UN Commission on Life-Saving Commodities for Women and Children

Commission on Information and Accountability WHO

Commission on Life Saving Commodities for Women and Children UNICEF and UNFPA

Commission Chairs
Kikwete, President of Tanzania Harper, Prime Minister of Canada

Commission Chairs
Goodluck Jonathan, President, Nigeria Jens Stoltenberg, Prime Minister , Norway

20 Commissioners
Michael Anderson, Director-General for Policy and Global Programmes, DFID H.E. Zainab Hawa Bangura, Minister of Health and Sanitation, Sierra Leone MK Bhan, Secretary to the Government of India Department of Biotechnology Heather Bresch, CEO, Mylan Inc. Dan Brutto, President, UPS International Ray Chambers, UN Secretary-General's Special Envoy for Malaria Gary Cohen, Executive Vice President, Becton Dickson Bob Collymore, Chief Executive Officer, Safaricom Jamie Cooper-Hohn, President and CEO, Children's Investment Fund Foundation Christopher Elias, President for Global Development, Bill and Melinda Gates Foundation Kenneth C. Frazier, President and CEO, Merck Julio Frenk, Chair, Partnership for Maternal, Newborn and Child Health Teguest Guerma, Director General, AMREF Per Heggenes, CEO, IKEA Foundation Robert Lee, President, Shanghai Fosun Pharmaceutical Development Co., Ltd. Hassan Mshinda, Director General, Tanzania Commission for Science and Technology Agns Saint-Raymond, Head of Human Medicines Special Areas, European Medicines Agency Rajiv Shah, Administrator, USAID Jasmine Whitbread, Chief Executive Officer, Save the Children International Sir Andrew Witty, Chief Executive Officer, GlaxoSmithKline

Objectives
1. Identify opportunities to increase the production, supply and use of affordable, high-quality, high-impact commodities for womens and childrens health, through shaping the market,
strengthening the quality of local production capacity, promoting innovative technologies and new product development ..

2. Propose innovative strategies to support high-burden countries to rapidly increase access to overlooked commodities through
proven, private and public sector market shaping interventions.

3. Recommend strategies to raise awareness of and demand for these life-saving commodities among health care providers and endusers.

Three criteria were established for identifying a list of underutilized, life-saving commodities
1. High-impact, 2. Inadequate funding effective commodities 3. Untapped potential
Innovation and rapid increases in product development and market opportunities (including the potential for better formulations, price reduction and improved stability of supply) could rapidly improve the affordability, availability and use of selected medicines, medical devices and supplies.

Inadequate funding means the commodity lacks the monetary In general, high-impact support that would allow a commodities are those rapid increase in its distribution medicines, medical and use. Selected commodities, devices and health supplies that effectively therefore, are not funded by address avoidable causes existing mechanisms, such as The Global Fund to Fight AIDS, of death and disease Tuberculosis and Malaria, and among children and GAVI. women during pregnancy, childbirth and childhood.

13 Life-Saving Commodities
RMNCH Continuum of Care Reproductive health Commodity Female Condoms Implants Emergency Contraception Maternal Health Oxytocin Misoprostol Usage Family planning/Contraception Family planning/Contraception Family planning/Contraception Post-Partum Hemorrhage Post-Partum Hemorrhage

Magnesium sulfate
Newborn Health Injectable antibiotics Antenatal Corticosteroid (ANCS) Chlorhexidine Resuscitation Equipment Amoxicillin Oral Rehydration Salts (ORS) Zinc

Child Health

Eclampsia and Severe PreEclamsia/Toxemia of Pregnancy Newborn Sepsis Respiratory Distress Syndrome for preterm babies Newborn Cord Care Newborn Asphyxia Pneumonia Diarrhea Diarrhea
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Three work streams of the Commissions Working Group

Cross-cutting barriers
Regulatory challenges - Many developing countries suffer from inadequate
regulatory capacity that leads to delayed registration of essential medical commodities, low quality medical commodities in the marketplace, and inefficiencies that drive manufacturers away.

Market failures - A market trap is a vicious cycle in which manufacturers expect

that investments in certain products will not result in large sales and profit, so existing manufacturers have no incentive to improve poor quality products, and new manufacturers have no incentive to bring new products to market.

