The CommoditiesAdvocacy Workshop on Integrating SRH into

Round 8 GFATM ProposalsAddis Ababa, Ethiopia

February 26-29, 2008

Reproductive Health Commodity Security

• Increasing demand for family planning and other RH commodities– Growing population size– Increasing popularity of family planning (FP)– Increasing demand for condoms for STI prevention

• Unmet need for FP still very high• Donor funds not increasing (and often being diverted into condom

procurement)• Govts. often putting their own money into contraceptive

procurement• Weak supply chains hinder availability

Result: shortages, stockouts, funding gaps, incomplete method mix for FP for all users

Contraceptive Services and HIV Prevention

• International consensus that provision of voluntary FP services is a critical component of mother-to-child HIV prevention activities

• Many people living with HIV want to avoid pregnancy but need help accessing contraceptive services– 93% of pregnant women receiving ART said their pregnancies were

unintended (Uganda 2008, CDC) – 84% of women in 3 PMTCT programs in South Africa said their

pregnancies were unintended– Estimates that adding FP services to PMTCT can prevent 2x number of

HIV infections and 4x the number of child deaths as Nevirapine treatment

• Most women don’t know their HIV status; so reducing unmet need for all women will reduce MTCT

Analysis of Condom Procurement, 2004 - 2008

Male Female

Funder Units Cost Units CostIPPF 51 m $1,354,666 601,821 $470,284

UNFPA 1,282 m $38,463,664 12,481,884 $8,113,225

USAID 1,928 m $93,417,900 16,941,000 $12,571,370

GFATM 571 m $12,991,495 5,266,517 $1,641,172

Total 3,833 m $146,227,725 35,291,222 $22,796,051

Source: RHI (USAID, UNFPA, IPPF; Price Reporting Mechanism (GFATM)

Male Condom Procurement, share by funder, 2004 -2008

1%33%

51%

15%IPPF

UNFPA

USAID

GFATM

Total: 3,833 million condoms

Female Condom Procurement, share by funder, 2004 -2008

2%35%

48%

15%IPPF

UNFPA

USAID

GFATM

Total: 35.3 million condoms

Number of Countries in SSA that procured condoms, contraceptives:

• Male condoms: – 13– Cote D’Ivoire, DR Congo, Djibouti, Equatorial Guinea, Gabon,

Lesotho, Namibia, Sao Tome, Somalia, Sudan, Swaziland, Tanzania, Togo

– Namibia and Tanzania combined procured 53% of all male condoms financed using GFATM funds; DR Congo 9%

• Female condoms: – 6 – Benin, Gabon, Lesotho, Namibia, Swaziland, Togo– Namibia alone procured 64% of all the female condoms financed

using GFATM funds; Djibouti 27%• Other contraceptives:

– 0

Why do we care?

1. Condoms are dual use and USUALLY condoms procured for STI prevention are available for FP use

2. If GFATM funds condoms other donors MAY have extra funding available for other contraceptives

What is Our Message

• Moving from integration in proposals to implementation & procurement• Consider GFATM funds for condom procurement (especially if it

means other donors can then procure more of other RH commodities)• If it makes sense (i.e. if there is a funding gap or shortages, or

method mix is incomplete) consider procuring other contraceptives with GFATM funds

• Coordinate with existing RH commodity procurements to avoid duplication and waste– Work with RHCS committees/technical groups

– Participate in national FP forecasts

• If you do procure don’t reserve them for “HIV” programs– Commodities are distributed by integrated supply chains

No product? No program!