Tackling the Triple Transition in Global Health Procurement

Abstract

Global health procurement needs are evolving rapidly as countries face a triple transition:

First, with income levels rising, low- and middle-income countries face the prospect of a transition from donor aid. Health products procurement, especially in low-income countries, remains heavily reliant on donors; making up for lost financing following donor exit will stretch already-strained national health budgets. Many low-income and lower-middle-income countries also have limited experience and capacity in procurement-related functions.

Second, low- and middle-income countries face an epidemiological transition. As countries become wealthier, disease burdens shift from infectious to noncommunicable diseases such as cardiovascular disease, cancer, and diabetes. To meet their citizens’ evolving health needs, governments will need to purchase and make available a very different set of health products from those procured today.

Third, countries face a transition in health system organization as they move away from siloed disease-specific programs and out-of-pocket spending toward universal health coverage. As more governments commit to protecting their citizens against catastrophic health spending, national or subnational procurement processes will be a cornerstone of equitable and universal access to health products. Achieving universal health coverage within tight budgets will require national governments and their global health partners to make procurement decisions that deliver the most value for money.

Key insights on health product markets in low- and middle-income countries

Key insight 1: In low- and middle-income countries, prices for basic generic medicines can vary and far exceed wealthy-country prices.

Key insight 2: Low- and middle-income countries disproportionately purchase expensive branded generic drugs rather than cheaper unbranded generics.

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