Training of doctors and midwives on contraceptive implant Implanon NXT in Savannakhet Province, Laos.
Photo: UNFPA Lao PDR
Contraceptive implants improve lives of poor women
Sida’s volume guarantee is a successful example of financing for development meeting the high demand for modern contraceptives in the world’s poorest countries. Sida and partners guarantee the production of 40 million contraceptive implants, benefitting the right of women and adolescent girls to better plan their future.
“The hope is now that the rate of unwanted pregnancies will drop, that childbirths will be safer for the women, and that the number of illegal abortions will be fewer.”, says Johan Hyltenstam, Senior Financial Advisor at Sida.
Today over 200 million women and adolescent girls demand modern contraceptives. Among 600 million women using contraceptives in these countries, only 1-2 percent have access to modern contraceptives that give active and long-lasting protection. An investigation led by the Clinton Associations found that where the demand for contraceptive implants was high, the price, 18 US dollar per unit, was too expensive compared to the alternatives.
Therefore Sida in cooperation with Norway (Norad), Bill and Melinda Gates Foundation and the Children's Investment Fund Foundation (CIFF) offered to guarantee the production of 40 million contraceptive implants so that suppliers would sell the products at USD 8.50 instead of USD 18 per unit. The products are then procured with aid through other donors for distribution in developing countries.
Optimizing delivery key to improved access
“We are currently in the project’s third year and so far the delivery has been higher than the minimum goal. There has been an enormous demand. The implants are preferred over the alternatives because they don’t show and you can be anonymous.”, says Johan Hyltenstam, Senior Financial Advisor at Sida.
Once inserted into the upper arm, the implant provides an active and long-lasting – up to five years – protection against unwanted pregnancies.
“Another advantage is that the contraceptive can be given to girls as young as 12 years old: it affects not only the physical health but the mental health of girls who later risk being rejected from their families if getting pregnant.”, Johan Hyltenstam continues.
In Laos the Ministry of Health introduced and launched the implants as an addition to existing family planning methods in October this year. So far, 3024 implants were procured and distributed via UNFPA Copenhagen and their country office in Laos. The Ministry of Health estimate that a substantial number of implants will be needed in the coming year to address the unmet need of family planning in the country.
“An important part of the work is to give information about this type of contraceptive. The project is well received and everyone I meet are happy to get access to the contraceptive implants”, says Susanne Lokrantz, Theme coordinator for health, education and water & sanitation at Sida.
The consortium now explores ways to optimize delivery so that the product is in stock at the health clinics and hospitals globally, with instructions available in the native languages where the implants will be used.
Innovative solution to tackle global health issues
The intervention is a good example of effective cooperation between aid, philanthropy and private sector guided by the aim to benefit women’ and adolescent girls’ right to better plan their future, and ultimately to improve global health.
Today suppliers Bayer and Merck have already established their presence in Africa to sell other products:
“Even if the guarantee ends, they are likely to keep the price and continue working in this innovative way benefitting development in these countries. That’s a result per se”, says Johan Hyltenstam.
The project was nominated in the health category earlier this year at the FT/IFC Transformational Business Awards in London, a price for innovations that create long-term solutions to environmental, social, and corporate governance challenges, particularly in developing countries.
“I think it simply touched so many people. Of course the project will benefit the situation for girls by allowing them to continue their education. We also see the connection between fewer children per women and improved living conditions for the whole family”, says Johan Hyltenstam.
The volume guarantee is a perfect instrument for scaling up innovations in poor nations where neglected diseases affect the populations disproportionately hard, says Johan Hyltenstam. The hope is that this way of financing for development will be used also for other products for improving global health:
“Especially when it comes to vaccines, the volume guarantee can be very effectual. If we guarantee one million doses, pharmaceutical companies should be able to reduce the price from 10 dollar per unit to only 1 dollar. There is always the security that no matter what the demand look like, products will be delivered. We now have the proof that this work, which we didn’t have earlier.”