Does structural form matter? A comparative analysis of pooled procurement mechanisms for health commodities

Area of Science:

• Health policy and management
• Supply chain management
• International health economics

Background:

• Pooled procurement, a collaborative buyer initiative, gained prominence during the COVID-19 pandemic to enhance access to health commodities.
• Mechanisms range from buyer-owned collaborative models to third-party managed organizations.
• Limited understanding exists regarding the distinct characteristics, implementation, and development processes of these different pooled procurement structures.

Purpose of the Study:

• To compare the characteristics, implementation, and developmental processes of buyer-owned and third-party pooled procurement mechanisms.
• To identify factors influencing the success of different pooled procurement models.

Main Methods:

• A qualitative multiple case-study design was employed.
• Four pooled procurement mechanisms were purposefully selected: two buyer's owned (Organisation of the Eastern Caribbean States and Pacific Island Countries) and two third-party (Global Drug Facility and Asthma Drug Facility).
• Data were collected using the Pooled Procurement Guidance, peer-reviewed articles, grey literature, and semi-structured interviews with procurement experts.

Main Results:

• Buyer-owned mechanisms necessitate greater alignment among buyers regarding procurement systems, financing, product needs, and legal frameworks, particularly when buyers are homogeneous and perceive urgent problems.
• Third-party mechanisms require less buyer-to-buyer consensus, focusing instead on alignment with the third-party organization's operations.
• Successful third-party mechanisms depend on the secretariat's ability to raise awareness, foster political will, secure funding, and attract skilled personnel.

Conclusions:

• Sustaining pooled procurement mechanisms requires continuous stakeholder engagement, robust funding mobilization, and strategic alignment of interests and needs.
• The success of pooled procurement is contingent on adapting strategies to the specific model (buyer-owned vs. third-party) and the context of participating buyers.