Reproductive Health Supplies Coalition Annual Report 2013 - Creating a blueprint for the future

Publication date: 2014

1 Creating a Blueprint for the Future annual report 2013 Reproductive Health Supplies Coalition annual report 2013 “Creating a blueprint for the future” $10 million Additional funds leveraged by the Coalition in support of both its own work and the cause of reproductive health commodity security more broadly (see page 27). $6 million Support leveraged by PSI Burundi to scale-up social franchising activities launched under a $40,000 grant from the Coalition’s Innovation Fund (see page 18). $60 million Cost savings realized in 2013 by the Coalition and its members, through reductions in the price of contraceptive implants, reduced demurrage costs arising from Innovation Fund initiatives, and the cancellation of redundant commodity orders by CARhs (see page 27). 227 crises The number of requests for support received in 2013 by the Coordinated Assistance for Reproductive Health Supplies (CARhs) group (see page 7). 2013 2 For the Reproductive Health Supplies Coalition, 2013 was a year of growth, transformation, and renewal. Building on a remarkable decade of achievement and fueled by an upsurge in donor support, we launched ambitious initiatives to expand access to crucial commodities and advance strategic planning for future organizational development. We developed a blueprint for a new decade of tremendous opportunities for deepening our impact in meeting urgent health needs around the globe. We grew at an unprecedented pace. The Coalition Secretariat’s staff nearly doubled in size, as did the number of offices. Membership grew by 24%, from 217 to 269 organizations. In addition, the number of major donors grew from three to seven, increasing core funding to US$23 million over the next four years. It was also a pivotal year in the global environment for improving reproductive health (RH). The launch of Family Planning 2020 (FP2020) stimulated new optimism for the future, and the United Nations Commission on Life-Saving Commodities for Women and Children provided extra impetus for progress. Capitalizing on emerging opportunities, the Coalition embarked on a new trajectory, balancing our traditional role of supporting and adding value to the work of our members—what we have often called “leading from behind”— with a new, more proactive role in strengthening markets for RH supplies, reducing stockouts, and fulfilling national commitments to commodity security. We also formulated the outline of a new strategic framework that will help us advance the cause of commodity security through equitable access to and greater availability, choice, and quality of supplies, while focusing on six “levers of change” that have made us who we are today (see additional information on page 15). These levers of change not only created a foundation for our past achievements but also hold the key to further success as we plan for a new decade of expanding possibilities. “We developed a blueprint for a new decade of tremendous opportunities.” 3 “Leading from behind” to leverage the power of partnership. 4 In 2013, we worked to ensure that supply security remains high on the global agenda and to provide a forum for moving that agenda forward. To accomplish this, we embarked on a dual approach, aimed at adding value to the work of our diverse and growing member base while simultaneously leveraging the skills and expertise of our members to focus even more closely on obstacles that impede product security, both globally and at the country level. Under one approach, which lies at the heart of the Coalition’s work, we reinforced core efforts to leverage the power of partnership by supporting our eight “Implementing Mechanisms”—our working groups, regional fora, and caucuses. Activities included expanding our communications mandate; engaging with new global initiatives such as FP2020 and the UN Commission on Life-Saving Commodities for Women and Children; hosting high-impact meetings to raise the profile of contraceptive security; mobilizing more than $10 million in additional resources for strategic initiatives; and relaunching the Innovation Fund. This core work provides a basis for success under our other approach, which consists of three focused initiatives: shaping markets, reducing stockouts, and fulfilling commitments to commodity security. Coalition Secretariat As the Coalition’s administrative and operative arm, the Secretariat ensures that our global partnership functions smoothly and achieves its goals. Headquartered in Brussels, Belgium, and with more than 14 staff spread across four continents, the Secretariat keeps reproductive health commodity security on the global development agenda. It also serves as the Coalition’s public face, responding to requests for information, engaging the group’s growing membership, and maximizing collaboration among partners and stakeholders. The Secretariat is managed by PATH, an international nonprofit organization that accelerates innovation to save lives and improve health, especially among women and children. 