How greater data visibility helped the reproductive health community confront the challenges of reduced funding for contraceptive supplies

by Bonnie Keith, Hannah Pandian, Maggie Murphy, and Julia White

Earlier this year, the government of the United Kingdom drastically reduced its foreign aid budget and even rescinded funds already committed for the 2021–2022 fiscal year. These cuts affected the International Planned Parenthood Federation, MSI Reproductive Choices, as well as the UNFPA Supplies Partnership (UNFPA) — all three critical suppliers of contraceptives to low- and middle-income countries (LMICs). They also set in motion a tailspin of ever-widening funding gaps across the reproductive health community as a whole.

This unanticipated withdrawal of financial support threatened the availability of family planning services and supplies in LMICs. It also risked aggravating an already existing gap between the need for those contraceptives and the financing available to procure and ship them.

In the months that followed the announcement, donors, procurers, advocates, and supply chain experts came together under the auspices of the Reproductive Health Supplies Coalition (RHSC) to better understand these cuts and figure out how to apportion resources in ways that could meet countries’ most pressing supply needs, be it through the public- or social marketing-sectors. In the end, the effort paid off. USAID committed an additional US$17.5 million to help fill supply gaps in 10 countries, and UNFPA Supplies mobilized around US$8.8 million in total resources, including a donation of US$3.8 million worth of products from Bayer, a leading contraceptive manufacturer.

What was it, though, that fueled this response and outcome? How did these agencies estimate how severely UK funding cuts would aggravate the gap between contraceptive supply needs and available financing?

Drawing on a range of tools and assessments, many commissioned by RHSC itself, community members began analyzing countries’ past consumption trends; they studied long-term relationships between countries and particular donors, and they assessed the unique financing and credit opportunities within the supplies ecosystem. But one platform in particular, the Global Family Planning Visibility & Analytics Network (VAN), offered a wholly unique set of insights. By having access to what are called “country supply plans”, which indicate the kinds and quantities of supplies a country intends to procure in a given year; and by comparing those plans with committed orders for those same supplies, the VAN was able to quantify a meaningful global gap―a gap based not just on historical extrapolations, but on real time data. It revealed an immediate disparity between the procurement needs of 48 countries and the cost of meeting those needs―a disparity that totaled $92M.

The VAN was able to quantify a meaningful global gap―a gap based not just on historical extrapolations, but on real time data.

Though the funding gap was clearly exacerbated by the UK cuts, the reality is that financial shortfalls had always been a perennial feature of the global supplies landscape. And so, it was critical that the discussions not devolve into a pretext for “bailing out” single procurers or for formulating unrealistic financial “asks” for gaps that probably would have existed anyway. Collaboration among VAN members made it possible to parse out the global funding shortfall to determine what part of it would have been covered had the FCDO cuts not taken place — about 50 percent, according to their calculations. That amount, equivalent to approximately $45M, became, in effect, a clarion call for the wider supplies community to come together and work as one.

The VAN went one step further, however, by offering insights that allowed the partners, but especially donors, to respond to the gap in an effective and meaningful manner. The VAN made it possible, for example, to identify the six countries that accounted for more than three quarters of the gap — the so-called “big tickets” that could have allowed donors to consolidate their contributions, or helped fill gaps through increased national procurement. The VAN also made it possible to assess the relative severity of the gap by identifying countries where, for example, the shortfall accounted for more than half of a country’s estimated supply need. And finally, the VAN revealed which countries had no gaps at all―countries whose needs had already been fully met. These nuances and permutations enabled stakeholders to understand better and appreciate the consequences of FCDO cuts. They made it possible to prioritize country requests; to advocate internally for more funds; and to allocate resources based on a clear understanding of countries’ needs.

These nuances and permutations enabled stakeholders to understand better and appreciate the consequences of FCDO cuts.

While much yet remains to be done to resolve the remnants of the global funding shortfall, the last few months have seen dramatic progress. As noted previously, USAID and UNFPA have mobilized more than US$26M for supplies. By applying these resources strategically, we have seen the number of countries with funding gaps decrease by 10. We have also seen relief come to the countries whose gaps accounted for more than 50 percent of needs. And last but not least, the conversations also brought other partners into the dialogue. The Global Financing Facility, or GFF, for example, has embarked on initiatives that look beyond today’s immediate crises to respond sustainably to longer-term funding shortfalls. The RHSC, meanwhile, continues to drive global partner discussions to resolve remaining gaps and providing a forum for discussing how to mitigate their impact.

As the world looks ahead to 2022, the family planning community will continue to face the dual burden of reduced donor funding and competing resource demands for COVID-19. We are confident, however, that the work of RHSC and the insights from the VAN will allow donors, governments, and other critical stakeholders to move beyond the rhetoric to identify country-specific, tactical approaches that will ensure critical family planning products continue to reach the women and girls who need them.