The East African Community (EAC) partner states are set to significantly reduce spending on medical products by pooling resources to purchase them in bulk directly from manufacturers. The implementation of this approach, known as the EAC Pooled Bulk Procurement Mechanism (EAC PPM), was rolled out on Monday, March 24, at a high-level regional meeting organised by the EAC Secretariat in partnership with the University of Rwanda/East African Community Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management (EAC RCE-VIHSCM). The EAC PPM aims to ensure the timely and affordable availability of quality health commodities through an efficient and sustainable supply chain. Its goal is to provide equitable access to safe, effective, and affordable medicines. Why does the pooled procurement mechanism matter? Dr Stephen Karengera, Director of the East African Community Regional Centre of Excellence for Vaccines, Immunization, and Health Supply Chain Management, said that the procurement mechanism addresses several challenges related to access to medicines, other medical products, and technologies. By aggregating demand, he pointed out, the region can negotiate better prices with manufacturers. “When you negotiate as a region, you bring a large amount of money to the table, making manufacturers more inclined to engage,” he said, adding that this model also helps eliminate substandard and counterfeit medicines, which he said affect up to 30-45 per cent of products in the region. “We know that up to 30-45 per cent of products circulating in the region is substandard and falsified and, the pooled procurement mechanism normally blocks those loopholes or those false entrances into the supply chain, so you get quality assured cost-effective medicines for patients,” observed. Karengera underscored the importance of African self-sufficiency in healthcare, pointing to one of the biggest supporters of health programmes in the world, USAID's reduced support due to changing political dynamics in the US administration. “This is an opportunity for Africans to step up, increase the budget for health products, and not rely solely on external donors,” he said. A feasibility study conducted by UN Economic Commision for Africa (UNECA) in 2020 estimated that EAC countries' annual expenditure on pharmaceuticals was $2.67 billion annually (in 2020 USD), and the implementation of pooled procurement mechanism could result in a 43 per cent reduction in costs, hence saving the region a whopping $1.15 billion annually. Priority medical products Initially, Karengera said, the EAC focused on 50 fast-moving medical items (which can easily be negotiated upon), based on a 2022-23 study. “We have now added on HIV/AIDS medicines because of the policies of the new US administration [which affected health programme funding in the region]; we have added on medicines for children, mothers and reproductive health,” he said. Overall, he said, the broad range of medical products aims to address regional shortages, particularly in hard-to-source medicines. Diana Mutoni, Deputy CEO of Rwanda Medical Supply, observed that the pooled procurement model would resolve challenges related to low-volume orders for some medical products, whereby the demand was falling short of the minimum supply quantity. “We need them in very few quantities and there are stringent processes, regulatory processes for getting them into the country. So, they've been challenging us and some products for HIV, like for the opportunistic infections, they were also challenging. But now, with this pool procurement method, the problem is going to be solved,” she stated. As a result, we've faced challenges, particularly with some HIV-related products, such as those for treating opportunistic infections. However, with the implementation of this pooled procurement method, the issue will be resolved, she stated. Andrea Aguer Ariik Malueth, Deputy Secretary General for Infrastructure, Productive, Social, and Political Sectors at EAC, underscored the importance of timely access to quality medicines for a functioning healthcare system, adding that importance of the event was to make a bold call to all key actors to start effective implementation of the bulk pooled procurement in our region. “We are intending to buy from one source, pool together and then distribute within East Africa. This is to make sure we get quality medicines and timely supply to the people of East Africa. This is in line with our vision for a healthier and a prosperous East Africa,” he said, adding that the new model will give bargaining power to the region and make it have discount on purchases through economies of scale. Fatuma Ndangiza, a member of the East African Legislative Assembly (EALA), pointed out that it is crucial to ensure effective implementation for the benefit of citizens through “access to quality medicines and vaccines in a way that is more efficient, affordable.” Our role as EALA is to fast-track legislation if needed and ensure proper oversight, she said. The development of the EAC Pooled Procurement Mechanism and its enabling information platform follows a directive from the EAC Sectoral Council of Ministers of Health, issued on March 26, 2019, in Dar es Salaam, Tanzania. The Monday event preceded its final launch scheduled during the upcoming EAC 25th Sectoral Council of Ministers of Health.
