Reproductive Health Commodity Security Global Programme to Enhance RHCS

1. Reproductive Health Commodity Security Global Programme to Enhance RHCS Presentation to Reproductive Health Supplies Coalition UNFPA HQ, New York City, 27 April 2006

2. RHCS is achieved when all individuals can obtain and use, affordable quality reproductive health commodities of their choice whenever they need them. RHCS is more than a supply side issue - also has elements related to quality of care, policy environment, access and demand. Success will depend on everyone – UNFPA and its RHSC partners – taking ownership of the GP and feeding into parts of it of most relevance to their work. Purpose of Global Programme:To Enhance RHCS

3. Broad range of commodities for: Obstetric and maternal health care Prevention, diagnosis and management of reproductive tract infections and sexually transmitted infections Family Planning and Sexual Health -Contraceptive commodities including male and female condoms for STI/HIV prevention What is meant byRH Commodities?

4. Global Programme to Enhance RHCS: Objectives • Build on earlier national and international efforts in the area of RHCS and, specifically: • Act as a catalyst to facilitate nationally driven efforts to mainstream RHCS; • Secure dependable funding flows to implement multi-year plans of action to enhance durable RHCS at national level; • Help promote strategic international support for RHCS.

5. Why do we need the Global Programme? • If RHCS is UNFPA core business why not funded from core resources? •  Limited core funds for multiple activities; RH commodity and capacity building needs dwarf resources • Need to accelerate efforts to strengthen and integrate health system development [urgent needs re ICPD + MDGs] • Predictable resource flows will facilitate qualitatively stronger dialogue; need to tackle unpredictability issue • RHC shortages are endemic; GP offers new partnership approach supportive of national processes • Not vertical programme but flexible mechanisms to facilitate policy dialogue with governments so they can mainstream RHCS

6. Global Programme: Unmet need and funding gap • Clear unmet need, particularly in sub-Saharan Africa • E.g. In Ethiopia, DHS shows CPR gone from 8% to 18% though unmet need is 22% and demand has increased; Same situation in all continents and, particularly, among the poorest populations • GP aims to secure commodity supply but is also very much about investments to strengthen health systems • Where current technical capacity low: national coordination, structures and ownership needed • Integrated human rights approach aims to strengthen broad national development with focus on end user • GP seeks to catalyse national efforts to ensure reliable RH supplies

7. Global Programme to Enhance RHCS: What’s new? • Inspired by the Paris Declaration, GP puts national governments at centre of decision-making process and encourages alliances of all relevant national stakeholders to define, own, drive the national RHCS strategy • GP does not detail activities as countries are yet to decide what to do • GP provides a framework and defines a set of parameters within which actions are recommended • GP’s country level objectives are defined in the document • UNFPA [with development partners] to facilitate country level work and provide requested technical support

8. Global Programme: How will funds be allocated? • Appeal for US$150 million per year for five years • Countries will be required to apply for funding under three separate funding streams [1, 2 and 3] • Category A and B countries eligible for funding from all streams [1, 2, 3] • Streams 1 and 2 will fund capacity and systems enhancement as well as planned RH commodity provision [<50% of GP funding for capacity and systems enhancement; >50% for planned commodity provision] • Stream 1 funding for 5 years will be for integrated RHCS Plan of Action • Stream 2 funding for 1-3 years will be preparation for stream 1 • Stream 3 funding will be available to meet emergency commodity needs

9. Global Programme: Indicative Budget Table [millions of US$]

10. Global Programme: How will Countries be selected? • Streams 1+2: Countries to apply for GP funds through a simple application process that outlines how funds would be used and • [1] demonstrates commitment to enhancing RHCS [government; other national stakeholders; international development partners] and • [2] provides evidence of / will to develop integrated, systematic approaches - with RHCS underpinning improved SRH[/MH]; • [3] details experience of / and future plans to promote/facilitate RHCS using development frameworks SWAps, HSR, PRS, etc. • Stream 3: Based on current system, develop a systematic approach to help promote national commitment to RHCS

11. Global Programme: Fund allocation if fewer funds? • Appeal for US$150 million per year for five years • As a guiding principle, funds are to be allocated on a pro rata basis as per the indicative budget table above [number of countries will fall; allocation per country will stay the same] • That is, if per year funding for five years is US$50m [i.e. totaling US$250 million] the figures would be divided by 3 • UNFPA would, however, seek flexibility in the allocation of funds of less than the US$150 million per year requested

12. Global Programme: Oversight mechanisms? • UNFPA Executive Board will receive regular progress reports and be the highest policy decision body for GP • A Technical Review Panel [TRP] made up of 6 recognised health experts to be established to make recommendations re. [i] fund allocation and [ii] approval of national RHCS Plans • 6 bodies to be invited to nominate experts are: [a] international HIV/AIDS community; [b] Partnership for Maternal, Newborn and Child Health; [c] Foundations active in developing country health sector; [d] RH Supplies Coalition; [e] EU MS active in RHCS; [f] UNFPA [to act as Chairperson].

13. Global Programme: National Coordination • UNFPA: • [a] recommends development of / support to an appropriate national body to drive RHCS nationally; • [b] will develop RHCS Orientation Tools and Guidelines to facilitate work of Country Offices and national/international RHCS partners; • [c] will facilitate an integrated strategy to develop national capacity in sphere of RHCS.

14. Global Programme: Regional Coordination • UNFPA: undertakes to develop/reinforce links with regional institutions that are active in spheres of particular relevance to efforts to promoting and facilitating RHCS. • E.g. in: [a] Capacity enhancement and training; [b] Research and Development; [c] Data collection and programme monitoring.

15. Global Programme:Global Coordination • UNFPA will continue to work: • [a] Within UNFPA, to institutionalise and mainstream RHCS; • [b] With other UN Agencies, to promote better collaboration among UN Agencies and better integration of RHCS in the context of joint country level work [including within UNDG]; • [c] With global development partners, to develop strong strategic partnerships. Focus on RH Supplies Coalition and stronger links with key funding mechanisms [e.g. GFATM].

16. Global Programme support to other work in SRH • UNFPA to use GP processes to strengthen links and facilitate work of other multi- and bilateral efforts in sphere of SRH, including MH + HIV/AIDS prevention. • E.g. work with UNAIDS under UBW; GFATM; PMNCH • GP to do this by facilitating integrated country-driven plans of action that emphasise linkages between RHCS and wider SRH/MH and HIV/AIDS prevention programmes and policies.

17. Global Programme: Country ownership Gandhi said: “If you do something for me and you do it without me, you do it against me”