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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

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.

Together for Health Pyramid showing the A Tier in the top of the pyramid; the CAMP Strategy B Tier, which is covered by private commercial sector, in the middle; and the C Tier, Government distribution to the poor and disadvantaged, on the base of the pyramid.

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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Group photo of the key participants in the launch of Together for Health Public-Private Partnership.
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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