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UN Commission on Life Saving
Commodities for Women and
Children
UN Commission on Life Saving
Commodities for Women and
Children
Lisa Hedman
World Health Organization
Department of Essential Medicines and Health Products
IPC, Washington DC
11-12 December 2012
UN Commission on Life Saving Commodities 2 |
OutlineOutline
• Objectives
• 13 commodities
• 10 point of implementation
• Conveners
• Pathfinder countries
• Structures
• Examples of a recommendation strategy
• Example of a commodity strategy
“Each year, millions of women and children die from
preventable causes. These are not mere statistics. They are
people with names and faces.”
- UN Secretary-General Ban Ki-Moon
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UN Commission on Life Saving Commodities 4 |
Objective Objective
• Identify opportunities to increase the production, supply and use of affordable, high-quality, high-impact commodities for women’s and children’s health
• Propose innovative strategies to support high-burden countries to rapidly increase access to overlooked commodities
• Recommend strategies to raise awareness of and demand for these life-saving commodities
UN Commission on Life Saving Commodities 5 |
13 commodities13 commodities
Commodity Key Barrier
Oxytocin Poor quality
Misoprostol Low demand, lacks policy support
Injectable antibiotics Poor compliance in administration
Antenatal corticosteroids Requires special training
Amoxicillin, paediatric Few child friendly formats
ORS Poor understanding of product
Zinc Poor understanding of product
Female condom Low awareness and demand
Contraceptive implants High cost
Emergency contraception Low awareness among women
UN Commission on Life Saving Commodities 6 |
10 Recommendations10 Recommendations
Improved markets for life-saving
commodities
• Shaping global markets
• Shaping local delivery markets
• Innovative financing
• Quality strengthening
• Regulatory efficiency
Improved national delivery of life-saving
commodities
• Supply and awareness
• Demand and utilization
• Reaching women and children
• Performance and accountability
Improved integration of private sector and
consumer needs
• Product innovation
UN Commission on Life Saving Commodities 7 |
ConvenersConveners
– AMREF
– BMGF
– CHAI
– CIFF
– DFID
– EMA
– GFTAM
– IWG
– MDG Health Alliance
– Nigeria (co-chair)
– Norway (co-chair)
– PMNCH
– PATH
– PmRN
– RHSC
– SC
– USAID
– UNICEF (co-vice-chair)
– UNFPA (co-vice-chair)
– World Bank
http://www.everywomaneverychild.org/resources/un-commission-on-life-saving-commodities/life-saving-commodities
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UN Commission on Life Saving Commodities 8 |
"Pathfinder" countries"Pathfinder" countries
– Democratic Republic of Congo
– Ethiopia
– Nigeria
– Rwanda
– Senegal
– Sierra Leone
– Tanzania
– Uganda
– Other countries are joining
High-level platform for catalyzing change
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Conveners of recommendations
Commodity coordination groups
Pathfinder countries
Coordination with existing initiatives
Translate recommendations into actions for countries
Leadership Structure & Roles
UN Commission
Advocates at the highest levels to catalyze
change
Chairs:Pres. G. Jonathan of NigeriaPM J. Stoltenberg of Norway
Vice-chairs: UNFPAUNICEF
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Commodities moving through
the recommendations
10
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"By 2015, at least 3 manufacturers per commodity are
manufacturing and marketing quality-certified and
affordable products"
Price driven purchasers
Lack of mfginvestment in
regulatory compliance
Weak enforcement capacity
Example: Recommendation 4, Quality strengthening
Example: Recommendation 4, Quality strengthening
Current challengeCurrent challenge
UN Commission on Life Saving Commodities 12 |
Example: Recommendation 5,Regulatory efficiency
Example: Recommendation 5,Regulatory efficiency
"By 2015, all EWEC countries have standardized and
streamlined their registration requirements…with support
from stringent regulators, WHO and regional collaboration"
For 20 countries, repeat 20 times
Current challenge: fragmented market less sustatinable
For 20 countries, repeat 20 times
