Market Development Approaches Working Group Update November 2007 – May 2008

1. Market Development Approaches Working Group Update November 2007 – May 2008 Ben Light MDAWG Leader, Reproduction Health Supplies Coalition MDA Update, RHSC membership meeting

2. Objectivesfrom Strategic Plan • Mobilize public sector and total market resources at country level • To increase by 2009/2015 utilization at country-level of the private sector to secure RH supplies and services • To increase by 2009/15 funding for RH supplies and supply systems at country-level through alternative domestic financing mechanisms (e.g., community health insurance, third-party payers, employers) MDA Update, RHSC membership meeting

3. Objectives from Strategic Plan • Strengthen capacity at country level to ensure and sustain functional RH supply chains across all sectors • By 2009/15, to increase the number of LMI countries and organizations procuring pre-qualified RH supplies • By 2009/15, to increase the number of LMI countries with effective supply chains in the private and other non-public sectors. MDA Update, RHSC membership meeting

4. Members • Six to 12 members meeting in teleconference every four to six weeks for last six months • Increase of members raises potential to increase number of strategies for MDAs • Current focus is finalising the definition of the new MDA workstreams and involving as many members as possible MDA Update, RHSC membership meeting

5. Achievements • MDA members’ regular teleconference • Analysis of RHSC Strategic Plan as foundation for definition of workstreams • Development of several workstreams [some still outstanding] • Discussion on how to manage the expanded MDA WG • Time to move to a practical exercise? MDA Update, RHSC membership meeting

6. MDA Workstreams Market Segmentation Toolkit [WS1] • Promote more effective market segmentation approaches to identify different RH consumer segments that can drive supply and demand creation strategies • Improve efficiency, reduce unneeded subsidy by coordinating the public and non-public market players toward appropriate market segments MDA Update, RHSC membership meeting

7. MDA Workstreams Market Segmentation Toolkit [WS1 - cont] • An inventory of approaches and segmentation bases [demographic, psychographic, risk profiles, wealth, etc.] • Strategies for matching sources of supply to consumer segments • Dissemination of tools, case studies on effective use of segmentation and sources of data MDA Update, RHSC membership meeting

8. MDA Workstreams • Indicators to measure total market development [WS2] • Establish and promote a consensus on indicators to be used in judging success in development of total market approaches to better inform programme design and evaluation • Indicators to judge market size, accessibility, equity and sustainability • Guidance on issues of measurability, reliability and cost MDA Update, RHSC membership meeting

9. MDA Workstreams Targeted Global Advocacy for Market Development Approaches [WS3] • IMS-Type Data-Base – In contact with International Pharmaceutical Association and IMS re work improving private sector supply chains for essential medicines; looking at whether [and how] RH supplies can be included in forthcoming surveys in Ghana and Gambia • DHS Modification – Paper prepared to advocate for changes to DHS questions to elicit information relevant to MDAs MDA Update, RHSC membership meeting

10. MDA Workstreams • Facilitating the availability of quality Generic Supplies [WS4] – with SS WG • Pre-qualification of RH products [Condoms, TC380A IUD] to ensure increase of pre-qualified products: working closely with WHO/UNFPA • Hormonal contraceptives: TA required by many potential suppliers to meet CGMP and complete dossiers for pre-qualification programme • Information and advocacy required for pre-qualification programme by many stakeholders [now SS WG work] MDA Update, RHSC membership meeting

11. MDA Workstreams • Facilitating an enabling environment for the non-public sector [with RMA WG?] • Emphasis on supporting stewardship role of government in ensuring health of whole population; • Recognition of significant role of non-public sector in health service provision • Promote enhanced cooperation and collaboration between public and non-public sector [QoC, QA, QC?] MDA Update, RHSC membership meeting

12. MDA Workstreams • Involving manufacturers in MDA work [WS6] • Focus on issues including: • Question of pricing versus choice • Procurement mechanisms • Registration processes • Import duties/procedures • Access to reliable data • Market segmentation and targeting • Marketing and market growth MDA Update, RHSC membership meeting

13. MDA Workstreams • Demand creation [WS7] MDA Update, RHSC membership meeting

14. MDA at a crossroads • Securing dedicated MDA time [conflicting priorities of day job] • Defining workstreams as foundations for action • Momentum building for a practical exercise to put ideas into concrete action MDA Update, RHSC membership meeting

15. MDA - management Four key areas; four sub-groups? • Facilitating government stewardship role ensuring health of all [Public sector focus] • Reaching the end user: access, demand, equity [social marketing, cost recovery, market segmentation, social insurance...] • Ensuring quality supplies: Pre-qualification, Quality assurance [with SS WG] • Involving manufacturers in MDA work MDA Update, RHSC membership meeting

16. Total Market Initiative Practical MDA Exercise – total market initiative in a country to hone and share ideas of the workstreams. Facilitate market segmentation with broad range of in-country stakeholders from public and non-public sector; Define targets, roles, responsibilities of groups involved; Need to build consensus; Draft plan and methodology; Select country; revise; finalise. Secure funds, implement. Scope for integrating MDA, SS, RMA work. MDA Update, RHSC membership meeting

17. Total Market Initiative Country or “market” selection criteria; • Government stability and support for concept; • Some potential for profit and commercial brands registered and in the market • Potential for growth and significant RH needs • Existence of NGO and SMO players in the market • Manageability and high probability for success MDA Update, RHSC membership meeting

18. Total Market Initiative Possible components of initiative: • Formative research to identify market segments • Advocacy around segmented approaches and consensus on matching providers to segments • Generic demand creation for RH products and services • Targeted subsidy schemes • Ongoing advocacy and supportive policy work • Evaluation and lessons learned MDA Update, RHSC membership meeting

19. Next steps • Complete definition of workstreams • Total Market Initiative practical exercise [?] – develop, revise, etc. • Redefine management structure of MDA? • Organise next MDA meeting in Autumn 2008 [Developing world? Africa?] MDA Update, RHSC membership meeting