“Commodity” is a term commonly used by our community to refer to a vast range of products, from contraceptives and menstrual pads at one end, to office products and furniture at the other. Everyone has their own unique understanding of the term, a study discovered some years ago. The same study also found that a variety of terms is used to describe commodities, such as: supplies, equipment, products, drugs, and consumables.
What’s in a name? Does it matter?
Some think it does. Language influences the way health care personnel think, plan, and manage programs, write Jane Wickstrom and Roy Jacobstein, recommending that “language … should avoid terms “contraceptives”, “commodities”, or “supplies” as synonyms for “contraceptive methods”.
The rich and varied terminology used to reference reproductive health products reflects the complexity of our community.
The expression “commodity security” for example, has been an integral part of the supplies narrative since the early days of the Coalition — in part because when it was unveiled, it captured the sense of urgency encompassed by the better known phrase “food security”, wrote Julie Solo in Reproductive Health Commodity Security: Leading from behind to forge a global movement.
Some players, however, feel very strongly about the power of these names — and nowhere is that more true than within the manufacturing community.
Whatever we may call them, the products we manufacture are the lifeblood of the RH movement: as the saying goes, “no product, no program”. But precisely because that product is so ubiquitous, it fosters the impression of being fungible — easily interchangeable. In reality, some contraceptives are more expensive than others, some have a longer duration, and some are more effective, but at the end of the day, there is a tendency to regard them all as the same product: all reducible to a simple CYP calculus, with little reference to what it takes to get them into women’s hands, never mind who produced them. In other words, a contraceptive is a contraceptive is a contraceptive.
We feel the word “commodity”, at the end of the day, devalues our products in the eyes of the wider RH community.
The term “commodity” captures — literally — the essence of this concept; and we feel that its repeated use just reinforces this concept within the RH community.
So why do we care? And why should the community care?
We care because we feel the word “commodity”, at the end of the day, devalues our products in the eyes of the wider RH community. And when that product becomes part of an undifferentiated mass — like sugar or flour — whoever produces it becomes, if effect, an afterthought. Does anyone really care who manufactures either, or what it takes to do so?
What many in our community often fail to realize is that before any contraceptive reaches the hands of a user, it must meet international quality assurance standards and be registered in-country. It must be packed and stored under appropriate conditions. It must be dispensed by appropriately trained providers. And it must allow for reporting of unanticipated side effects, should they occur.
It’s not the international procurers who do these things; or the even the ministries whose staff provide family planning services. It’s us, the invisible manufacturers.
Price is always to some degree, a function of supply and demand. But unlike sugar or flour, the price of the products we make is also a function of more than just the cost of goods. Each of the activities described above has a cost — costs that some manufacturers, because of their size and product range, are better able to absorb than others. There is the need for registration, logistics support, packaging in different languages, training … the list goes on.
For a community accustomed to thinking about “commodities” — anonymous, undifferentiated, fungible goods — there are many risks to the supplies-related structures on which the international RH community has come to depend. We take it for granted that there will always be “hungry” manufacturers out there, willing to deliver the range and quantities of supplies on which our community depends. And to some extent, that may be true. But will they meet quality assurance standards? As their ranks tighten, will they be willing to sell at the lowest price? And will they continue to prioritize RH supplies, if other products offer the prospects of higher returns on investment? The answers to those questions are not so clear. And that is why the wider RH community needs to care. At the end of the day, safeguarding the products on which our programs depend means treating those products with respect.
We believe passionately in the world the RHSC is striving to create, a world in which stockouts become a thing of the past.
Our aim is by no means to ban the use of words from within the lexicon of the RH supplies community. As I noted at the beginning, we are too diverse a community with too many diverse interests to suggest that any one shoe can fit all.
But we do want colleagues within the RH space to recognize that behind the term “commodity” rests a complex reality. We believe passionately in the world the RHSC is striving to create, a world in which stockouts become a thing of the past. And we are here because we know that we are an intrinsic — if not central — part of the supplies story. We are here to address the reproductive health needs of millions of couples worldwide. And we’re hopeful that the conversations will become richer and the mutual respect greater.