3M (Money, Markets, Movement) - Operationalizing the Coalition’s new workplan

Publication date: 2021

Operationalizing the Coalition’s new workplan The Reproductive Health Supplies Coalition (RHSC) has embarked on a new four-year agenda to make sure that people in the world’s poorest countries can access and use a full range of affordable, high- quality reproductive health supplies. This brief aims to help members of the Coalition’s working groups, caucuses and other implementing mechanisms define their part in furthering this new agenda. It follows the journey from input to impact, revealing how the Coalition’s levers of change make it possible to pursue an agenda built around three key drivers of change: money, markets and movement; and then presenting the indicators against which progress will be measured. The RHSC’s new four-year program of action is focused on achieving the four strategic pillars enshrined in our 2015-2025 Strategy: availability, quality, equity, and choice. To reach those pillars, we will tap the assets our global partnership can bring to bear – the creativity and engagement of our membership; the technical expertise of our global brain trust; and the legal and fiduciary capabilities of a hosted Secretariat. As shown in in the Theory of Change, our journey from input to impact will yield outputs aimed at overcoming three key bottlenecks to commodity security identified in our recent 2030 RH Supplies Ecosystem Analysis. These include: (1) inadequate funding to meet the growing need for reproductive health supplies; (2) power imbalances that de-incentivize growth and new investment in the supplies market; and (3) weak supply chains that hinder the efficient movement of supplies from manufacturer to last mile. These “3 Ms” — money, market, and movement — will form the bases for our engagement in the coming four years. They will shape our interventions on the ground; they will inspire and guide our research; and they will inform the conversations within our implementing mechanisms, our general membership meetings, and our community outreach. To help our implementing mechanisms determine how they might contribute to our new four-year agenda, we present below the concerns and issues underlying each of the 3 Ms. We do so, however, without presuming which concerns offer the greatest opportunities for any given implementing mechanism. We know from nearly two decades of experience that delivering change is both a collective and an exploratory effort that takes us in directions often unseen at the outset. So, our aim is to leave to each implementing mechanism the choice of what it wishes to do, with whom, and when. Just as important as understanding the rationale behind each of the 3 Ms is knowing the indicators that will be used to measure our progress. The desire to confront problems and issues can lead in any number of directions, only some of which will actually meet the deliverables in our monitoring framework. While these do not exhaust all the options open to us, making our deliverables explicit does make it easier to determine which activities make the most sense, both for our implementing mechanisms and the Coalition as a whole. MONEY, MARKETS, MOVEMENT Updated: February 2021 Theory of Change MEMBER ENGAGEMENT Cultivation of new ideas and approaches for field-based interventions by member organizations and their implementing mechanisms. AVAILABILITY • New resource streams mean more products reaching more women. • Better supply chain visibility and management lead to fewer stockouts. • Better market intelligence facilitates production planning and supply flow. MONEY • Initiatives directing donor attention to the RH supply needs of vulnerable countries and populations at risk of falling through the cracks. • Advocacy efforts at country level to increase domestic public sector investment to further RH commodity security. • Replication of successful efforts to grow the contribution of private sector financing to commodity procurement. COUNTRY-LEVEL • Fewer countries without the requisite donor funding needed to ensure RH commodity security. • Domestic public sector resources for RH commodity security increased and used more efficiently. • More women getting the quality RH supplies they need due to more efficient flow of products from manufacturer to the last mile. • Sustained delivery of RH supplies by applying the lessons of current COVID-19 mitigation efforts. • Sustained entry of new supply chain managers and logisticians. GLOBAL LEVEL • A larger buyer- and supplier-base in the global market for RH supplies. • Comprehensive market data available for manufacturers to assess demand, plan production, and understand global supply options. • A more inclusive and stable RH supplies marketplace that balances and harmonizes the interests of all public- and private-sector actors. • Sustained entry of new supply chain managers and logisticians. MARKETS • Diagnostic efforts to improve market intelligence across the full spectrum of RH products. • Platforms for knowledge sharing, dialog and consensus building amongst market players at both country- and global-levels. • Assessments of the opportunities and challenges associated with innovative procurement strategies including pooled procurement and e-procurement. MOVEMENT • A functional and financially sustainable VAN that tracks and ensures uninterrupted product flows from manufacturer to the last mile. • National e-LMIS systems successfully linked to the VAN. • Field tests of interventions to overcome COVID-19-related supply chain constraints and risks. • Young people accessing a fully operational LAPTOP course- finder, career video series and scholarship program. TECHNICAL EXPERTISE Application