Have you experienced any obstacles in your work trying to improve open contracting, what were they and how were you able to overcome them?
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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?
Examples of national pharmaceutical procurement and supply chain institutions were identified through rapid search and input from experts. Institutions identified were largely from Africa. Up-to-date details of the governance of these institutions was not easy to find within the scope of this work. The resources in the annotated bibliography of this report include grey literature and media articles to give some information where strong evidence in this area is lacking. This overview highlights some of the findings on institutions from different countries.
Open Contracting for Health (OC4H) is a DFID-funded project which seeks to improve the transparency and accountability of public procurement in the health sector. By ensuring that the procurement of things like medical supplies and the building of health centres is conducted openly and transparently, it greatly reduces the chance of a situation like that in Aromo repeating.
In Lira County, Uganda, Transparency International Uganda has worked with and trained individuals representing three key stakeholder groups:
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