Delivering Public Health Goods: Buy It Locallly?
By Fiorenzo Conte
Official foreign assistance modus operandi to source and deliver goods is to ship them from outside into the country wherever the needs exist. Public health is no exception to the rule. The latest of this example is the commitment of pharmaceutical companies for neglected tropical diseases: they promised drugs giveaways while sharing new research on antidotes to push forth the research efforts. This way of sourcing is best suited for those disease defined as disease of poverty: where by very little profit can be harnessed in return for the initial investment. Often associated to this method of sourcing is a method of delivering these drugs. It is often called mass drug administration and it consists in setting up distribution structures parallel to the national health system.
This is the business as usual approach. There is however an alternative model of producing and sourcing medicines or health products. It is not panacea as it presents both advantages and challenges. Instead of shipping condoms or any other health good from 20 thousand miles away from where they are needed they can be manufactured locally. Partners In Health has partnered with Abott Foundation to set up an industry in Haiti which will produce therapeutic foods using peanuts grown locally. By so doing they can strike two birds with one stone: reducing child malnourishment while creating local jobs which is so needed in the country. Such approach presents also the advantage of having a supply which much more elastic to the demand: the local manufacturer is in a better position to gauge what is the best way to manufacture and if necessary market the product to make it appealable for the recipient population.
There are also tradeoffs however. Malaria presents an example of such challenge: UN agencies and the Global Fund had a quarrel with the Ugandan government as to where sourcing the insecticide treated nets, the latter being favorable to buy the net from a local manufacturer. This manufacturer had however failed to receive the certification about the quality of its product and for that reason was not recognized by the international health community not willing to compromise on the quality issue. To produce locally can in fact delay, at least in the short term, the availability of much needed health goods. However given the advantages in the long term, it remains an option to be explored.