5 We embarked on a new, dual approach. core support We reinforced core efforts to leverage the power of partnership by supporting our eight “Implementing Mechanisms”—our working groups, regional fora, and caucuses. Activities included expanding our communications mandate; engaging with new global initiatives such as FP2020 and the UN Commission on Life-Saving Commodities for Women and Children; hosting high-impact meetings to raise the profile of contraceptive security; mobilizing more than $10 million in additional resources for strategic initiatives; and relaunching the Innovation Fund. PAGES 7-18 6 shaping the market Drawing on its solid track record in assembling a brain trust and creating a neutral space, the Coalition embarked on a new initiative to reduce information gaps, disseminate critical data about the market, and facilitate discussions with key stakeholders. The Coalition’s market shaping work seeks to reduce barriers to entry, optimize procurement practices, and deliver crucial market data. It also seeks to facilitate discussions with manufacturers on key issues such as price, quality, production volumes, market entry, and registration. Delivering on promises Many commitments made in recent years have been largely aspirational, rarely aligned with previous commitments, and only occasionally supported by concrete strategies. Through its partners, the Coalition will transform such commitments into powerful drivers for change. Working with partners, the Coalition will forge innovative, multi- sectoral partnerships at country-level to operationalize and deliver commitments; it will also encourage new and more effective supplies-related commitments. Reducing Stockouts Addressing stockouts of life-saving supplies is as much about getting people to care as it is about fixing bottlenecks in supply chains. The Coalition’s new initiative will call on advocates to raise awareness and overcome complacency, technical experts to address inefficiencies in the supply chain, and researchers to put a human face on the impact of stockouts. Foremost is the formulation of a common language for measuring progress in the battle against stockouts. The Coalition will also draw on its relationships to disseminate lessons of past successes and to drive attention to the problem of stockouts, especially in the poorest countries. PAGES 19-20 PAGES 21-22 PAGES 23-24 7 Coordinated Assistance for Reproductive Health Supplies group (CARhs) This year, the Coalition assumed management of the CARhs, succeeding the United Nations Population Fund (UNFPA) in this role. A work stream of the Coalition’s Systems Strengthening Working Group, CARhs provides a platform for global procurers and country partners to take corrective action when threats of country- level stockouts or overstocks are reported. In 2013, CARhs helped five countries in sub-Saharan Africa secure 2 million units of Depo-Provera®, thereby avoiding stockouts that could have resulted in 143,000 unwanted pregnancies, 72 maternal deaths, and 952 infant deaths. This effort required an unprecedented level of collaboration among Pfizer, USAID, USAID I DELIVER, and UNFPA. CARhs also began the process of formulating its first strategic plan. Information gathering and analysis led to publication of a report entitled Coordinated Assistance for Reproductive Health Supplies (CARhs): How a Phone Call Led to Improved Supply Chain Management. 143,000 unwanted pregnancies averted 952 infant deaths avoided 72 maternal deaths prevented Core support .the human impact of averting stockouts of Depo-Provera® in five countries in sub-Saharan Africa. co re s up po rt 8 9 Building regional fora In 2013, the Coalition’s Spanish-speaking and Francophone forums—the Latin America/ Caribbean Forum on Reproductive Health Commodity Security (ForoLAC) and Sécurité Contraceptive en Afrique Francophone (SECONAF)— significantly enhanced their operations. In Latin America, a full-time facilitator came on board to support the ForoLAC, which grew to 65 member organizations and 300 individuals across more than 18 countries. In June 2013, the Forum launched its first strategic plan and three new working groups—one each on multi-sectoral collaboration, commitments, and resource mobilization—at the Forum’s second membership meeting in Lima, Peru. The Lima meeting also showcased projects funded through ForoLAC’s own small grants