of the RHSC’s brain trust (including in-house technical expertise) to undertake research, diagnostics, analysis, and tool development (Commodity Gap Analyses, landscape analyses, etc.). QUALITY • Less product degradation due to better functioning supply chains. • Manufacturers incentivized to pursue quality assurance due to better market intelligence. EQUITY • Marginalized populations better served by providers able to offer access to more affordable supplies. • New domestic funding streams targeted to those most in need. • Supply bottlenecks (especially at the last mile) identified through market research. CHOICE • More products, more choice as manufacturers are incentivized by the prospect of healthier markets, increased demand, and opportunities for market entry. • More efficient supply chains facilitate flow of more products to those who want them. INSTITUTIONAL SUPPORT Financing and administrative support made available to advance the broader RHSC agenda (management of Innovation Fund; contract management, legal support). OUTPUTS Coordinated effort to address three key supply bottlenecks identified in the 2030 RH Supplies Ecosystem Analysis OUTCOMES Results of activities undertaken under 3Ms both globally and at country-level IMPACT Contribution of this initiative to the RHSC’s strategic pillars INPUTS The RHSC’s six levers of change are brought to bear through the following MONEY The first bottleneck, money, refers to the resources needed to finance supplies. Current trends suggest that donor funding for family planning and other reproductive health supplies will almost certainly decline over the coming decade. National governments will struggle to make up for the loss in that funding, meaning that an increasing share of commodity financing will come from out-of-pocket expenditures. Depending on countries’ dependency on donors and their domestic resource base, the growing funding gap will have implications for a host of issues: the sustainability of public-sector reproductive health programs; the capacity of governments to compensate for the loss of donor funds; growing reliance on out-of-pocket expenditures; and future prospects for product choice and access. Clearly, each issue reflects a complex confluence of factors. But ultimately, money lies at the root of them all: how much there is, where it comes from, and how efficiently it is spent. . and speaking of money Implementing our new workplan will require resources. Nearly a third of the total budget of $35M has been set aside for “program interventions”. And of that amount, approximately $3.7M will be allocated on a competitive basis to RHSC members. This includes funding for consultants, Innovation Fund, advocacy, initiatives to advance end-to-end visibility, and recommendations from the JSI/RHSC COVID road map survey. OUTPUTS Our workplan for the next four years envisions three sets of activities, each grounded in one of three funding sources. In the case of donor funding, we will work to ensure that countries truly in need of such support do not fall through the cracks. Given our presence on the global stage, our close partnership with key international donors, and our ability to leverage the voices of advocates and social media, we are well positioned to ensure that those countries most in need remain front and center on the radar screen of the donor community. In the area of domestic funding, we will advocate for governments to increase domestic investment in reproductive health commodity security. Our hope is to see governments increase commodity procurement; invest in efforts to strengthen national supply chains, build robust supply plans, and engage in global supply networks such as the VAN (Global Family Planning Visibility Analytics Network); modify cumbersome regulatory provisions that delay product entry and discourage manufacturers from introducing new products; and pursue proven strategies that allow governments to realize greater value for the money they do invest. Finally, we will grow the contribution of private sector financing to commodity procurement. We will explore the effectiveness of current public/private partnerships, share the success of public sector interventions with the private sector, and build on earlier RHSC research which demonstrated the potential for impact investment in emerging-market manufacturers and product positioning. $3.7M to be allocated competitively to RHSC member organizations DELIVERABLES By the end of this workplan, we are committed to demonstrating evidence of: + RHSC-supported initiatives that lead to increased domestic public investment in RH commodity security. + Coalition-supported initiatives that support for increased private sector engagement in RH supplies procurement and management. Activities may include webinars, meetings, publications, advocacy with targets groups and individuals. MARKETS The second bottleneck is the marketplace for reproductive health supplies, which buyers and suppliers concede is becoming increasingly fragmented, vulnerable to interruptions, and inconducive to market entry or product innovation. Healthy markets hinge on expectations of fair pricing and thrive where players can act strategically based on reliable intelligence and mutually acceptable rules of engagement. OUTPUTS Over the next four years, we will provide market actors—global, national, private, and especially public—with the information needed to act in an informed manner and with a view to the total market. First, we will lead efforts to improve market intelligence across the full spectrum of reproductive health products, thereby reducing uncertainty over the demand for new products, which often undermines decision-making by buyers and sellers. We