IMPLANON Access Initiative

Partnership objectives

MSD* supports the ambitious, but achievable, goal set out by the global reproductive health community in 2012 of ensuring that voluntary life-saving family planning information, services and products reach an additional 120 million women and girls in the world’s poorest countries by 2020. They also support the UN Commission on Life-saving Commodities for Women and Children’s call to improve equitable access to 13 overlooked commodities, including contraceptive implants. The IMPLANON Access Initiative seeks to support both of these goals. 

Governments, donors and international funding organizations realize that investing in family planning is not only good for health, but is necessary for economic development. Governments, donors and international funding organizations realize that investing in family planning is not only good for health, but is necessary for economic development. Copyright IFPMA

What are the needs and challenges?

The unmet need for family planning, particularly in developing countries, has been well-documented. According to the Guttmacher Institute, 222 million women in developing countries have an unmet need for family planning. Of these, 162 million women live in the world’s poorest countries. The impact is significant:

  • Half a million women die each year due to complications of child birth
  • 80 million unplanned pregnancies
  • 30 million unplanned births
  • 40 million abortions every year

Research has shown that for every $1 spent on family planning, $6 can be saved. In fact, global health experts estimate that investing $8.1 billion a year in voluntary family planning would:

  • Reduce unintended pregnancies by more than 60 percent
  • Prevent 30% of maternal deaths
  • Avert 20% of newborn deaths
  • Reduce unsafe abortion by 40%

Governments, donors and international funding organizations realize that investing in family planning is not only good for health, but is necessary for economic development. It increases productivity for girls and women, helps to develop a more sustainable world, and positively affects population dynamics. As USAID has stated, it “targets the symptoms of and pathways out of poverty.”

Description of partnership activities and how they address needs and challenges

In July 2011, MSD and the Reproductive Health Supplies Coalition (RHSC) announced a partnership to enhance access and appropriate and effective use of the company’s long-acting reversible contraceptive implant IMPLANON® (68 mg etonogestrel implant) for qualified buyers in developing countries. Under the initiative, IMPLANON was available at MSD’s lowest access price to donor agencies and family planning members of RHSC in sub-Saharan Africa, and in all other Low Income countries as defined by the World Bank and Lower Middle Income countries with maternal mortality ratios of >200 according to UN data.

Less than one year later, in November 2012, RHSC announced that the initiative had met its initial target of supplying 4.5 million units of the product, triggering a further credit rebate for the eligible recipient countries.

In May 2013, building on the company’s previous price announcement, MSD and a group of public- and private-sector partners announced an agreement to further expand contraceptive access and options for millions of women in some of the world’s poorest countries. The increased volume generated from the success of the initial initiative with RHSC and the guarantee of continued volume has allowed MSD to achieve improved economies of scale making the further price reduction possible.

Under the agreement, MSD will reduce the cost of IMPLANON and its next-generation implant, IMPLANON NXT® (68 mg etonogestrel implant), radiopaque, by approximately 50 percent for the next six years in the targeted poorest eligible countries of focus for the reproductive health community. These countries are those with a 2010 per capita gross national income less than or equal to US$2,500 per year based on the World Bank classification using the Atlas Method. They are thought least likely to meet the Millennium Development Goals set by the UN General Assembly in 1990 to reduce the number of infant and young child deaths by two-thirds and to improve maternal health by 2015. Collectively they are referred to as the FP2020 countries.

In the countries where MSD products are included in family planning programs, they work closely with ministries of health and local implementing partners, who play a pivotal role in supporting training, counseling and other related activities. Local implementing partners have included Jhpiego, EngenderHealth, Marie Stopes International, International Planned Parenthood Federation, Population Services International, Pathfinder International and DKT. Such collaboration ensures that countries have the expertise and support they need to achieve their reproductive health objectives.

Lessons learned

  • Communication with all partners is critical to making a partnership work. This includes ensuring accurate forecasting in order to meet product demand.
  • Making the product available to the local purchasing or recipient entity is not enough; the private sector can play an important role working with other stakeholders to ensure the product gets to the women who need it.
  • The voice of the customer is as important in developing countries as it is in developed countries. It’s important for the private sector to listen to needs and desires of women, providers and other stakeholders to ensure we are best able to meet them.
  • The role of community-based health workers is critical in raising awareness of family planning and the options available so that women, particularly those outside urban centers, can make voluntary, informed choices.
  • Strong support from donors, governments and the private sector for capacity building for implant service delivery is essential for increasing access.

Summary of impact and forward looking information

In 2013, more than 4 million women had access to IMPLANON/NXT in FP2020 program through the IMPLANON Access Initiative. MSD worked with more than 35 countries in sub-Saharan Africa, Asia and Central America to provide IMPLANON and IMPLANON NXT through numerous partnerships with governments, donors and non-government organizations.

Moving forward, MSD continues to work with stakeholders to address barriers beyond price, including regulatory approvals, logistics and supply chain management, health provider training, and awareness creation and demand generation efforts.

 

*MSD is known as Merck in the United States and Canada.

Partnership information

Company(ies) MSD

Partner(s) Bill and Melinda Gates Foundation, Children’s Investment Fund Foundation, Clinton Health Access Initiative, DKT Interntional, EngenderHealth, International Planned Parenthood Federation (IPPF), Marie Stopes International, Norwegian Agency for Development Cooperation (Norad), Pathfinder International, Population Services International (PSI), Swedish International Development Cooperation Agency (SIDA), UK Department for International Development (DFID), UNFPA, United Nations Foundation, US Agency for International Development (USAID)

Type of Partner(s) Government, IGOs, NGOs, PDPs

Therapeutic Focus Women and Children's Health

Disease(s) Family Planning, Sexual & Reproductive Health, Women's Health

Program Type(s) Availability of Treatment - Differential Pricing

Targeted Population(s) People with low income, Women, Youth

Region(s) East Asia & Pacific, Europe & Central Asia, Latin America & Caribbean, Middle East & North Africa, South Asia, Sub-Saharan Africa

Number of Countries 64

Country(ies) Afghanistan, Bangladesh, Benin, Bhutan, Bolivia, Burkina Faso, Burundi, Cambodia, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Djibouti, Egypt, Eritrea, Ethiopia, Ghana, Guinea, Guinea-Bissau, Haiti, Honduras, India, Indonesia, Iraq, Kenya, Lao PDR, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Morocco, Mozambique, Myanmar, Nepal, Nicaragua, Niger, Nigeria, Pakistan, Papua New Guinea, Philippines, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Solomon Islands, South Africa, South Sudan, Sri Lanka, Sudan, Tajikistan, Tanzania, The Gambia, Timor-Leste, Togo, Uganda, West Bank and Gaza, Yemen, Zambia, Zimbabwe

Start Date 2013

More information Merck Responsibility

Anticipated completion date Ongoing