Health care depends on the supply of medicines and other health commodities. Without a steady supply of these commodities, health facilities suffer stock outs and health workers are unable to provide appropriate services. It is therefore important to ensure that health workers and the public can at all time freely access, obtain and use health commodities that they may need. Such a situation can be termed as Health Commodity Security. In developing countries, systems for health commodity procurement and supply management are highly donor dependent. For example, TB medicines in Uganda are only financed and procured through the public sector which is mainly supported by donor funds (over 90%) while over 80% of health commodity needs for HIV/AIDS and malaria in Uganda are funded using donor funds.
Health commodity security should be a strategic objective for any country and requires a multi-stakeholder approach involving the users of the commodities, the financiers of the commodities and national agencies responsible for the procurement, warehousing and supply management. Efforts to attain health commodity security should be demand driven such that users of the commodities play a key role in the financing, procurement and supply management of the commodities that they may need. In order to maximize efficiency, leading donors like the Global Fund, USAID and UN Agencies like UNFPA and UNICEF have set up global partnerships responsible for procurement and supply management such that support to government is often in form of health commodities delivered in kind. This arrangement provides relief in the short run but it allows national level stakeholders to distance themselves from this responsibility. However, we know that dependency on donor support for health commodity security is not sustainable. No matter how long it takes, any country shall finally assume full responsibility for its health commodity security.
Under involvement of national agencies and the business community could have a net weakening effect and they may completely breakdown if there is no supportive intervention. Ultimately, health commodity security is threatened in case donors withdraw funding. The design of donor supported health commodity security interventions should therefore provide for sufficient involvement of the users, national agencies, and the business community. Donor support should be strategically used cognizant of market principles which could lead to a sustainable demand and supply relationship in which empowered users, national agencies and the local business community takes lead in the financing, procurement and supply management of the health commodities that a country may need. Such an approach will be of two fold benefit: Increased access to the health commodities and sustained health commodity security and business growth for national agencies and businesses involved in the financing, procurement and supply management of health commodities to such an extent that they may be able to compete at a regional and or Global level.
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