How resilient is our funding?

By Safia Ahsan
Senior Technical Officer, Reproductive Health Supplies Coalition

A few weeks ago, the Reproductive Health Supplies Coalition released a new report seeking to shed light on contraceptive supplies funding patterns during the COVID-19 pandemic. ‘Contraceptive Commodity Funding During the COVID-19 pandemic’ was commissioned by the RHSC and produced by Avenir Health and explores the impacts of the pandemic on public funding for contraceptive supplies in low- and middle-income countries (LMICs).

The report reminds us of how a global catastrophe such as COVID-19 holds the potential to destabilize our contraceptive supplies ecosystem. Along with disruptions and shifts in supply chains and demand patterns, funding priorities are vulnerable as available resources are rerouted toward crisis relief. Also, large-scale economic downturns mean less money for contraceptives and for everything else.

So, what actually happened during the pandemic to public funding for contraceptives, including both domestic and donor resources? Avenir’s analysis found that when viewed across a range of LMICs, an overall funding decline was not detectable. However, a deeper dive revealed a wide variation between countries, and certain countries indeed faced a significant reduction in funding for contraceptives. Here are some of the top-level findings from the report.

While countless challenges affected RH supply chains and markets during the pandemic, severe and prolonged disruptions to RH product funding and procurement on a broad geographic scale were thankfully avoided. The report discusses numerous factors that helped to foster this resilience in RH product funding, such as: commodity reserves, pre-existing funding agreements, diverse funding sources for pandemic response, volume guarantees, and the actions taken by supply chain actors that enabled rapid resumption of global supply chains and purchase order fulfillment.

The pandemic highlighted how dependent the sector remains on donor funding and on donor-funded supply chains, at a time when many are pushing for more domestic resource mobilization, national ownership of supply chains, and national health insurance schemes. Dependence on donors can leave governments and manufacturers at the mercy of last-minute and short-term funding decisions by donors; delays are common, and ministries may be forced to inefficiently enter just a few, very large purchase orders per year.

Despite the push for domestic resource mobilization, many countries still appear unprepared to take on the full burden of financing contraceptive supplies, and thus remain very vulnerable to challenges such as the pandemic.

In the context of declining donor funding and limited domestic resource mobilization, the role of the important private sector was often discussed by stakeholders. The report discusses opportunities for increased private sector engagement but also contains important cautions. Namely, care must be taken to ensure that lower-income women are not being expected to bear the cost burden for their reproductive health, especially for long-term methods. This calls for thoughtful, continued engagement between health ministries, private sector stakeholders, and donors, to foster an enabling environment that encourages and supports healthy market development.

‘Contraceptive Commodity Funding During the COVID-19 pandemic’ builds its case on data from 2020 and 2021, as well as from the couple of years leading up to the pandemic. As additional data sources become available, it will be important to continue analyzing the available data, to map evolving trends, and make better sense of market patterns and opportunities. While challenging, another suggestion is to explore ways to extend the scope of analysis from donor and domestic financing to include private sector data. Accessing private sector data poses its own set of challenges across countries, but if we are to prepare for an uncertain future, we need greater access to data across market sectors, as well as the willingness to collectively take data-driven actions that strengthen markets and supply chains.

Later this year, Avenir Health will update the country-level analysis conducted for the recently released report. They will incorporate FP Market Report data for 2021 and RHViz/VAN data for 2022, both of which were unavailable at the time of the previous analysis. Country trends will be updated accordingly. In addition, Avenir will build an online interactive data annex tool to allow access to country level data, including for overall public funding, donor funding, and government funding by data source. Stay tuned to hear more on this.

With these few high-level insights, we encourage you to read the report and/or the executive summary, to gain a fuller picture of how the community responded to COVID-19 and how we should use these learnings to prepare for the future.

To discuss these findings and ideas, please consider joining us in an upcoming webinar, “Contraceptive Commodity Funding During the COVID-19 pandemic”, at 10am EDT / 4pm CEST on 4 April 2023.