JSI Research & Training Institute, Inc. successfully implemented the Together for Health for the U.S. Agency for International Development from 2005 to 2011. For further information on project activites, visit the TfH page on jsi.com.
Together for Health Launches Public-Private Partnership to Improve Access to Family Planning/Reproductive Health in Ukraine
December 2006 - With a handful of signatures, USAIDs Together for Health (TfH) project launched a groundbreaking
public-private partnership on December 7, 2006, when representatives from TfH, the Ministry of Health
of Ukraine, 7 manufacturers and distributors of contraceptives, and a market research firm signed a
Memorandum of Partnership. The partnership aims to work through pharmacies to improve the
availability of quality, modern family planning services and supplies at available prices and to
disseminate accurate reproductive health information.
This partnership represents a unique approach in the post-Soviet world, bringing together the
government, a major donor, and private sector companies for a shared social objective. Moreover, the
collaboration lays the foundation for a truly sustainable national family planning/reproductive health
program that can continue even when donor support ends.
The public-private partnership is a core part of TfHs strategy to address a major challenge: ensuring the
availability of a range of contraceptives at affordable prices. There are no donated contraceptives in
Ukraine, and currently, the Ministry of Health doesnt procure any. Those available in pharmacies are
priceyabout $6-10 per cycle of oral contraceptives—in a country where the average monthly salary is
only $200. While there are pharmacies in both urban and rural areas, most offer little variety in choice of
method; most offer Combined Oral Contraceptives (COCs) and condoms, but less than 1% of
pharmacies offer all of COCs, POPs, injectables, IUDs, condoms, and emergency contraception.
It is estimated that 55% of the need for high-priced oral
contraceptives is met, but only 25% of the need for mid- and
low-priced brands is met. TfH wants to improve this
situation using a fully sustainable total market approach,
appropriate for a middle-income country aspiring to
European living standards. Pharmaceutical companies
currently target women from wealthy urban areas who can
afford the high-priced contraceptives. Women with low to
moderate incomes living in both rural and urban areas are
TfHs priority. The public-private partnership plans to
increase the availability of a broader range of affordable
contraceptives for this group by developing and actively
promoting a Contraceptive Availability Minimum Package
(CAMP): a group of contraceptives on the market, but not
actively promoted by pharmaceutical companies, which can
be produced by the partners and distributed at lower prices.
To reach women from rural areas with low or
no income & limited access to pharmacies,
TfH is supporting the Ministry of Health to
include a budget line-item for contraceptive
procurement in the new Reproductive Health
of the Nation Program 2006-2015.
USAID Mission Director, Earl Gast,
participated in the Memorandum of
Partnership signing ceremony as a witness.
The pharmaceutical partners signing the
Memorandum of Partnership included:
- Janssen-Cilag, which produces contraceptive pills and the new patch;
- MedCom, the largest distributor of condoms in Ukraine;
- Organon, which produces the only progestin-only pill on the market and the vaginal ring;
- Richter Gedeon, which produces a range of pills and emergency contraceptives;
- Schering, which also has a range of pills as well as a new hormonal IUD;
- SMD, which conducts research and analysis for the pharmaceutical community; and
- Tespro, the distributor of a copper-T IUD.
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Launch of Together for Health Public-Private Partnership.
Another partner, Pfizer, was not able to participate in the signing but is committed to providing overall
regulatory support for their injectable contraceptive, the only one on the Ukrainian market. Organon and
Tespro have reduced prices on some of their products as a contribution to the partnership. All
commercial partners will contribute in-kind resources, including informational materials and public
awareness activities, training for health providers and pharmacists, and continuous product support for
their specific brands. In addition, the partners will collaborate to provide doctors and other health workers
with up-to-date information and skills on contraception and reproductive health and to inform the
Ukrainian population about the benefits, safety, and availability of modern contraceptives.
For its part, TfH will support training for about 2,000 health workers and 3,500 pharmacists in the first
year of the partnership; will produce educational materials and information for the public; and will work
on critical policy issues. It will also coordinate, monitor, and evaluate the partnership. TfH is currently
focusing its efforts in two oblasts (regions), but plans to reach about half the 27 oblasts of Ukraine by
2009. The scope of the pharmaceutical companies contributions, however, is nationwide.
At the launch ceremony, USAID Mission Director Earl Gast remarked, We are pleased to see that seven
leading national and international pharmaceutical companies will become our partners in this new effort
to improve the health of Ukrainians. Their participation is recognition that they understand their social
responsibility and the influence that decisions made in corporate board rooms can have on society. The
First Deputy Minister of Health, Olexandr Orda, noted, Today a new approach of uniting the efforts of
state, international and commercial structures and civil society to strengthen the health of people, family
values, and cultural relationships is being created in Ukraine. Such approach will allow making health
services closer to a patient, ensuring the better access to quality and safe contraceptives and reducing
negative consequences of abortion and sexually transmitted infections.
TfH is a five year cooperative agreement, supported by USAID and implemented by JSI Research and Training Institute, with assistance from the Academy for Educational Development on private sector activities.
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