Ensuring Real Contraceptive Choice Through a Robust Supply Chain

Posted on: April 7, 2013 by: Amy McNally

This story was originally published on the Women Deliver website on April 4, 2013. View the original here.

As a new member of the Women Deliver Board of Directors and as CEO of WomanCare Global, I am so looking forward to attending the May 2013 Women Deliver meeting.  We will be thousands of voices strong, united in our call to bring women better choices for improving their health. In particular, I am eager to learn more about the work so many organizations are doing in family planning.

Less than a year ago many of us assembled in London for a groundbreaking family planning summit, where we committed ourselves to mobilizing resources so that an additional 120 million women and girls in the world’s poorest countries receive family planning information, services and supplies by 2020. Currently there are more than 200 million women in developing countries who want to avoid pregnancy but lack access to contraceptives – in part, a problem with the contraceptive supply chain.  These women need effective products that allow them to determine how many children they will have, and when. They need real, meaningful choice.

And yet contraceptive choice is not as easy as we once thought it was. Does a woman have true choice when a provider in a rural health clinic offers her injectables or pills, but no other family planning options? What about a woman who wants a non-hormonal method?  Real choice means that a full range of family planning methods is widely available, even in the smallest rural clinic, and that providers are skilled and comfortable prescribing all the methods in the mix.

Fortunately, donor organizations and R & D companies are prioritizing the search for new and better methods. Private sector pharmaceutical companies continue to explore products that are affordable and meet specific needs, such as Andromaco’s Progering, a vaginal ring for lactating women.  Non-profit developers like PATH and The Population Council are also developing products: user-friendly diaphragms, women’s condoms, and vaginal rings are in different stages of development.  One of the small private sector companies with which I work closely, Evofem, is conducting clinical trials of a contraceptive vaginal gel.  In all these cases, product developers – with support from shareholders, investors and donors – are leading efforts to innovate and improve their contraceptive offerings to create more choice.

Designing great new products to satisfy unmet family planning needs, however, is only half the battle – the upstream portion of the supply chain.  Moving products out of laboratories and into the hands of women who need them is the next step in broadening the method mix. New products need to clear stringent regulatory authority approvals (such as the US Food and Drug Administration), be registered in each country of distribution, shipped from a quality-assured manufacturer, and moved out of central warehouses to clinics, providers and drug shops in both the public and private sector.  This middle stretch of the supply chain is often difficult to navigate and far too time consuming, so that new products are not introduced for years.

Farther down the supply chain, family planning providers must be aware of all the products that are available on a national scale, and offer these products in their own practices.  It is not enough for a new technology to be stocked in a central warehouse; the product must also be “pulled” out of these central medical stores by providers who are skilled in using the new product, comfortable prescribing it to appropriate clients, and insistent upon offering a wide range of family planning options.

The supply chain for contraceptives is complex and perhaps less glamorous than other interventions to improve women’s health.  But if we are to meet our promises from the London Summit to reduce the unmet need for family planning, we must at a minimum succeed in three areas.  We must work with R & D companies to design and launch new products.  We must understand and improve upon the ways high quality products move from labs to in-country warehouses.  And we must focus on supporting medical providers to offer a greater variety of suitable options to their clients. A robust supply chain is critical to offering women more choices for planning their families.

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WomanCare Global is a sponsor of the Women Deliver 2013 conference. To learn more about the upcoming event in Kuala Lumpur, Malaysia on 28-30 May, visit: www.wd2013.org!

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