fund, the FondoLAC. These projects included a new advocacy video, “Con las Manos Vacías”, produced by Population Action International (PAI). In December, a Mexican nongovernmental organization (NGO), Investigación en Salud y Demografia, received a second FondoLAC grant to develop an advocacy tool for ranking regions and populations with an unmet need for RH services. In Dakar, the Secretariat’s second regional facilitator was hired—this time to provide leadership and cohesiveness to SECONAF’s growing membership, which now includes more than 330 individuals representing 75 organizations in 34 countries. In 2013, SECONAF consolidated its institutional framework by establishing a new advisory committee and communications network, publishing its own bimonthly newsletter, and translating and publishing 13 product briefs in French on new and underused RH technologies. SECONAF was also instrumental in adding eight Francophone Africa countries to the CARhs electronic database for procurement planning. This has now made it possible to engage regional players, such as the West African Health Organization, in the analysis of available information. 65 members from more than 18 countries now comprise ForoLAC. 75 members from more than 34 countries comprise SECONAF co re s up po rt 10 Con las Manos Vacías Watch it online 11 Harnessing partners’ talents for global campaigns The Coalition Secretariat harnessed partners’ skills, knowledge, and experience in 2013 to support new global initiatives to promote universal access to RH commodities. The Coalition Director assumed his seat on the governing body of FP2020 and began his term as co-chair of FP2020’s Market Dynamics Working Group—one of four such groups within FP2020 working to ensure that an additional 120 million women and girls in developing countries have access to high-quality, voluntary family planning information, services, and contraceptives. UN Commission on Life-Saving Commodities for Women and Children Since the establishment of the UN Commission on Life-Saving Commodities for Women and Children in 2012, the Coalition has actively supported its work. Represented on no fewer than nine of the Commission’s Technical Reference Teams (TRTs), the Coalition helped the Commission establish key communication tools and eventually took the lead in transitioning the three family planning TRTs into a second phase of the multi-year effort. Under the Commission’s Advocacy & Accountability Working Group, the Coalition contributed to the development of a new advocacy toolkit, Scaling Up Lifesaving Commodities for Women, Children and Newborns, with sections devoted to emergency contraception, contraceptive implants, and female condoms. And finally, the Commission used the Coalition’s Supply Information Database (SID) as the primary vehicle for disseminating a collection of 46 information sheets on tools and resources used in the provision of maternal health supplies. co re s up po rt 12 13 Delhi 2013 draws 200 participants Two hundred participants from 33 countries gathered in New Delhi, India from October 7 to 11, 2013, for the Coalition’s 14th General Membership Meeting. Co-hosted by the Indian Ministry of Health and Family Welfare and opened by its General Secretary, Ms. Anuradha Gupta, the meeting served as an occasion to thank the Coalition’s outgoing chair, Julia Bunting, OBE, for her four and a half years of service and to welcome the incoming chair, Dr. Marleen Temmerman. The meeting featured a joint session of the Coalition’s two regional fora and the inaugural meeting of the Generic Manufacturers (GEMS) Caucus for Reproductive Health. New caucus of manufacturers Representatives of seven manufacturers of generic products joined forces to get their views and voices heard by a global audience. Called the Generic Manufacturers Caucus for Reproductive Health, or GEMS Caucus for short, this new group supports Coalition initiatives in market shaping, quality assurance, and reduction of stockouts. GEMS video Watch it online co re s up po rt 14 Panel presentation by members of the GEMS Caucus at 2013 Delhi Membership Meeting. Pictured from left to right: L. Chinery, H. Gunawan, A. Joshi, V. Iyer, L. Yong, S. Jimmy, E. Oosterman, K. H. Rademacher (not in this picture) 15 Creating a new strategic framework The Coalition made significant progress in 2013 in reformulating our strategy and better positioning ourselves for the future. Members from across the Coalition revised the group’s vision and mission statements and outlined six key levers of change—proven strategies that the Coalition has effectively employed to achieve success (see text box). The updated strategic framework was endorsed during the Coalition’s General Membership Meeting in October 2013, and a