Global Contraceptive Commodity Gap Analysis

Posted by Tara Asgarilaleh on July 2, 2018 at 1:21 pm



This edition of Global Contraceptive Commodity Gap Analysis
2018 (CGA 2018) is the Reproductive Health Supplies
Coalition’s fourth report to highlight disparities between the
growing demand for family planning services and the
resource base required to provide the supplies on which
services depend.
The first two reports, published in 2001 and 2009,
examined funding shortfalls in the public sector alone. Our
third report, the Global Contraceptive Commodity Gap
Analysis 2016 (CGA 2016), broadened the scope of analysis
to include the private as well as the public sector. It
expanded the range of countries to include 135 low-and
middle-income countries, and it projected two growth
scenarios: one based on historical trajectory, the other on
the achievement of the FP2020 goal of 120 million
additional users of family planning in 2020. It also drew on
input from the reproductive health community to identify
four key questions to guide the analysis:
› How much is spent on contraceptive supplies, and what
are the relative contributions of donors, governments,
and individuals?
› How many women use each method of contraception,
and what volume of supplies do they consume? How
much will these figures change by 2020?
› What is the cost of the volume of supplies currently
consumed by all users of contraception? How much
greater will the cost be in 2020?
› Will funding gaps emerge as we move closer to 2020? If
public sector funding does not increase, what burden will
shift to individual users of contraception?
In this edition of the CGA, we follow the broad outlines set
out in 2016. We project growth in contraceptive use along
each country’s historical trajectory and revisit the four key
questions. We also, for the first time, probe more deeply into
the division between the public and private sectors. We
draw on updated data from the diverse sources we used last
year, and introduce entirely new data – particularly data on
private sector pricing and procurement. We also reflect, in a
more nuanced way, the implications of declining public
sector funding for the role of the private sector, in terms of
the latter’s absorptive capacity, equity, and contraceptive
availability.
The results of this analysis suggest that by 2020, there will
be 493 million users of contraception in the 135 low- and
middle-income countries, of whom 337 million will live in
the 69 FP2020 countries.
Meeting their contraceptive consumption needs over the
next three years will require $8.45 billion across the 135
countries, and $3.5 billion in the FP2020 countries alone. In
both cases, out of pocket expenditures will account for the
vast majority of that financing. The new data have also
allowed us to see an inverse relationship between cost and
users across the public and private sectors. Among the 69
FP2020 countries, for example, we found that while the
public sector contributed only 37% to total spending, it
actually supported 58% of users.
Many of the findings and observations contained in this
report have already been shared at public fora and our
analysis has benefitted immensely from the feedback to
emerge from these exchanges. This has been especially true
with respect to our analysis of private sector pricing, which
now carefully applies both full market price retail sales
(based on newly acquired pricing and sales data from IQVIA)
and subsidized products sold by social marketing and other
non-public organizations.
Through this insight and a richer array of data, we can better
appreciate the differences not only between the public and
private sectors, but also within the sectors themselves. The
data reveal dramatic price variations for core contraceptive
commodities, and they document how these variations
manifest themselves, both geographically and by product.
As our community increasingly turns its attention to
operationalizing the Sustainable Development Goals,
understanding better the role of donors, national
governments, and the private sector will be critical.
Commodity financing over the next decade will see a
declining donor resource base – about that, there is little
debate. Out of pocket expenditures will increase, as will the
contributions of national governments. But as we plan for
the coming decade, the real challenge will be to figure how
to make the most of our existing resource base; how to
allocate resources that maximize both comparative
advantages and manageable interests. This report goes a
long way to providing the evidence that will help answer
these pressing questions. It reminds us, as the saying goes,
to mind the gap.

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