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Around the world, procurement processes—which are vital to ensuring an affordable, reliable, and high-quality supply of health products—remain fraught with obstacles. Further, the ongoing pandemic is magnifying challenges, for both COVID-19-related supplies and other essential health products. This paper summarizes current challenges in health product markets in low- and middle-income countries; presents estimates for the range of potential savings that could be realized from improved procurement; and highlights possible policy options for the way forward. From simulations of three procurement reform approaches, we find that 50 of the poorest low- and middle-income countries could achieve savings between $10 to $26 billion per year, equivalent to 16 to 41 percent of the estimated $63 billion in annual spending on health products. Precise estimates of the potential savings from improved procurement of health products are difficult to compute due to scarce data. We also recognize that procurementrelated reforms are contingent on overcoming complex political-economy dynamics in the real world. Nevertheless, our findings provide an illustrative range for the magnitude of possible savings and highlight the value proposition of addressing the inefficiencies that characterize procurement systems in low- and middle-income countries. In a post-pandemic world, improving procurement of health products must remain central to countries’ efforts to maximize health outcomes—it will also ensure health systems are more resilient when the next outbreak hits.
This report was created with the following audiences and objectives in mind:
● Public procurement officials, to increase understanding about the nature of the barriers WLB
face in public procurement markets, and to recommend potential solutions, including the
collection and use of data to inform strategies supporting GRP.
● Social policy design and implementation practitioners, to understand and incorporate
linkages between policies and initiatives that support women’s economic participation and
the procurement system.
● Entrepreneurial ecosystem actors (including but not limited to businesses development
service providers, investors, banks, women entrepreneurs’ networks), to help identify
challenges for WLBs and women entrepreneurs in accessing public procurement, which can
be used to inform GRP initiatives and programs.
This report aims to evaluate the effectiveness and fit of open contracting reforms to LMIC contexts and to provide
recommendations on how and when countries should pursue open contracting reforms. This objective was broken
down into the following questions on reform outcomes and reform drivers.
1. How advanced and comprehensive is the legal framework for open contracting? How did it evolve in the last 10-
15 years?
2. To what extent are the laws relating to public procurement transparency and accountability implemented? How
did the comprehensiveness and quality of publicly available government contracting data evolve in the last 10-15
years?
3. What is the political-economic context in which public procurement occurs? Who are the main actors in
government and civil society, what are their power relations and interests? Which actors have driven or blocked
open contracting reform?
4. Which conditions and institutional capacities have facilitated or hindered public procurement transparency
reform?
5. Which reform strategies have proved most successful and unsuccessful in which contexts? What were the
typical time frames and pathways for successful reform that can inform design of future advocacy strategies?
This booklet highlights some of the World Bank initiatives in the region, which we consider good examples of what can be done to strengthen state capacity and increase citizens’ trust in their government. The booklet contains a section on “Using Data Analytics in Public Procurement to Increase Efficiency and Identify Corruption Red Flags”.
Morocco has been working in close co-operation with the OECD for several years as part of the Good Governance for Development in Arab Countries Initiative. The aim of this Initiative is to modernise public governance in the Middle East and North Africa (MENA) through a programme divided into seven key areas: integrity and prevention of corruption in the public sector; human resource management; e-government and administrative simplification; regulatory quality; relations between national, regional and local authorities; management of public finance; public service delivery and public-private partnerships.
This Joint Learning Study addresses integrity in public procurement, following the adoption of the new regulations on public procurement by the Moroccan government in May 2007.
This article discusses corruption in the South African health sector. The researchers used a combination of research methods and triangulated data from three sources: Auditor-General of South Africa reports for each province covering a 9-year period; 13 semi-structured interviews with health sector key informants and a content analysis of print media reports covering a 3-year period.
A blog by the Open Contracting Partnership describing the implementation of open contracting in Nigeria and the role of social accountability mechanisms.
The Spring 2020 Fiscal Monitor called on governments “to do what it takes” in launching emergency
measures to address the adverse impact of the COVID-19 pandemic on people and firms, “but to keep the
receipts.” Commensurate with the magnitude of the economic and health crisis, massive fiscal support
packages 2 have been adopted by governments, including a variety of revenue and expenditure measures
(e.g., additional expenditure on healthcare, cash transfers to households and businesses, loan guarantees,
and equity injections). This note argues that ensuring fiscal transparency, public accountability, and
institutional legitimacy are the main pillars of “keeping the receipts.” It provides guidance and best public
financial management (PFM) practices, drawing on cross-country examples.
TI-HI’s report “Making the Case for Open Contracting in Healthcare Procurement” examines the utility of open contracting in healthcare procurement. The process relies on governments to disclose procurement information to businesses and civil society improves stakeholders’ understanding of procurement processes increasing the integrity, fairness and efficiency of public contracting.
In several countries, including Honduras, Ukraine and Nigeria, corruption was significantly reduced throughout the healthcare procurement process following the implementation of open contracting, according to the report.
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Monitoring, Evaluation and Learning Senior Project Officer at Transparency International Health Initiative. Primarily focused on TIHI's Open Contracting for Health project, which seeks to improve health outcomes in partner countries and increase public trust in health services through increased transparency in the health procurement cycle. Also working on the ‘Improving COVID19 procurement to increase equitable access to medicines and medical equipment’ which seeks to improve transparency in emergency, specifically COVID-19 related, procurement processes. Have experience in social accountability focused, capacity building and transparency projects.