new ten-year strategy will be completed in 2014. Levers of change The Coalition’s new strategic framework identifies six levers of change that the Coalition has consistently employed to deliver success and prioritize interventions. Neutrality—Our neutrality provides a space for technical collaboration and problem-solving. Convening power—Our convening power enables us to draw from a global network of stakeholders. Brain trust—Our brain trust of RH experts serves to incubate new ideas and solve problems. Partnerships—Our ability to broker partnerships helps in influencing policies and guiding global direction. Flexibility—Our flexibility to confront new issues as they arise. Respected brand name—Our good name and successful track record provides credibility and trust. The Coalition has consistently employed its levers of change to deliver success. co re s up po rt 16 Drafting the Coalition “Theory of Change” as part of the strategic planning process 17 Innovation Fund relaunched The Innovation Fund serves as the Coalition’s flagship program for translating ideas into action. Since 2009, it has provided more than $2 million in small grants to Coalition members to develop new tools, support advocacy and research, leverage additional support for program funding, and launch new initiatives. This year, the Fund was replenished and relaunched, with emphasis on support to developing country partners, including technical assistance for proposal development. This year saw. Marie Stopes International (MSI) Sierra Leone use $40,000 in seed funding to change national import policies for contraceptives, a change which promise to yield an estimated $200,000 in annual savings. MSI Afghanistan used its Innovation Fund grant to assemble parliamentarians to form Afghanistan’s first Sexual and Reproductive Health Caucus. With the support of the Caucus and the involvement of key religious leaders, Afghanistan’s national regulatory authority approved the special registration of the contraceptive implant Jadelle®. Finally, the Uganda Family Planning Consortium used its grant from the Innovation Fund to hire a coordinator who has enhanced the consortium’s ability to work effectively with the government to improve commodity delivery systems and increase access to contraceptives. Since 2009, the Innovation Fund has provided more than $2 million in small grants to Coalition members. co re s up po rt 18 Close-up: Exploring social franchising in Burundi In 2010, the Burundi Ministry of Public Health published a national health plan calling for increased collaboration with the private sector. The Coalition’s Innovation Fund enabled PSI Burundi, an affiliate of Population Services International, to act upon that call. A small grant of US$40,000 enabled PSI Burundi to assess the potential for leveraging private-sector assets to achieve public goals for sexual and reproductive health—an approach known as social franchising. It also provided resources to design and plan a social franchising project based on the findings. Building on the knowledge gained through this project, PSI Burundi secured a three-year grant of approximately $6 million from the Government of the Netherlands to kick-start a social franchising project. The project is now collaborating with the private sector to improve the quality of services and accessibility of contraceptives through training of providers, commodity procurement, and quality assurance visits. Project staff are also increasing demand for contraceptives and reproductive health services through mass media efforts. Read the story: 19 The past decade has witnessed remarkable improvements in access to a wide range of affordable, high-quality medicines and health supplies. In the case of vaccines and anti-retroviral drugs, for example, market interventions and greater market competition have yielded millions of dollars in cost savings. In the family planning sphere, innovative financing mechanisms, volume guarantees, and expansion of a quality-assured supplier base have increased access to a range of contraceptives, including injectables, implants, and female condoms. These efforts illustrate the power of the market to influence health outcomes. They also illustrate the potential of the reproductive health community to consciously and wisely shape what goes on in the market—whether by leveraging purchasing power, increasing access to market data, incentivizing new entrants into the marketplace, or simply eliminating policy barriers. Forging a common vision and pathway to the future In 2013, the Coalition launched a comprehensive review of market shaping and its role in improving the effectiveness of markets for family planning products. In May 2013, representatives from more than 30 