This post is part of a monthly blog series profiling viewpoints from leaders in reproductive health who are members of the Bellagio Group on Long-Acting Reversible Contraception. The Bellagio Group is a coalition of experts who convene annually to discuss practices for expanding contraceptive choice and accelerating progress toward the Millennium Development Goal of universal access to reproductive health services. This post represents the views of the authors, and is not a representation of the Population Council or the Bellagio Group. Please direct any questions to the author at firstname.lastname@example.org.
The United Nations formulated it clearly: Family planning is a fundamental right of every human being. It is an important step toward breaking the cycle of poverty—for women, their families, and for their communities. Yet much remains to be done before the right to self-determined family planning can be fully realized. According to estimates, more than 220 million women in developing countries don’t wish to become pregnant, yet are not using modern contraception.
The successful promotion and adoption of family planning depend on three factors: first, information, including education and counseling—because only knowledge of the possibilities and benefits of family planning empowers individuals to take independent decisions. The second factor is access to the contraceptives, including the freedom to choose between an array of method options to best meet clients’ specific needs. And last, societal support is essential to ensure successful use. Young people in particular often find it difficult to take personal decisions which may be inconsistent with the expressed interests or advice of their family, community leaders, and peers.
We, at Bayer, can make a valuable contribution toward improving access to family planning information and services. As a research-based pharmaceutical company, we invest in creating innovations and products for patients all over the world to improve their quality of life. As a leader in hormonal contraception, Bayer has been supporting family planning programs for nearly 50 years, to date in more than 130 countries. We are part of a global family planning network of public and private partners.
We strongly support the Millennium Development Goals and sincerely hope that family planning will remain high on the post-2015 global health agenda, currently being developed. The challenge of addressing barriers to accessing high-quality contraception worldwide is a task that no company, aid organization, government, or research institute can manage alone. However, as part of a network of strong partners it is possible to make a real difference.
Access and availability are crucial for family planning. But, in addition, we also need education, counseling, and training for health care providers and advocates delivered through partnerships. For this reason Bayer initiates focused dialogues with leaders in politics, industry, and healthcare at local, national, and international levels. We are committed to partnerships, not only in access programs but also in educational programs and initiatives.
As a testament to our long-standing commitment, Bayer was the first pharmaceutical company to be accepted as a member of the Reproductive Health Supplies Coalition in 2007. Our contraceptive products were the first to be pre-qualified by the World Health Organization (WHO). This seal of approval encourages long-term confidence in the reliable, high quality of our work and products.
The Jadelle Access Program conducted by Bayer and the Bill & Melinda Gates Foundation is the story of how successful partnerships can be formed among a range of public- and private-sector organizations with a shared commitment to increasing contraceptive options for women around the world. This program has now been expanded to implants from other pharmaceutical partners, among other strategies to make a range of implants available at affordable prices.
At the London Summit on Family Planning in 2012, global leaders issued an urgent call for more innovative, effective public–private partnerships. In poor countries, where access to health clinics is often limited and stock-outs are common, there is a particularly strong demand for long-acting, reversible contraceptive methods (LARCs). These methods are a vital part of the contraceptive method mix because they are highly effective and can be used for extended periods of time without requiring frequent trips to a physician or pharmacy. Recognizing this need, we worked with our partners to achieve a more than 50% reduction in the price of Jadelle—which was also the first implant to be pre-qualified by the WHO.
The Jadelle Access Program aims to improve access to this long-acting, reversible method in order to give women more family planning options. From 2013 to 2018 this program will make Jadelle available to 27 million women in the world’s poorest countries. Within the framework of the program, we are also collaborating with organizations to support training of health care providers in counseling, insertion, and removal.
Another example is the Global Development Alliance between the US Agency for International Development (USAID) and Bayer as the first-of-its-kind collaboration between a public-sector company and a US governmental organisation. The Contraceptive Security Initiative provides the oral contraceptive Microgynon® Fe at an affordable price to middle-income women in sub-Saharan Africa at local pharmacies. They did not have this freedom of choice before. Anyone who could not afford the highly priced original product had to receive the contraceptives from development aid organizations free of charge. In addition to putting up with long waiting times, the women had to accept being regarded as poor.
The costs of production and distribution are fully covered by the purchase price, so this effort is completely sustainable. Specifically, this means that supply and availability are controlled solely by demand in the respective country and are independent of subsidies—gaps in supply are practically impossible, and contraceptive security is assured. Local wholesalers and pharmacists generate income on sales as part of the supply chain, which gives them a personal interest in having the product in stock. By earning money they are simultaneously helping their country's economic performance—a further contribution the program makes to sustainability.
Since 2010, Microgynon® Fe has been successfully introduced through this Alliance in Ethiopia, Uganda, Tanzania, Rwanda, Ghana, Kenya, and Malawi. The Bayer-USAID partnership will expand the initiative to enable introduction and increase availability in several more sub-Saharan countries by 2016. USAID supports the Contraceptive Security Initiative by covering the costs related to communications activities for the rollout within the first five years.
Long-term commitment and sustainability are the pillars of Bayer’s engagement in family planning. Within our network we need as many perspectives and initiatives as possible to bring us closer to achieving the goal of self-determined family planning as a fundamental right worldwide.
Other posts in this series:
- The Manufacturer’s Perspective: Stronger Supply Chains and Forecasting for Improved Access and Reproductive Choice, by Maggie Kohn, Merck
- Contraception: Why Access, Choice, and Price Matter, by Victoria Hale, Medicines360
- A Balanced Response to Basic Human Rights Needs in Crisis Settings, Campbell Bright and Vivian Cintron, UNFPA
- Rights-Based Family Planning: Importance of Increased Access, by Chastain Fitzgerald, WomanCare Global