Procurement of medicines
Procurement involves efforts to quantify medicines requirements, selecting appropriate procurement methods, prequalifying suppliers and products. It also involves managing tenders, establishing contract terms, assuring medicines quality, obtaining best prices, and ensuring adherence to contract terms. Procurement methods need to be strengthened to ensure that procurement is linked to national medicines lists and prescribing patterns.
The growing number of players involved in the procurement and distribution of medicines at the country level has lead to a lack of coordination of medicines supply systems, particularly for priority diseases, often resulting in duplication, inefficiency and increased workload at the facility level. Assessment of national procurement and distribution systems is carried out by gathering data from all partners involved in the process on: the category of products supported, the financial investment in the product, the procurement agent used by the donor, and the ensuing storage and distribution channels. Since 2007 WHO has supported sixteen countries to assess and map their medicines supply systems. These findings are being disseminated and used to support country specific strategies to strengthen medicines supply management capacity and promote better coordination between procurement bodies.
Tools for mapping financial flows for medicines procurement and distribution, and for rapid assessment of medicines supply management systems
The assessment in Burundi revealed that there are 25 partners providing financing for procurement and these partners have 22 different agents procuring for these partners; almost one agent per development partner. This situation is not positive for health system strengthening. This lack of coordination is similar across many countries where the WHO assessment tools have been used.
In Tanzania, 60% of bilateral partners interviewed use their own procurement agents while 54% of all partners interviewed use their own agents and deliver products directly to selected beneficiary health facilities. Setting up parallel systems for procurement is not the best cure an already weak system. Capacity can be built by allowing the public procurement system to function and to correct mistakes, thereby strengthening the system. Even in the most developed countries, public procurement systems are not as complicated as what has been revealed by the assessments in countries.