organizations gathered in Washington, DC to agree on a framework for better understanding of “market shaping,” a frequently used but often misunderstood term. Together with Dalberg Global Development Advisors, the review identified key elements of a healthy market, offered a conceptual framework and vocabulary for understanding the logic of market shaping, and explored the structural tensions and trade-offs that often arise from implementation of market shaping efforts. Prior to publication of a full report in 2014, the findings were presented at meetings and conferences and used to inform the work of FP2020’s newly launched Market Dynamics Working Group. Expanding product availability The new GEMS Caucus supported a number of initiatives to shape markets, assure quality, and reduce stockouts. In June, the directors of both the Caucus and Coalition published an article on the value of generic RH products in the Impatient Optimists blog of the Bill & Melinda Gates Foundation. As an indication of success in advancing generic products, 2013 saw the World Health Organization (WHO) Prequalification of Medicines Programme approve nine generic reproductive health products—the largest number to date in any single year. Read more about this initative on our dedicated portal: Shaping markets fo cu se d in it ia ti ve s 20 In 2013 alone, WHO Prequalification of Medicines Programme approved 9 generic reproductive health products— the largest number to date in any single year. 21 This year, the Coalition embarked on a new approach to combat stockouts. The approach calls upon the strengths of all players: advocates to raise awareness and overcome complacency, technical experts to strengthen supply chains, and researchers to put a human face on the impact of stockouts on people’s lives and the health system more broadly. Forging a common language By the close of 2013, the Coalition had completed the first critical component of its new stockouts initiative— forging a common language, including a set of indicators to address stockouts. A Stockouts Advisory Group was established within the Systems Strengthening Working Group to conduct a stakeholder survey and literature review. Their results, including a draft set of indicators, were presented at the Coalition’s General Membership Meeting in Delhi and at the 2013 International Conference on Family Planning in Addis Ababa, Ethiopia. “Our new approach puts a human face on the impact of stockouts.” Read more about this initative on our dedicated portal: Reducing Stockouts fo cu se d in it ia ti ve s 22 23 Recent years have seen governments from across the Global South commit themselves to ensuring equitable access to affordable, high-quality reproductive health supplies. Many have chosen to deliver those commitments at key international events where they can attract a global audience and hopefully garner the support needed to make those commitments a reality. This year, the Coalition launched a new initiative to leverage aspirations voiced on the global stage into powerful drivers for change at home. By working with partners at the country level, this initiative promises to assemble the diversity of technical skills required to realize those commitments, celebrate the successes of governments that take appropriate action, and ensure those successes are replicated globally. The Coalition also developed an action plan for the first of up to three field-based interventions associated with this initiative. Uganda was identified as the pilot country based on local interest, the presence of strong local partners, and the country’s prominence at the 2012 London Summit on Family Planning. The intervention will serve as both a proof of concept and field test for subsequent efforts. Global compendium on country commitments In 2013, the Coalition Secretariat, together with Cambridge Economic Policy Associates, compiled a global compendium of supply-related commitments made by governments and other institutions over the past decade. The compendium will serve as the basis for identifying country-level interventions, structuring the content of those interventions, and synthesizing lessons concerning the design and implementation of new supply commitments. It includes more than 200 separate commitments and will be available on the Coalition’s website in 2014. Read more about this initative on our dedicated portal: Delivering on Promises fo cu se d in it ia ti ve s 24 The Coalition launched a new initiative to leverage aspirations voiced on the global stage into powerful drivers for change at home. 25 Conclusion The past year was a period of historic significance for the Coalition. It marked the end of a decade of growth that saw the Coalition evolve from a loose network of