Steve Kinzett Reproductive Health Supplies Coalition

Mobilizing for RH/HIV Integration26-29 February, 2008 – Addis Ababa, Ethiopia

Securing Reproductive Health Supplies for All:

Challenges and Initiatives

Who are we?

A diverse international partnership with members from:

•Multilateral Organizations: UNFPA, WHO, World Bank, EC, GFATM

•Bilateral donors: Germany/BMZ/KfW, Netherland Ministry of Foreign Affairs, DFID, USAID, Spain

•Foundations: Gates, Hewlett, Packard, United Nations Foundation

•NGOs: IPPF, PPD, PAI, PATH, JSI, DSW …

How do we work?

RHSCRHSC

ExecutiveExecutive

SecretariatSecretariat

SSWGSSWGSystems strengtheningSystems strengthening

MDAWGMDAWGMarket Development Market Development

ApproachesApproaches

RMAWGRMAWGResources Resources MobilisationMobilisation

and Awarenessand Awareness

Examples of workstreams

•Project RMA : An advocacy effort on supplies availability provided by:

•Global – PAI•Regional – DSW•Country – IPPF

•Reproductive Health Interchange: Database of contraceptives supplied by UNFPA, USAID, IPPF to 144 countries (Crown Agents and PSI joining) – hosted by JSI•2nd Tier Markets – IPPF (ICON) •Prequalification of RH supplies (WHO/UNFPA)

What are RH supplies?

Driving the agenda

The future of RH supply security is threatened by three main factors:

• Available resources are insufficient to meet increasing demand for supplies

• Weak systems at country level, coupled with a more complex supplies environment

• Lack of coordination and information sharing

Contraceptive use is increasing…

Graph

0

200

400

600

800

10001

99

2

19

94

19

96

19

98

20

00

20

02

20

04

20

06

20

08

20

10

Total Est. Contraceptive Cost Actual donor Support

Supply is not meeting demand…

Available, predictable, and sustainable financing

20/11/2007 Rabat, Morocco

• Seek out new resources at global level

• Increase access to existing resources at country level

• Maximize private sector/total market

Supplies environment is becoming more complex

20/11/2007 Rabat, Morocco

GFATM and HIV/RH Integration

• Yesterday a list of topics were given that various countries have already received GF support for:– Sexual and Reproductive Health– Condoms– PMTCT+– Ante-natal Care– Councelling– ARV’s/STIs– Gender-based services

GFATM and HIV/RH Integration

• All these have supplies attached to them (for example):– Contraceptives– Condoms– Neviriprine/Cotrimoxazole– Oxytocin– Rapid HIV tests– Drugs to treat STI’s (as well as ARVs)– Emergency Contraception/Pregnancy tests

Putting supplies into your requests

• There is no point in having a superb integrated RH/HIV service if there are inadequate supplies

• Often supplies are controlled by government – GFATM funded supplies can ensure that supplies are available to all programmes

• Again yesterday it was highlighted that good sound data was required for applications to be successful. The careful landscaping of available supplies by different donors and providers is necessary prior to quantifying supplies to be requested.

• Forecasting imperative (including lead time)

A last note on systems

• Supplies themselves depend on good systems to get them out there. Think about :-– Small trucks instead of luxury 4-wheel

drives – Refurbishing stores at district level (or

adding a room) for good storage– Information systems

Reproductive Health Commodity Reproductive Health Commodity SecuritySecurityGlobal Programme to Enhance RHCSGlobal Programme to Enhance RHCS

Addis Ababa, 27 February 2008Addis Ababa, 27 February 2008

Global Programme toGlobal Programme toEnhance RHCS: SummaryEnhance RHCS: Summary

Aim to catalyse national action to mainstream RHCS within national Aim to catalyse national action to mainstream RHCS within national development frameworks, budgets policy and programmes to underpin development frameworks, budgets policy and programmes to underpin SRH/FPSRH/FP

Bridge from donor dependency to new aid approaches; guiding principles Bridge from donor dependency to new aid approaches; guiding principles from Paris Declaration on Aid Effectiveness; Consistent with One UN from Paris Declaration on Aid Effectiveness; Consistent with One UN

Country-driven approach; Ownership / cooperation requested from key Country-driven approach; Ownership / cooperation requested from key national / international stakeholdersnational / international stakeholders

Flexible, multi-year funding source to stimulate commitment and reward Flexible, multi-year funding source to stimulate commitment and reward measured progress and impactmeasured progress and impact

Strong country focus on enhancement of national capacity and systemsStrong country focus on enhancement of national capacity and systems

Move towards unitary supply systems/mechanisms for all health Move towards unitary supply systems/mechanisms for all health commoditiescommodities

Reproductive Health Commodity Security underpins work across Reproductive Health Commodity Security underpins work across Sexual and Reproductive Health. SRH, in turn, crucial to efforts to Sexual and Reproductive Health. SRH, in turn, crucial to efforts to implement ICPD Programme of Action and to meet the Millennium implement ICPD Programme of Action and to meet the Millennium Development Goals. Development Goals.

Funding shortages hamper the adequate provision of Funding shortages hamper the adequate provision of contraceptives, condoms and other RH supplies. contraceptives, condoms and other RH supplies.

Donor community support:Donor community support: 1995 – 30%; 2005 – 20%.1995 – 30%; 2005 – 20%.

Challenge for governments and partners to ensure universal Challenge for governments and partners to ensure universal access to reproductive health care by 2015.access to reproductive health care by 2015.

Without supplies, people cannot exercise their reproductive Without supplies, people cannot exercise their reproductive rights.rights.

Why the Global ProgrammeWhy the Global Programmeis important?is important?

Global Programme: Global Programme: Stream 1 countriesStream 1 countries

Intensified support currently being provided in small number of stream 1 Intensified support currently being provided in small number of stream 1 countries: Ethiopia, Burkina Faso, Mozambique, Nicaragua, Mongoliacountries: Ethiopia, Burkina Faso, Mozambique, Nicaragua, Mongolia

Recommended steps leading to definition and implementation of country-Recommended steps leading to definition and implementation of country-owned and country-driven national RHCS Plan of Actionowned and country-driven national RHCS Plan of Action

[1] Broad situation analysis [RHCS links to FP/RH, STI and HIV prevention, [1] Broad situation analysis [RHCS links to FP/RH, STI and HIV prevention, maternal health, etc.]; maternal health, etc.];

[2] Broad policy/programme analysis; [2] Broad policy/programme analysis;

[3] Stakeholder workshop to build consensus for RHCS Plan of Action[3] Stakeholder workshop to build consensus for RHCS Plan of Action

National coordination mechanism to aid coordination and implementationNational coordination mechanism to aid coordination and implementation