E-drug: Bulk procurement of TB drugs in Southern Africa
-------------------------------------------------------
dear E-druggers
I today attended a meeting of SATCI, the Southern African Tuberculosis
Control Initiative. The meeting discussed a consultant report into the
feasability
of introducing a bulk purchasing scheme. The report found that it should be
feasable, and projected that around USD 2 million could be saved by the
subregion if they procured 5 common TB drugs through a bulk purchasing
scheme.
The 5 drugs were proposed as a practical start, to test the principle
(start small). A "virtual tender system" was proposed, whereby a
subregional bid committee would do a Limited Bidding procedure, and the
individual countries would then buy drectly from the supplier.
Ministers of Health of the subregion and also WHO/AFRO have expressed their
interest in bulk purchasing schemes recently. So there is political will to
do something.
However, the consultant report mentioned also some administrative barriers
to bulk purchasing, such as:
- Different treatment regimes (can we standardize/harmonize them?)
- National tender procedures (will they accept supranational bidding?)
- National registration procedures (will they recognize each others
registration decisions? How fast can they harmonize?)
- Convertible currency is needed (the bills are in USD)
- National preferential tariffs to protect local industries (local
production interest versus public health interest)
Bulk purchasing schemes have been tried in many regions. A 1982 initiative
in Africa by WHO failed. Carribean and Middle-America revolving funds seem
to have
done better. UNICEF is a big institutional buyer of vaccines.
Recently the West-African association of Central Medical Stores (ACAME)
claimed it had managed a 7-27% reduction in costs for the region. The
administrative and other costs were however not included.
Are bulk purchasing systems viable? If so, what are the critical success
factors? Can we overcome burocratic hurdles to save money and treat more
patients?
Wilbert Bannenberg
South African Drug Action Programme
Email: WilbertBannenberg@compuserve.com
--
Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.