1. Wilbert Bannenberg wilbert@sarpam.net SARPAM
Regional procurement policies and access to medicines - lessons from the SADC Pooled Procurement project
Wilbert Bannenberg
SARPAM

2. Situational Analysis: Key Challenges
Limited transparency and poor availability of information
Prices, quality, sources of medicines
Use of TRIPS flexibilities
Reluctance to disclose information
Varying availability of selected medicines
Lack of standardisation on procurement and pricing information
difficult to compare between countries
Various levels of development of medicines regulatory systems – no MRAs in some countries
Shortages of qualified staff in fields of specialisation
No coordination in efforts to strengthen PSM systems
Demographic and economic differences among countries

3. Percentage of NMPA prices below the international MSH benchmark

4. SADC Pharmaceutical Business Plan: 4.1.5 Promoting joint procurement
Evaluate options for pooled procurement for priority medicines and harmonize procurement regulations
Identify the priority essential medicines which can bring about the largest savings from pooled procurement or price negotiations
Identify and facilitate access to funding sources and finance mechanisms for joint procurement
Establish a regional mechanism for pooled procurement of medicines
Assess and strengthen national procurement agencies and supply chain management systems

5. SARPAM Pooled Procurement project
Based on SADC Pharmaceutical Business Plan
SADC Health Ministers wanted PP since 1997!
Efforts did not work due to Drug Regulatory and Procurement system differences
SARPAM developed proposal to start with information exchange between Procurement Agencies
13 countries now sharing information
At same time, SARPAM started Drug Regulatory harmonisation project
Common Technical Document being implemented
SADC PP Strategy developed in 2012

6. SADC Pooled Procurement Strategy
Developed by a working group from SADC Member States and partners WHO, UNDP, MSH with technical assistance from SARPAM
Discussed and approved by SADC Ministers of Health and HIV/AIDS – Nov 2012
SARPAM facilitating implementation of the strategy
Member States choose taking a step-wise approach:
Recognition of challenges – 14 sovereign states vs region
Prioritise information and work sharing first
Group contracting in a later phase

7. The 4 Pooled Procurement models (Adapted from MSH, 2012)
Informed Buying
Member States share information about prices and suppliers but undertake individual procurement.
Coordinated Informed Buying
Member States undertake joint market research, share supplier performance information and monitor prices. Countries undertake individual procurement.
Group Contracting
Member States jointly negotiate prices and select suppliers.
Countries agree to purchase, individually, from selected suppliers.
Central Contracting and purchasing
Member States jointly conduct tenders and awards contracts through an organisation acting on their behalf.
Central buying unit manages the purchase on behalf of countries
Member states have chosen to begin with information sharing first until clarity is there on rules and regulations will dictate extent collaboration can go.

8. PP Strategic Objectives
To establish a mechanism for regional procurement of medicines and related commodities.
To mobilise resources for the SADC regional procurement for Essential Medicines and Commodities
To develop and harmonise policies and guidelines for procurement of Essential medicines and Commodities.
To facilitate trade and movement of Essential Medicines and Commodities in the region
This includes working on using TRIPS flexibilities!

9. Intersectoral Cooperation
Between the Health sector and
Trade (and customs): increased medicines’ trade among MS
Finance: ensure resources
Procurement: procurement guidelines
Legal affairs: legislation and regulations
While including development partners, private sector (SAGMA) and Civil Society

10. Main Responsible Parties
SADC Pharmaceutical Procurement Services (SPPS)
SADC Secretariat
MOH Pharmaceutical Departments
Procurement Agencies (e.g., NDSO)
Regulators (e.g., LMRA)
Partners
Suppliers
Ministries of Trade, Finance, Justice

11. Pooled Procurement Benefits
Considerable savings by applying information and work sharing among procurement agencies
Leading to improved access to essential medicines
Development and implementation of regional standards and procedures will lead to increased efficiency
Quality assured medicines through regulatory harmonisation
Functional regional pharmaceutical procurement agency (SPPS) offering procurement services like
information sharing, work sharing , coordination, (e-) procurement services including group contracting

12. Information & Work Sharing Platform
To make available to stakeholders in SADC Member States all key information on medicines that are on the market in the region
information on prices, sources and quality of at least 50 essential medicines and other difficult to source products
To make available information on ‘good practices’ in SADC Member States on pharmaceutical Procurement and Supply Management (PSM) systems including
procedures and tools used
a database of expert staff in Member States that apply these practices.
Price benchmarking

13. ACT prices on SADC e-platform

14. Price comparison per product

15. Big differences....

16. Lesotho data ( )

17. SADC can save 18% or $100m

18. Finally... SADC member states:
Pooled Procurement implementation plan approved
Options paper for SPPS approved SADC Secretariat)
agreed to establish the information sharing e-platform
SADC member states meet week 22 September in JNB
Acknowledgement - based on a presentation by :
Geoffrey Ngwira, SARPAM Pooled Procurement Officer
Phone:

19. Yes, we can!