Procurement of life that saves life is a difficult task in many low -income states. There are often required treatments It is not available or is not inexpensive Even in these countries Decades later The drug has entered the market.
Preliminary buyers of these countries can face hundreds of patents in the face of patent bushes. This makes it costly and legally difficult to secure license authority for manufacturing.
These buyers also face complicated and often broken supply chains. Many major pharmaceutical companies have little incentives to sell products in no profitable market. Quality assurance adds another complexity Standards and counterfeit drugs Many of these countries are widespread.
Organization supported by the United Nations Pharmaceutical Effectively increased Supply of the general version of the patented drug. But the problem is to go beyond patents or manufacturing. The method of purchasing medicines is also important. Buyers of low -income and intermediate income countries are often healthy ministry and community organizations that often have a budget to negotiate with sellers who can have market power and much more experience.
we are economist Study the method Increase access to the drug World. Our research can help to lower costs while pooling orders for essential medicines and to guarantee steady supply to low -income and mid -income countries. Trade off that requires flexibility and early plans Solve it.
Understanding these compromises can help the state better preparing for future health emergencies and treating chronic diseases.
Pool procurement reduces the cost of drugs
One of the low -income countries is adopting more and more to improve treatment accessibility.Pool. ” This can help the buyer meet the minimum batch size requirements by adjusting the purchase to strengthen the collective bargaining power and lowering the price of essential medicines.
Lucy Xiaolu Wang and Nahim Bin Zahur,,, CC by-NC-ND
The state generally depends on four models for pooled drug procurement.
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One method called decentralization procurement is related to the buyer directly from the manufacturer.
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Another method of international pool procurement is related to passing international institutions such as global funds. Fulled procurement mechanism or UN.
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The state can also purchase prescription drugs through government operations or anti -autonomous institutions that procure, store and distribute medicines on behalf of the national health system. This method is called Centralized domestic procurement.
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Finally, the state can also experience independent non -profit organizations, foundations, non -governmental organizations and private wholesalers.
We wanted to understand how other methods of procurement It affects the cost and time it takes to provide. HIV/AIDS, malaria and tuberculosis drugs Three infectious diseases Explain many deaths and events around the world. So we analyzed more than 39,000 drug procurement transactions across 106 countries between 2007 and 2017. Global Fund,, Maximum multilateral funder HIV/AIDS program worldwide.
We found fundraising through international institutions Price drop price 13%to 20% Compared to the purchase directly from the pharmaceutical manufacturer. Purchased drugs produced by only a few buyers and a few manufacturers have saved the most cost. In comparison, purchase through domestic pooling Less savingThe larger buyer is seeing a bigger price advantage.
There were especially the global fund and the United Nations It is effective to lower The price of old and stimulating drugs.
Trade off with pooled procurement
Cost savings from pooled drug procurement can be available with trade off.
Global funds reduced unexpected delivery delays by 28%, but buyers Order much earlier. As a result, the longer expected procurement lead time between spells and delivery -average 114 days more Than direct purchase. In contrast, domestic pool procurement has shortened the lead time for more than a month.
Our result suggests key tension. Full procurement improves prices and reliability, but can reduce flexibility. Organizations that promote pooled procurement tend to limit the availability of other types of drugs by using drugs that can be purchased in large quantities. In addition, the longer the lead time may not be suitable for the emergency.
together Spread of COVID-19Some big Armed conflict Customs wars, the government is increasingly Vulsion of global supply chain. Some countries, KenyanIn 2005, we have invested in domestic procurement, and we have tried to reduce our dependence on international pooling.
However, the transition to domestic self -sufficiency is as follows. Slow and difficult process Due to quality assurance and challenges of large -scale manufacturing. In addition, it can weaken the international pooling system that relies on extensive participation to negotiate better conditions with the supplier.
RAFIQ Maqbool/AP Photo
Interestingly, we have little evidence that international pool procurement affects the US president’s emergency plan for AIDS relief, which is a major buyer of HIV treatment in developing countries. PEPFAR eligible products do not seem to receive more benefits from pooled procurement than those who are not qualified.
However, domestic procurement agencies could be done Secure a lower price For pepfar eligible products. This suggests that the presence of large donors, such as PEPFAR, can reduce costs, especially when the state is internally managing procurement.
USAID cut and global drug access
International organizations such as pharmaceutical patents and global funds can handle upstream barriers, such as patents and procurement of global drug supply chains, but other institutions are essential for drugs to actually reach patients.
US international development agencies played an important role in providing HIV treatment abroad. Through pepfar. that Trump administration’s decision February 2025 Reduces more than 90% of USAID’s foreign aid contract A US $ 60 billion reduction American support worldwide. Hundreds of thousands Already happeningand Millions will die more.
The World Health Organization (WHO) warned that it included eight countries. Haiti,,, KenyaNigeria and UkraineCan be done soon HIV processing is lacking Due to these aid cuts. South Africa has HIV service. Already reducedWith a massive report of health workers and HIV clinic closures. Such a down stream crack can weaken profits by trying to make the drug more accessible if the drug cannot reach the patient.
This is because HIV, tuberculosis and malaria are often Share the same processing infrastructure -The diseases to manage one disease, including drug procurement and distribution networks, laboratory systems, data collection, medical workers and community -based services, can be spread over other diseases. Researchers warn that they had a wider development over these epidemics. Potential “lineage” in global HIV reactions.
Research shows that support for the treatment of the world is not to save overseas life. also It will help to prevent the next world health crisis. It was reached in front of the American door.
