There’s no well-stocked warehouse in the sky
Why timely contraceptive orders are critical, especially in these troubled times.
Last month, the RHSC’s Latin America and Caribbean Forum (ForoLAC) received a desperate call. A country in the region was nearly stocked out of two-rod contraceptive implants and needed 100,000 units urgently. The scramble that followed raised the curtain on an ominous reality: lead production times for many contraceptive products are at an all-time high.
The numbers are sobering. In a webinar ForoLAC hosted recently, UNFPA Procurement Specialist Mónica Lay levelled with those who had tuned in. Production time for a new generic implant is currently 32–36 weeks. Male condoms are taking four months to produce. Emergency contraception 12 months. And, this is before figuring in the time needed for administration, printing, packaging and transport, which could all add months to these already lengthy times.
The threat of extended waiting times should spur governments to get their orders in early, but that doesn’t seem to be the case. The business intelligence platform SEPREMI has recorded no government procurement of contraceptive products in any of the 15 Latin American and the Caribbean countries that contribute data to it. It is not uncommon, experts say, for countries to drag their feet till the last moment, placing urgent orders when the need becomes too large to ignore, after months of toying with the idea of completing an order. What many countries may not realize is that when they do place their orders, they may be in for a major shock.
As COVID-19 sneaked into 2020 and began to compromise supply chains everywhere, this situation continued to become increasingly tenuous. As public spending got rerouted into COVID-19 medications and personal protective equipment, new RH commodity procurement dwindled in many countries. Yes, with COVID-imposed curbs on movement and services, consumption has dwindled temporarily. But when demand grows again, unsuspecting countries stand to be rudely shocked by stockouts and growing unmet need.
Strictly speaking, this is not really breaking news. Supply constraints have been with us for more than a year and a half. Back in April 2019, the Coordinated Supply Planning group, now part of the Global FP VAN, issued a global statement, advising the RH community of critical production delays for Depo Provera-IM and the likely consequences for lead times and supply shortages. And for some time now, partners like UNFPA-PSB have published regular reminders urging countries to apply foresight and to purchase contraceptives strategically.
What can countries do?
- Avoid nasty surprises: familiarize yourself with current lead times and be in the full picture.
- Don’t wait until you see the flames before you act. Yes, COVID mitigation is a priority, but when you decide the time is right to turn your attention and resources to contraceptive security, it might well be too late.
- Don’t expect anyone to come to the rescue. Don’t plan to borrow from a neighboring country or play off one supplier against another. We’re all in this boat together.
The country in dire need mentioned at the start of this story went from pillar to post in a bid to secure supplies, and finally approached a commercial manufacturer who, fortunately, was able to provide emergency stock. They were lucky. But in times like these, luck can be thin on the ground.