Mary-Ann Etiebet, Lead and Executive Director, Merck for Mothers

Expanding access to family planning is a critical step in improving the health of women around the world. In developing regions, it is estimated that 214 million women who wish to safely plan and space their births do not have access to modern family planning services and information, placing them at greater risk of death and disability during pregnancy and childbirth. In Sub-Saharan Africa, the proportion of women who want contraception but are not using a modern method is 21%, the highest proportion in the world.

One way for countries to address unmet need is to rethink their health supply chains. The status quo of using wholly publicly-owned and -operated systems of getting health products to people is fraught with challenges, and misses out on the comparative advantages that the private sector can offer.

At a recent UNFPA meeting in Abidjan, many African government leaders expressed a desire to work strategically with the private sector to address supply chain issues. This is encouraging. Private companies, both local and multinational, have resources and expertise that can help drive innovation and improve logistics and overall performance. A well-functioning health commodity supply chain doesn’t just help women plan their families – it can improve access to quality health care for all.

To help drive progress in this area, Merck for Mothers has partnered with the UPS Foundation to share best practices and help tackle supply chain issues in low- and middle-income countries. A key focus will be last-mile delivery to remote areas and other difficult geographies. Top priorities: helping governments to strategically engage with local private operators in transport, warehousing and distribution, and building their capacities to do so. A working group representing our UPS partnership, which also includes The Global Financing Facility (GFF) and the Bill & Melinda Gates Foundation, is currently exploring possible collaborations in Nigeria and Mozambique.

As a starting point, we will look to leverage what we have learned through our ongoing partnership in Senegal, working with the government to transform the country’s supply chain. Called Yeksi Naa, Wolof for “I have arrived,” the model started out as an effort to reduce contraceptive stock-outs. After demonstrating results – contraceptive stock-out rates dropped from a high of up to 80% in some areas to less than 2% – the model was later expanded to cover other key health products, ultimately improving availability across the board.

A key component of Yeksi Naa is the use of third-party logistics providers (3PLs) to deliver goods and manage inventory using data-driven demand forecasting among other commercially-developed techniques. It’s a terrific example of what can be achieved when the local private sector is integrated as part of the solution.

To continue to deliver for women, these performance gains will need to be sustained. This will require successful integration of Yeksi Naa into government policy, financing, management and stewardship systems. Ensuring that governments have the capabilities and systems in place to execute on what may be new roles and new functions will likely prove to be a key driver for sustainability.

We recognize there’s growing interest, but also lingering skepticism around engaging the private sector in matters of public health. There’s a lot of uncertainty around how to go about it. We must maintain an open dialogue between sectors; create opportunities for government leaders and policymakers, private sector organizations and other development partners to sit down and align on objectives and approach, to study models like Senegal’s to see what parts might be replicated elsewhere, and the lessons that can be learned.

Innovative financing mechanisms such as The GFF Trust Fund, which leverages private capital to catalyze investment in maternal and child health in countries where it is needed most, can support integration of private sector into public sector supply chains. Merck for Mothers is collaborating with the GFF and other organizations to see about crowding in more private capital to finance health initiatives.

Through public-private partnership, we can do better to meet the needs of women.

Mary-Ann Etiebet leads Merck for Mothers, Merck’s $500 million initiative to help create a world where no woman dies giving life. Merck for Mothers is known as MSD for Mothers outside the United States and Canada.