UNDP is taking a lead globally to support countries in the procurement of health commodities in some of the most challenging operating environments. The expertise built through decades of supporting Global Fund procurement in such contexts is being used to deliver value-for-money, quality assurance and reliability for domestically funded health procurement.
Procurement value of Global Fund and domestically funded programmes (2017)
Zimbabwe: Creating value-for-money in HIV treatment
Price negotiations between UNDP and suppliers have achieved a landmark cost for ARVs of less than $100 per patient per year for the one-pill combination of the three HIV medicines known as TLE (Tenofovir, Lamivudine and Efavirenz). Because of this UNDP in 2017 was able to purchase 7.4 million packs of medicines for $ 46 Million USD for Zimbabwe – resulting in savings of over $29 Million USD compared to previous orders. So far procurement savings in Zimbabwe total $48 Million USD. With the help of these savings, the Ministry of Health and Child Care has now put over 1 million people on HIV treatment with support from the Global Fund, PEPFAR, DFID and UNDP.
Procurement value by commodity type (2017)
Sustainable Health Procurement - saving more lives sustainably
UNDP provides dedicated support for countries to implement large-scale health programmes and to strengthen institutions to deliver essential services in challenging and high-risk country contexts. While it is essential for UNDP to help deliver on health programmes in accordance to the HIV, Health and Development Strategy 2016-2021 and the SDGs, this also includes addressing the rising social and environmental challenges that are a part of a sustainable health system. As specified by the Lancet, climate change is the biggest global health threat in the 21st history and yet, it is evident that the health sector is also paradoxically contributing towards climate change. This is notably with the environmental issues of health product production, consumption practices and the incredible scale of the global health procurement footprint.
While UNDP has identified this as a health procurement challenge, it has taken a new organizational model and business approach within its procurement practices by working in partnership with manufacturers and freight forwarders as part of the procurement and contract management process. This allows to further assess, measure and provide dedicated support for the innovation and gradual adoption of sustainable health manufacturing and procurement practices. The main sustainable health procurement programme milestones include the following:
The UNDP Sustainable Health Procurement programme is conducted in partnership with the United Nations Interagency Sustainable Procurement in the Health Sector (UN-SPHS) Secretariat.
Spotlight: Reducing emissions through health procurement planning and packaging optimization
UNDP is committed to reduce its C02 footprint as it is evident that health procurement is paradoxically contributing towards the negative impacts of public health and climate change. Therefore, UNDP in partnership with Kuehne Nagel are collecting data to measure, monitor and reduce C02 impacts on specified UNDP heath procurement trade lanes. The procurement planning data provided by UNDP Country Offices is also used to switch to more efficient freight options that provide reduced emissions per shipment (e.g. sea vs. air), which has led towards significant C02 reductions and freight cost savings. UNDP also leverages on the procurement volume presently channeled through its heath procurement architecture to facilitate the reduction of unnecessary product waste through packaging reduction and optimization. This not only improves environmental aspects and adds towards additional C02 reductions, but also leads additional to substantial cost savings and resource efficiencies – which can essentially save more lives.
As an example, for the TLE/ARV Framework, carbon emissions per pack were reduced by 67% for units shipped by sea as opposed to air from Mumbai to Zimbabwe, which represents 86% of total procurement volume. Therefore, for 26 Million packs that were prioritized and delivered via sea freight versus air, this represents a calculated savings of over $5.85 Million USD.
Ukraine: Ivan's fight for free cancer treatment
When he was 34, Ivan Zelenskiy, a power plant engineer in the Poltava region of Ukraine, was diagnosed with myeloid leukemia. To add to the shock of the diagnosis, he soon discovered that the treatment he now needed daily would cost him up to 1,000 USD per month. While there was a state program to provide this treatment for free, resources allowed to cover only one of three patients. He was not covered.
“It was difficult for us to understand who bought medicines, at what price, and how the number of patients that could be covered was calculated”
Agreements between the Ministry of Health and pharmaceutical companies were not transparent. The patient community came up with an idea: why not shift the procurement to international organizations, who would ensure higher transparency and a more efficient use of resources?
UNDP is one of the international organizations now procuring medicines on behalf of the Government. With this support now almost 100% of the patients requiring Imatinib, the treatment Ivan follows, have access to free, state-purchased treatment.
Innovation in Procurement
Solar for Health
Saving lives, Saving money, Saving the environment
Clinics, maternity wards, operating rooms, medical warehouses, and laboratories rely on electricity to power the lights, refrigerate vaccines, and operate life-saving medical devices. The inability to carry out these basic functions puts lives at risk. A recent review by WHO shows between a quarter and a third of health facilities lacking a reliable supply of power.
UNDP’s Solar for Health initiative supports governments to increase access to quality health services through the installation of solar energy photo-voltaic systems (PV), ensuring constant and cost-eﬀective access to electricity, while also mitigating the impact of climate change and advancing multiple Sustainable Development Goals. The installation of solar systems under the current phase of the Solar for Health initiative is estimated to be saving 250 thousand tons per year of carbon.
UNDP is currently working to install solar systems in health facilities across Africa, the Arab States and Central Asia. See the link below for further information.
Solar for Health
Electronic Vaccine Intelligence Network (eVIN)
Robust Technology for Low-resource Environments
In 2015, India launched eVIN, or electronic vaccine intelligence network — an easy-to-use mobile- and cloud-based technology that enables last mile management of supply chain. The project, run in partnership with GAVI, the Indian Ministry of Health and Family Welfare and Logistimo (technical partner) has effectively digitised the entire supply chain for vaccine distribution across India meeting the needs of their ambitious vaccination programme.
Once in use it allows cold chain handlers to update information on vaccine stocks after every immunization session. These updates are stored on a cloud server that gives health officials an immediate look at vaccine stocks and flows. It helps officials course correct, reducing wastage and empowering health workers.
UNDP support in implementing eVIN goes beyond just the technology in addressing the three ingredients critical to any successful service delivery transformation: people, processes and technology. At the forefront of India’s immunization efforts are thousands of cold chain handlers. Each roll-out of the technology is accompanied by training.