1. Dr. Tenu Avafia HIV, Health and Development Group UNDP
Policy coherence as an enabler for local pharmaceutical production Africa Pharma Conference 5 June 2019
Dr. Tenu Avafia
HIV, Health and Development Group
UNDP

2. Underlying Principles of Agenda 2030
UNIVERSALITY
INTEGRATION
‘NO ONE LEFT BEHIND’
Policy integration means balancing all three SD dimensions: social, economic growth and environmental protection
An integrated approach implies managing trade-offs and maximizing synergies across targets
Implies that goals and targets are relevant to all governments and actors:
Universality does not mean uniformity. It implies differentiation
The principle of ‘no one left behind’ advocates countries to go beyond averages.
The SDGs should benefit all – eradicating poverty and reducing inequalities.
Building on the unfinished MDG agenda

3. Global Health Funding Changing Trends
Many governments benefit from multilateral health financing programmes like PEPFAR Global Fund and Gavi
Several countries are transitioning out of eligibility: burden of disease remains high
Botswana, Namibia, Swaziland not eligible for GAVI funds
Angola has graduated
Ghana on track for accelerated transition
Kenya, Sao Tome & Principe, Sudan, Zambia preparing to transition from eligibility from GAVI Funds
Countries in transition expected to increase domestic resources for health, may have to pay higher prices

4. Policy coherence: enabling environment
Laws, policies and practices that tailored and harmonized to foster
local production
Balancing industrial policy and public health objectives (integration)
government procurement processes favoring local production
E.g. government tenders giving slight price preference to local manufacturers
Infant industry protection
Fiscal and tariff levers on APIs
Laws, policies and incentives promoting local R&D and production
Removing barriers to inter and intra regional trade
eg Africa Continental Free Trade Area critical

5. Coherence across multiple stakeholders
UN Member States
Patients
Biomedical private sector industries (originator and generic)
Research institutions/academia
Financial institutions
Regional economic communities (AU, NEPAD,)
Development partners
Civil society

6. Preserving policy space, promoting coherence
One size does not fit all
First US patent law barred foreigners from filing patents
Brazil & India changed colonial laws to exclude pharmaceutical products from being patented, stimulating innovation
TRIPS Agreement reflects the fact that governments may want to take different policy approaches
There are important flexibilities within the TRIPS Agreement that can be employed alongside voluntary licensing
LDC waiver was central to development of industries in Bangladesh and Uganda

7. Promoting coherence: Governance mechanisms
“Ministries in most national cabinets operate in an asymmetrical power structure and do not necessarily coordinate, thus fueling policy incoherence at the national level.
“Governments should strengthen policy and institutional coherence by establishing national inter-ministerial bodies to coordinate laws, policies and practices that may impact on health technology innovation and access”

8. Promoting coherence: multisectoral co-ordination
“Appropriate member/s of the national executive who can manage competing priorities, mandates and interests should convene such bodies”
UNDP has supported national governments to promote cross-sectoral cooperation and policy alignment for quicker introduction and uptake of new health technologies

9. Coherence across the health ecosystem
“Governments should strengthen policy and institutional coherence by establishing national inter-ministerial bodies to coordinate laws, policies and practices that may impact on health technology innovation and access”
“Appropriate member/s of the national executive who can manage competing priorities, mandates and interests should convene such bodies”

10. Three mutually reinforcing axes
Multisectoral coordination platforms for national stakeholders
National roadmap for policy and regulatory harmonization
Technical and capacity strengthening support to analyse policies, laws and regulations
Support sustainable procurement in the health sector
Strengthen policy and regulatory harmonization
Identify and address specific capacity gaps, and institutionalize good practices within relevant national institutions across the value chain
Develop and implement context-specific tools and guidelines
Strengthen institutions for accelerating introduction and access
Impact beyond focus countries through South-South exchange and learning
Develop and disseminate region-specific tools and approaches; e.g., regulatory harmonization
Track progress made towards meeting local pharmaceutical production
regional and global platforms for technology delivery preparedness
Enhanced Availability, Affordability and Accessibility of Quality-Assured Health Technologies

11. Coherence across the local production ecosystem
Addressing regulatory barriers e.g. for registration of medical products
Strengthening Drug Regulatory Authorities for e.g. Pharmacovigilance
Investing in infrastructure
Access to capital (at reasonable interest rates)
Fostering skilled workforce
Improving procurement efficiencies e.g. incentivizing local manufacturers where appropriate
Addressing supply chain bottlenecks