Supporting UNECA to Tap into the Power of Pooled Procurement

The Challenge

The pharmaceutical industry is among the leading developmental sectors in Africa and is forecasted to reach US$249 billion by 2035. And yet, between 70 and 90 percent of medicines consumed on the continent are imported, highlighting the high dependence on foreign pharmaceutical manufacturers (mostly from China and India) over local production1. The African Continental Free Trade Area (AfCFTA) provides an opportunity to improve access to quality-assured essential medical products while supporting the growing African pharmaceutical sector through pooled procurement mechanisms.

Our Approach

USP is working with the United Nations Economic Commission for Africa (UNECA), through the AfCFTA-anchored pharmaceutical production and pooled procurement project, to provide technical guidance to develop a continental framework to establish a regional pooled procurement mechanism for essential pharmaceutical products. The project aims to improve local production of essential medical products, establish pooled procurement of pharmaceutical products, and create a harmonized regulatory and quality framework. The framework will pilot in 10 Small Island Developing States (SIDS) - Seychelles, Sudan, Madagascar, Mauritius, Comoros, Djibouti, Eritrea, Rwanda; anchored with Kenya and Ethiopia - using key reproductive, maternal, newborn, and child health pharmaceutical products.

To develop this framework, USP conducted a comprehensive review of regional pooled procurement models to understand lessons learned, challenges, and issues associated with operation of each model. USP interviewed key informants and subject matter experts in the Southern African Development Community (SADC), the East African Community (EAC), and the Organization of Eastern Caribbean States (OECS) about their models. The regional models were triangulated with global pooled procurements initiated by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Alliance for Vaccines and Immunizations (GAVI) to analyze the effects of low volume/high cost or high volume/low cost procurement mechanisms. USP also conducted a thorough review of procurement and regulatory environments in terms of current procurement laws, pharmaceutical policies and strategies, market product development laws/incentives and intellectual property rights. The collected data provided insight on each country’s existing infrastructure and collective pooled procurement drivers/enablers, which informed the recommendations of the framework.

To respond to the potential increase in demand of pharmaceutical products due to pooled procurements, USP undertook baseline assessment of local manufacturing capabilities in strategic countries. Through this work, USP identified more than 900 vendors, suppliers, retailers, and pharmaceutical manufacturers on the continent, of which only about 300 are local manufacturers distributed across the regional economic blocks. USP developed a database of local manufacturers as way of identifying companies to provide quality assured medicines for the pooled procurements.

Expected Outcomes

USP’s proposed framework of action is designed to remove governmental and institutional bottlenecks to pooled procurement of key products, enhance local manufacturing capabilities, advance health outcomes, and shape health markets in Africa. This framework leverages AfCFTA in facilitating regional pooled procurement and delivery of MNCH drugs and pharmaceutical products across specific cluster markets with identified interest. UNECA plans to hold a stakeholder consultative meeting with key partners including WHO, AUDA NEPAD, to validate the operationalization of the framework. After a successful pilot among the Small Island Developing States, it is envisioned that the framework could be further expanded to other countries and can leverage the capacity of African pharmaceuticals manufacturers to provide quality-assured health products to their population in line with the principles of universal health coverage.