A most serious constraint to managing diabetes and hypertension effectively is the reliable availability and affordability of diagnostics and medicines. In the case of diabetes, this means insulin and oral hypoglycaemic agents, and the associated technology for the self-monitoring of glucose levels: handheld meters and test strips (for both blood and urine). For example, some estimates suggest that for those on insulin, 50% don’t receive it on a reliable basis – with obviously grave consequences for them. In addition, the optimal care of diabetes requires blood pressure lowering and cholesterol reducing drugs, when indicated. Laboratories need the equipment and supplies to test for HbA1C as well as lipid (cholesterol) levels. Various types of anti-hypertensives and easy-to-use blood pressure monitors are needed for managing hypertension.
Our Essential Supplies Procurement and Distribution Facility is geared towards the poorer countries through a marketplace that makes the provision of medicines, diagnostics, and equipment more cost effective for them. This Facility is guided by the WHO Model List of Essential Medicines. It includes pooling the purchasing power of small countries who do not currently get value-for-money in their procurement alongside ensuring quality and continuity of supplies. Pharmaceutical companies have expressed interest including, for example, to a low maximum cost of insulin for the world’s poorest countries, and scales of production could bring this cost further down. An important aspect of the arrangement ensures that current antitrust and anti-dumping legislation is followed while allowing participating companies to engage in a bundled fashion with volumes and prices that are competitive.
The Facility’s marketplace subscribes to good public service procurement principles benchmarked to standards established by the United Nations that are, inter alia, accepted by all countries. These seek to achieve best value for money through an open, competitive, fair, transparent, and accountable process with established rules and regulations that are applicable to all who wish to offer or purchase products or services through the Facility.
Thus, the Facility tackles the main barriers to reliable supplies provision through lower prices, quality control, standardisation, speed and reliability of distribution to prevent stock outs, and ensures transparency. An important added value of the Facility is to provide technical assistance to build national capacities in supply chain management including skills in procurement, customs clearance and exemptions, warehousing and stock control and rotation, and secondary distribution to delivery points. Experience suggests that these are frequently encountered choke points, even when supplies are available.
In summary, the Facility helps countries to ensure that NCD-related diagnostics, medicines, and equipment are widely and reliably available close to where people live, and accessible by them.