fewer than 15 institutional members into the world’s largest voluntary network of reproductive health organizations. At the same time, we began formulating an ambitious new vision for our place in the decade to come. Buoyed by new resources, energized by a truly global Secretariat staff, and empowered to take on new initiatives, 2013 served as a blueprint for framing our ambitious goals for the future. We refined our theory of change, formulated a new strategy, put down new regional roots, and positioned ourselves within the ever-evolving global landscape. The Coalition looks forward to an exciting year ahead as we dedicate ourselves to a new decade of expanded work to meet global needs for reproductive health supplies. The road ahead The road ahead will see the Reproductive Health Supplies Coalition: • Incubate new ideas through a renewed and replenished Innovation Fund. • Build the skills of country partners to take advantage of new funding opportunities through more effective proposal development. • Launch a global advocacy campaign to combat stockouts. • Add functionality to Coalition tools and databases, such as Learning and Professional Training Opportunities (LAPTOP) and the Supply Information Database (SID). • Launch new initiatives with country partners under each of the four strategic pillars (availability, quality, equity and choice). All these activities will be occurring as we celebrate the Coalition’s tenth anniversary and hold our general membership meeting in Mexico City, Mexico. 26 “2013 served as blueprint for framing our ambitious goals for the future.” Ph ot o: P AT H /A ar on Jo el S an to s 27 Financing our work Core support In 2013, the Reproductive Health Supplies Coalition received $4,6m in core support from the UK Department for International Development (DFID), Bill & Melinda Gates Foundation, William and Flora Hewlett Foundation, John D. and Catherine T. MacArthur Foundation, Norwegian Agency for Development Cooperation (Norad), United Nations Population Fund (UNFPA), US Agency for International Development (USAID). Additional funding was provided by the William and Flora Hewlett Foundation and the John D. & Catherine T. MacArthur Foundation. Leveraged funding In addition to these contributions, the Coalition has, since 2007, leveraged $53.3m in support of both its own work and the cause of reproductive health commodity security more broadly. Nearly one-fifth of this amount, $10.3m, was leveraged in 2013 alone. These resources represent new money for Coalition-related initiatives not channelled through either the Secretariat or PATH as its fiscal agent. They include support to membership meetings, scaling up support for Innovation Fund pilot projects, procurement of supplies recommended by CARhs, and support to the Pledge Guarantee for Health. Contributors of this in-kind support include: David & Lucile Packard Foundation, Ministry of Foreign Affairs of the Netherlands, Population Action International, Swedish International Development Cooperation Agency, The William and Flora Hewlett Foundation, UNFPA, USAID and many other organizations. Cost savings Finally 2013 saw the Coalition and its global partners mobilize over $60m, primarily through cost savings. Most of these savings resulted from reductions in the price of implants; others from the reductions in demurrage costs associated with MSI’s Innovation Fund work in Sierra Leone (see page 18); and the cancellation of redundant commodity orders by CARhs. 28 P ho to : P AT H /E ve ly n H oc ks te in Members of the Executive Committee, October 2013. Pictured from left to right: Emma Iriarte, Frank Roijmans, Moses Muwonge, Francois Sow, Gloria Asare, Leslie Patykewich, Marleen Temmerman (Chair), John Skibiak, Ian Askew, Jagdish Upadhyay, Julia Bunting Not shown: Monica Kerrigan, Jothan Musinguzi, Zhang Ruiheng, Ellen Starbird Photo credits: PATH/Paul Libiszowski (cover), PATH/Gabe Bienczycki (page 3), PATH/Umit Kartoglu (page 8), UN Photo/Eskinder Debebe (page 12), PATH/Aaron Joel Santos (page 26) The Reproductive Health Supplies Coalition The Coalition is a global partnership of public, private, and non-governmental organizations dedicated to ensuring that everyone in low- and middle-income countries can access and use affordable, high-quality supplies for their better reproductive health. It brings together agencies and groups with critical roles in providing contraceptives and other reproductive health supplies. These include multilateral and bilateral organizations, private foundations, governments, civil society, and private sector representatives. Rue Marie-Thérèse 21, 1000 Brussels, Belgium Tel: +32 2 210 0222 / Fax: +32 2 219 3363 / E-mail: / Website:

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