User supply and demand challenges- Examples include: low demand for the
product by prescribers and patients, local delivery and distribution break-downs at or near the patient/caregiver level, and incorrect prescription and use. Opportunties include: innovative approaches to product formulation, packaging and/or delivery devices, and harnessing social media and mobile technology to promote demand, proper use, and manage supply bottlenecks.

Recommendations in 3 Strategic Areas

Improved markets for life-saving commodities 1. Shaping global markets 2. Shaping local delivery markets 3. Innovative Financing 4. Quality strengthening 5. Regulation efficiency Improved national delivery of life-saving commodities 6. Supply and awareness 7. Demand and awareness 8. Reaching women and children 9. Performance and accountability Improved integration of the private sector and consumer needs 10. Product innovation
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Implementation
23 working groups (13 commodities + 10 recommendations) Technical experts engage for change at the global level

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22 Working Groups Cross-cutting areas 1. 2. 3. 4. 5. 6. 7. 8. 9. Shaping global market Shaping delivery markets Innovative Financing Quality strengthening Regulation efficiency Supply and awareness Demand and awareness Reaching women and children Performance and accountability

Conveners CHAI, DFID CHAI, Gov. of Nigeria World Bank, Norway WHO, Gov. of Nigeria WHO, Gov. of Nigeria USAID, UNFPA USAID, Gov. of Tanzania Gov. of Uganda, Save the Children AMREF, m-Health Alliance PATH USAID UNFPA SNL Save the Children, BMGF PATH USAID UNICEF, CHAI CHAI, UNICEF UNFPA BMGF, DFID WHO
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10. Product innovation Commodity-specific areas Oxytocin, MgSO4 Misoprostol, Female Condoms Injectable antibiotics Antenatal Corticosteriods Chlorhexidine Newborn resuscitation Equipment Amoxicillin ORS, zinc Female condoms Contraceptive implants Emergency contraception

UNCoLSC Working Groups & Conveners

October 2012, Abuja: 8 Pathfinder Countries

1. 2. 3. 4. 5. 6. 7. 8. DRC Ethiopia Malawi Nigeria Senegal Sierra Leone Tanzania Uganda
16 October 2012: Ministers of Health sign Abuja Declaration 12

National leadership is the key element

The goal of engagement at the country level is to:
Sharpen existing RMNCH plans to ensure alignment between interventions/ strategies and the local situation. Identify and prioritize key high-impact interventions for scale-up. Develop a concept note that outlines key catalytic, highimpact, cost-effective interventions; existing funding and funding gaps.
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Country planning for 8 pathfinder countries The Nigeria example

Priority commodities Priority interventions (LiST) Burden of disease

AIM: to rapidly increase access to and use of ORS, zinc , amoxicillin DT and CHX

Focus on local market shaping and on access/demand

Process for Landscape Analysis of RMNCH Programmes

(Addressing the goals of EWEC, A Promised Renewed, and UNCoLSC)

2011, September : UN SG calls Exec Directors of UNFPA and UNICEF to organize a UN Commission on this issue 2012 , March UN Commission in launched Implementation plan endorsed + funding is announced 2012, September 26 Goodluck Jonathan, President, Nigeria and Jens Stoltenberg, Prime Minister, Norway handover the Commission Report to the UNSG 2012 , October 16, Abuja meeting President Goodluck Jonathan hosts a Commission meeting in Abuja countries sign the Ministerial Communique

2012 Nov onwards - Planning and action Country planning in 8 pathfinder countries Implementation for the 13 commodity and 10 recommendation groups

RMNCH Fund
Purpose: Mobilize catalytic funding for national RMNCH strategies Hosted by UNFPA Secretariat housed at UNICEF, with staff from WHO, UNFPA, UNICEF Secretariat managed by Pascal Bijleveld Steering Committee to advise donors, based on analysis by Commission working groups, H4+, IHP+ etc.
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Next steps
April 2013 Finalization by Government and country stakeholders of sharpened national RMNCH plans Steering Committee meeting to review country engagement progress and strategy for the coming year Harmonizing work- G8 Muskoka Initiative, H4+, FP2020, A Promise Renewed, Commission on Information and Accountability (CoIA) and the UN Commission on Life-Saving Commodities for Women and Children (UNCoLSC) June 2013 8 Pathfinder country Ministers of Health meet in Dakar to share best practices and progress, as agreed in Abuja
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