Steve Kinzett Reproductive Health Supplies Coalition Mobilizing for RH/HIV Integration February, 2008 – Addis Ababa, Ethiopia Securing Reproductive Health Supplies for All: Challenges and Initiatives

Who are we? A diverse international partnership with members from: Multilateral Organizations: UNFPA, WHO, World Bank, EC, GFATM Bilateral donors: Germany/BMZ/KfW, Netherland Ministry of Foreign Affairs, DFID, USAID, Spain Foundations: Gates, Hewlett, Packard, United Nations Foundation NGOs: IPPF, PPD, PAI, PATH, JSI, DSW …

How do we work?RHSC Executive SSWG Systems strengthening MDAWG Market Development ApproachesRMAWG Resources Mobilisation and Awareness Secretariat

Examples of workstreams Project RMA : An advocacy effort on supplies availability provided by: Global – PAI Regional – DSW Country – IPPF Reproductive Health Interchange: Database of contraceptives supplied by UNFPA, USAID, IPPF to 144 countries (Crown Agents and PSI joining) – hosted by JSI 2 nd Tier Markets – IPPF (ICON) Prequalification of RH supplies (WHO/UNFPA)

What are RH supplies?

Driving the agenda The future of RH supply security is threatened by three main factors: Available resources are insufficient to meet increasing demand for supplies Weak systems at country level, coupled with a more complex supplies environment Lack of coordination and information sharing

Contraceptive use is increasing…

Graph Supply is not meeting demand…

Available, predictable, and sustainable financing 20/11/2007Rabat, Morocco Seek out new resources at global level Increase access to existing resources at country level Maximize private sector/total market

Supplies environment is becoming more complex 20/11/2007Rabat, Morocco

GFATM and HIV/RH Integration Yesterday a list of topics were given that various countries have already received GF support for: –Sexual and Reproductive Health –Condoms –PMTCT+ –Ante-natal Care –Councelling –ARV’s/STIs –Gender-based services

GFATM and HIV/RH Integration All these have supplies attached to them (for example): –Contraceptives –Condoms –Neviriprine/Cotrimoxazole –Oxytocin –Rapid HIV tests –Drugs to treat STI’s (as well as ARVs) –Emergency Contraception/Pregnancy tests

Putting supplies into your requests There is no point in having a superb integrated RH/HIV service if there are inadequate supplies Often supplies are controlled by government – GFATM funded supplies can ensure that supplies are available to all programmes Again yesterday it was highlighted that good sound data was required for applications to be successful. The careful landscaping of available supplies by different donors and providers is necessary prior to quantifying supplies to be requested. Forecasting imperative (including lead time)

A last note on systems Supplies themselves depend on good systems to get them out there. Think about :- –Small trucks instead of luxury 4-wheel drives –Refurbishing stores at district level (or adding a room) for good storage –Information systems

Reproductive Health Commodity Security Global Programme to Enhance RHCS Addis Ababa, 27 February 2008

Global Programme to Enhance RHCS: Summary Aim to catalyse national action to mainstream RHCS within national development frameworks, budgets policy and programmes to underpin SRH/FP Bridge from donor dependency to new aid approaches; guiding principles from Paris Declaration on Aid Effectiveness; Consistent with One UN Country-driven approach; Ownership / cooperation requested from key national / international stakeholders Flexible, multi-year funding source to stimulate commitment and reward measured progress and impact Strong country focus on enhancement of national capacity and systems Move towards unitary supply systems/mechanisms for all health commodities

Reproductive Health Commodity Security underpins work across Sexual and Reproductive Health. SRH, in turn, crucial to efforts to implement ICPD Programme of Action and to meet the Millennium Development Goals. Funding shortages hamper the adequate provision of contraceptives, condoms and other RH supplies. Donor community support:1995 – 30%; 2005 – 20%. Donor community support: 1995 – 30%; 2005 – 20%. Challenge for governments and partners to ensure universal access to reproductive health care by Without supplies, people cannot exercise their reproductive rights. Why the Global Programme is important?

Global Programme: Stream 1 countries Intensified support currently being provided in small number of stream 1 countries: Ethiopia, Burkina Faso, Mozambique, Nicaragua, Mongolia Recommended steps leading to definition and implementation of country- owned and country-driven national RHCS Plan of Action [1] Broad situation analysis [RHCS links to FP/RH, STI and HIV prevention, maternal health, etc.]; [2] Broad policy/programme analysis; [3] Stakeholder workshop to build consensus for RHCS Plan of Action National coordination mechanism to aid coordination and implementation