1. Procurement and Supply Management Potential roles for IHP+ IHP+ Steering Committee 12 December 2014 1

2. Rationale for IHP+ engagement Importance in health service delivery Leverage better use of domestic health spending as well as external funds Multiple parallel systems: inefficient, wasteful, unsustainable Difficult area: some countries far from having procurement capacity DPs want to use Scope for progress: (at least) harmonisation of supply chains

3. Current major supply chains in the Myanmar health system

4. Issues from CHTM 2014 Countries at very different stages – Myanmar example: developing a single supply chain strategy for all partners to support – Ethiopia example: High % of DP funded procurement through national agency, gradual strengthening of systems – Guinea Bissau, Chad et al struggling to reform PSM, with fragmented support Issues include – Performance improvements are hard to sustain – how to respond to declines (corruption, crises)? – Outsourcing to private sector – requires skills in contracting; willing, competent providers; recurrent financing – Drug quality assurance - continuing need to strengthen – Capacity building & knowledge transfer needed

5. Global procurement mechanisms Benefits of lower prices, faster procurement appreciated (but sometimes countries can buy cheaper) Multiple mechanisms which work differently a challenge to learn at country level May be inconsistent with country regulations (registration, procurement process etc) Scope to identify combined effects and good practices

6. Roles for IHP? Inter-agency Supply Chain Group (ISG) has identified areas for collaboration including joint PSM planning for Nigeria and DRC, common performance indicators ISG is an informal global group, no governance or funding (so far) IHP+ could review progress and learn lessons – Progress at country level in harmonising PSM support and strengthening systems: joint procurement assessments, joint plan for support, reducing parallel and inconsistent systems, use of national procurement – Feedback from countries on effect of multiple, diverse global procurement mechanisms, how to improve

7. Questions to the Steering Committee Are these the most relevant issues for IHP+ to address? What are highest priorities for IHP+ efforts? How to take forward? Suggestions – Case studies (at country request) e.g. progress in Myanmar, DRC and/or Nigeria; other volunteers – Engage countries, implementers and CSOs to oversee case studies, spot gaps (as steering or working group)