Reliable access to contraceptives and other commodities is a fundamental requirement for reproductive health. Yet millions of women in developing countries go without, leaving them vulnerable to unwanted pregnancy, sexually transmitted infections including HIV/AIDS, and unsafe childbirth.

• The cost of quality contraceptives and condoms needed is projected to rise from $810 million to $1.8 billion between 2000 and 2015. The cost of services to deliver and provide these supplies is projected to increase from $4 billion to $9 billion over the same period - four times that of the products themselves.

UNFPA is the largest international public sector supplier of reproductive health essentials, including condoms and other contraceptives. This strong position means that we can keep costs down for countries in need. Almost every aspect of reproductive health depends on reliable access to commodities.

Trend of reported donor support for contraceptives compared with estimated requirements:


Source: Global Estimates of Contraceptive Commodities and Condoms for STI/HIV Prevention 2000-2015, UNFPA 2002

Global Strategy

Many different kinds of equipment and supplies are required for reproductive health, and a great deal must happen in order for these commodities to reach the people who need them, involving partnerships among UN agencies, national governments, nongovernmental organizations (NGOs) and others. There must be a system in place that makes equipment and supplies readily available - the right quantities of the right products in the right condition in the right place at the right time for the right price.

The Global Strategy for Reproductive Health Commodity Security (RHCS) provides a framework for such a system. From this starting point, UNFPA and its partners are improving advocacy and resource mobilization, strengthening national capacity, reinforcing programme sustainability and improving coordination.

The success of this global strategy will mean a reduction in the amount of unmet need for family planning, fewer unwanted births, a decrease in the number of women who die of pregnancy-related causes and reduced HIV prevalence among young people. It will also means reduced costs as a result of efficient management and accountability. All of this contributes to the global development agenda to reduce poverty and improve reproductive health.

Securing the Supply

Contraceptives, condoms and medical equipment and supplies are in high demand and short supply - yet contributions from donors and developing countries are not keeping pace. Shortfalls in reproductive health commodities, including contraceptives and male and female condoms for HIV/AIDS prevention, can have grave consequences.

Each $1 million shortfall in support for contraceptives means an estimated:

• 360,000 more unwanted pregnancies
• 150,000 additional induced abortions
• 800 maternal deaths
• 11,000 infant deaths
• 14,000 additional deaths of children under 5

A secure supply of quality reproductive health commodities is a basic requirement for achieving the ICPD goal of universal reproductive health care. Such "security" requires not only the commodities themselves, but also the capacity to forecast, finance, procure and deliver them to the places they are needed at the times they are needed. Reproductive health commodity security means that a secure supply and choice of quality contraceptives and other reproductive health commodities is available to meet every person's needs.

Procurement

UNFPA is the largest international public sector supplier of contraceptives, condoms and other reproductive health supplies.

• UNFPA purchases nearly $80 million to $100 million in goods and services each year for many partners in development.

UNFPA's Procurement Section has established a worldwide network of suppliers and offers high-quality products at the most competitive pricing, while at the same time supporting emerging industries. For those countries able to purchase their own supplies, the aim is to provide access to the lowest possible prices.

Urgent requests for supplies are met through the Global Contraceptive Commodities Programme, a revolving fund that helps UNFPA maintain buffer stocks of essential commodities in case of emergency.

Examples of UNFPA in Action

• When three earthquakes struck El Salvador in early 2001, UNFPA sent supplies, equipment and medicine so that health workers in makeshift clinics could provide urgently needed care to pregnant women and new mothers. UNFPA supplied items required to perform clean and safe deliveries; health centre delivery equipment to stabilize convulsions and bleeding; instruments for Caesarean sections, resuscitation and other complications; and items for HIV prevention and safe blood transfusion.

• A series of UNFPA technical and regional meetings has been scheduled with governments, key donors, NGOs and other partners to discuss the demand for reproductive health commodities, planning, procurement and programming. In May 2001, participants from 10 countries at a conference in Istanbul, Turkey, agreed that concrete and immediate actions are needed to meet the challenge of securing reproductive health supplies.

• As part of condom programming to encourage men to take responsibility in the prevention of unwanted pregnancy, HIV/AIDS and STIs, more than 70 condom vending machines were installed in public locations in Sri Lanka. Information on the correct use of condoms was widely distributed by local organizations and members of the armed forces in charge of managing the project.