirements Donors to continue the dialogue with GOP to incorporate NGO commodity requirements into national need Greenstar to conduct analysis on price increases and sustainability planning and mitigate impact on poor Sector-wide Programs to include earmarks for contraceptive funding for public and NGO sector. Ministry for Social Welfare to develop long term funding plan for contraceptives commodities for public and NGO sector and include this is National Strategic Plan

Potential reasons for slow response from GOP Reasons for GOP hesitation might be –Funds provided through Budget Support and Sector – wide programmes are competed by many interests –expectations that additional donor funds can be raised in the last moment, –Commitment to Contraceptive Security not widely enough shared outside Ministry of Population and Social Welfare –Political or religious pressure against Reproductive Health Rights –Others???

Thank You Greenstar is funded by The US Government through USAID – the United States Agency for International Development, The German Government through KfW – the German Development Bank, The Global Fund (GFATM), The British Government through DFID – the Department for International Development, UNFPA/UNAIDS, John Snow Research & Training Institute, Packard Foundation, Procter and Gamble (P&G), The Micronutrient Initiative and PSI