Current challenge: fragmented market less sustatinable
Technical
International standards and evidence
Policy
National treatment guidelines and policies
Regulation
Country registrations, standards, inspection
UN Commission on Life Saving Commodities 13 |
Interdependency of recommendationsInterdependency of recommendations
Competing cycle of unaligned forces
Recommendations 4 and 5:
� Policy alignment across countries
can focus demand on needed
commodities
� Opens options for joint or
harmonized regulatory
activities
UN Commission on Life Saving Commodities 14 |
Submit to EML for single tab format
(5)
Evidence to change
prescription authority to pharmacists
(5)
Adopt in national RH and FR guidelines
(5)
Train providers and communities
(2)
Example: emergency contraceptionExample: emergency contraception
Diarrhea and Pneumonia Treatment Working Group for the UN
Commodities Commission – UNICEF and CHAI
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• The Goal: Save lives of children
dying from pneumonia, diarrhea
and malaria and accelerate
progress towards MDG4 by
improving access to available
treatments
• By 2015: 60-80% coverage of
diarrhea, pneumonia and malaria
treatment for children under five
• By end 2012: Concrete progress
towards this goal in all ten
priority countries
Across 10 high-burden countries:
UN Commission
Advocates at the highest levels to catalyze change
Chairs:
Pres. G. Jonathan of Nigeria
PM J. Stoltenberg of Norway
Technical Working Group (3 Themes)
Supports the Commission to examine barriers to scale-up
Diarrhea & Pneumonia Working Group
Translate Commission
recommendations into
actions for countries
Identify barriers to scale-up and
translate country needs into
concrete decisions for Commission
Leadership Structure and Roles
“Making sure that women and children have the medicines they need is critical for our push to achieve MDGs”
Secretary-General Ban Ki-Moon
“Making sure that women and children have the medicines they need is critical for our push to achieve MDGs”
Secretary-General Ban Ki-Moon
Provides near-term support to countries in
efforts to scale-up access to treatment
Vice-chairs:
UNFPA
UNICEF
Market
shaping
Regulatory
environment
Best practices &
innovations
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This initiative has potential to save xxx lives from pneumonia and
diarrhea and achieve a significant reduction in child mortality by 2015
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Diarrhea and pneumonia treatment offer perhaps the greatest untapped
opportunities to further progress towards MDG 4…
Across the 10 countries, national scale-up plans call for four primary
interventions that have been part of successful small programs
Source: Diarrhea poster: WHO Archives, http://archives.who.int/prduc2004/rducd/Session_Guides/framework_for_learning_about_a_d.htm
Awareness and
demand
interventions
motivate supply
Increased supply
further drives
demand and builds
awareness
Generate awareness & demand Ensure availability of the product
Secure a conducive policy environmentIncrease provider awareness
• Engage manufacturers
to ensure availability of
an affordable product
• Optimize packaging &
branding
• Incentivize expanded
distribution in the
private sector
• Build broad support and
mobilize additional
resources from local &
international donors
• Ensure adjustment &
wide dissemination of
treatment guidelines
• Ensure OTC and EML
status
• Launch a national
action campaign for
child health
• Use partnerships
with mobile
operators
• Health diplomacy
through national &
community leaders
• Improve skills and
knowledge of public
and private health
workers
• Facilitate supplier
promotional reach
of rural areas
through facilitated
detailing
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UN Commission on Life Saving Commodities 17 |
� Country engagement planning 13 December 2012
� Funding mechanism established
� Steering committee and technical support groups
� Progress report due by April and December 2013
Next stepsNext steps
UN Commission on Life Saving Commodities 18 |
Thank you to all
This presentation was prepared with materials developed
from multiple teams within the
WHO Departments of Essential Medicines
and Health Products,
Reproductive Health and Research (HRP+)
and UNICEF
