Mar 22, 2006
Lead Contributors and Summary: March 13-20; Having a positive effect on the market for essential health products:
Lead Contributors:
Ben Karenzi (Rwanda), Mohammed Jimoh (Nigeria), Rose Joshi (Nepal), Njei Moses Timah (Cameroon), Manuel Lluberas (FL, USA), Vanessa Marenco (DC, USA), Darren Fast (Canada), Pinaki Mukherjee (India), Don Pedro (Denmark), Umesh Vanahalli (India), Stella Attakpah, (Austria), Manuel Lluberas, (FL, USA), Basil Kransdorff, Jack Mann, (Canada), Ddungu H, Pramod Dingh (India), Loverne Scott-Heron (Denmark), Joseph Mambo (Tanzania), Odong (Uganda) A J Hardy, (USA), Tasleem Akhtar (Pakistan), Athanase Loshima, St. Alex Ofhsna (RD Congo), Jean Gilbert Kabeji, Peter Kimbondo (RD Congo), Mangaty ,Lengo (Senegal), Dahane Hakim, Emmanuel Roch, Azamat (Kyrgizstan), Gennady Roschupkin (Russia), Samad (Russia), Victoria (Russia), Yuri Verdesh (Moldova), Gulnoz (Uzbekistan)
Summary:
Question: In your opinion, what should the Global Fund do to have a positive effect (i.e. lower prices, more sustainable supply, etc.) on the markets for essential health products (e.g. ARVs, bed nets, diagnostic tests) used for the prevention, treatment and care of HIV/AIDS, TB and malaria?
1. The UN, as a globally respected organization, could establish market control mechanisms with the following Terms of Reference for the Global Fund to fulfill:
a. Obtain a large financial base.
b. Initiation, monitoring and financing of medical research initiatives.
c. Open a tender and bidding process for drug suppliers and pharmaceutical companies
d. An agreement passed by the UN General Assembly on the minimization of tax for the production, importation and distribution of essential health products.
e. Exclude parties found to engage in corruption and other malpractices.
2. Consider representation in the boards of major product manufacturers or their consortiums e.g. as major financier of consumers, or, -more ambitiously- shareholder, to influence market.
3. Collaborate more with similar private sector organizations to influence essential product markets e.g. as is currently done with Clinton Foundation, and others.
4. Consider immediately advocating for tax reductions for companies that offer drug subsidies or low prices.
5. Spend more on research, appropriate technologies for local manufacturing & vector control.
6. Identify credible manufacturers and distributors; propose long term contracts to guarantee quality and prices.
7. Work with environmental protection, primary health NGOs to improve malaria prevention.
8.. Emphasize entomology & quality integrated vector management in malaria control programs.
9. Create or support local micro enterprises, industries that could learn how to make malaria nets, or work with governments to leverage resources from outside of pharmaceuticals, to improve welfare.
10. Involve communities in finding working local solutions, e.g. production, alternative drugs, etc.
11. Set up a research centre in a suitable country devoid of controversy, with Experts & CSOs to work on the objective of influencing essential health product markets.
12. Involve retailers and consider community based vendors- work with them under the aegis of national patent medicine regulation agencies- to ensure sustainability, provide seed stock and encourage more aggressive marketing.
13. Develop a standard list of supplies relevant to Global Fund priorities- HIV/AIDS, Malaria and TB.
14. The issue of nutrition as a key supply in prevention and treatment should be accorded higher priority.
15. Find more ways to support and encourage companies that could supply at much lower prices but are often afraid of creating a differentiated price on the global market.
16. Focus on cost-reduction processes on spending in other areas to optimize short-term supply of essential health products.
17. Streamline the procurement and supply process from the pharmaceuticals-governments –communities- there is too much inefficiency (cost) and ineffectiveness due to delays, etc.
18. Create an emergency fund to ensure sustainability of supplies, and increase the current budget of essential health products significantly, e.g. by 100%
19. Build the capacity of public, civil and private partners to negotiate for and supply products.
20. Look to the private sector to further subsidize prices through sponsorships, for example, or advertisement on the packages: e.g. ‘’Subsidized by Z12 Corporation’’.
21. Encourage recipients in countries to form their own procurement and supply networks.
Challenges:
1. The idea of influencing pricing may not have been a reasonable expectation of the Global Fund since there are too many market variables influencing pricing, for any one fund to do it alone. (However as financier of the majority of ACT consumers, the Global Fund may stand a chance.)
2. There is more need for development agencies in general to view and better understand local problems and their causes in order to develop workable local solutions. e.g. the general reduction in immunity in Africa over the decades, the preference of traditional healers and nutritional medicine to manufactured drugs, etc, all factors which influence demand.
3. There are too many solutions specific to too many local situations (variables or factors influencing market demand and supply); the more involved the local community is in making the solution work, the more effective it will be in the longer term.
4. A question from Russia: What impedes the production of ARVs by local companies? And is it possible to organize direct delivery of essential health products to treatment and care centres?