will fill this information gap by tapping into the data collection and analytical skills of our membership. Secondly, we will provide a neutral “safe space” for critical conversations, sometimes commercially sensitive discussions, at the heart of the global marketplace—conversations which the principal protagonists, buyers and sellers, often have difficulty communicating face-to-face. They include issues such as quality assurance, market shaping, regulatory approval and contract management. One potential area of engagement, currently under consideration, is a new Market Access Initiative, which recognizes that community-wide efforts will be required to address today’s market challenges, both globally and at country level. Finally, we will Identify ways to extend many of the benefits achieved in public sector procurement to national governments and the private sector. Innovative approaches such as e-commerce offer new opportunities to manage procurement more efficiently and to do so in line with all players’ interests – manufacturers, procurers, and private sector actors. We will, therefore, study the potential for wider application of e-procurement. Ultimately, our aim will be to foster discussion among relevant stakeholders; assemble technical experts and national decision-makers to weigh-in on the opportunities and challenges associated with e-procurement; document lessons- learned through published reports and white papers; and finally, formulate recommendations for further action. DELIVERABLES By the end of this workplan, we are committed to demonstrating evidence of: + Diagnostic and other landscaping exercises undertaken and published to clarify the market factors affecting supply and demand of reproductive health products. + Tools applied to estimate demand for reproductive health products, improve forecasting, and/or coordinate procurement. Global and national decision-makers need accurate information to ensure that product volumes meet demand, that budget allocations for reproductive health products are accurate, and that global supply systems are stable. Tools may include the VAN, Commodity Gap Analysis, SEPREMI, D-RISC, MICRO, and others. + Coalition-supported meetings (physical or virtual) that bring together procurers, suppliers, and/or other market players to address concerns such as quality assurance, market shaping, and product registration. The Coalition offers a neutral platform for raising and addressing concerns among procurers, suppliers, donors, and other key market players. MOVEMENT The third bottleneck is the movement of reproductive health supplies from manufacturer to the last mile—movement that is often undermined by limited visibility into critical supply data, weak estimations of supply chain costs, the existence of duplicative, parallel supply chains; the absence of consistent criteria for assessing supply chain maturity; and limited human resource capacity for effective supply chain management. OUTPUTS As a global partnership, admittedly at some distance from actual product flows, we see our contribution as resting in four distinct areas. First, we will advance the agenda of the VAN so that supply chain players, both upstream and downstream, can estimate supply needs, procure and distribute products, and advocate for adequate funding. In situations where global supply is constrained, the systematic collection, sharing and use of supply chain data will be critical to balancing stock levels and coordinating shipments across countries. Second, we will pursue the goal of end-to-end supply chain visibility by working with a select group of countries to link their national Logistics Management Information Systems to the global “trunk line,” of the VAN—a linkage would allow for the flow of information circulating upstream to draw more deeply from countries and the data circulating at the country level to flow upward. Thirdly, we will help the community sharpen its focus on pandemic- related supply issues and galvanize action to mitigate their effect on the flow of reproductive health products. In addition to serving as a clearing house for COVID-19 supply-related issues, we will support implementation of key recommendations to emerge from a joint RHSC/JSI effort to develop a community road map for achieving greater supply chain resiliency in the short term and a more coordinated reproductive health community response in the longer term. Key themes include globalization of supply chains, more localized manufacturing, COVID-engendered threats to contraceptive access, and consumer-based insight into supply chain constraints. Lastly, we will work to replenish the ranks of supply chain professionals who, in response to COVID mitigation efforts, have either retired or switched to new employment. By flagging educational opportunities, providing scholarships, and showcasing the life of supply chain managers, we will bring new entrants— particularly women—into the field. DELIVERABLES By the end of this workplan, we are committed to demonstrating evidence of: + Countries having linked their e-LMIS to the VAN as a result of RHSC engagement. + New supply initiatives launched in Francophone Africa whose inspiration can be traced to actions undertaken in connection with the recent devolution of decision-making authority under the VAN to the West Africa region. + Countries having submitted country supply plan data to the VAN + New members (national governments, suppliers, etc.) joining the VAN by signing its Terms of Use. + Research and/or other initiatives undertaken to address the recommendations emerging from the JSI/RHSC assessment of COVID-19-related supply chain constraints and risks.

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