Around the world, there are many proven health-, education- and nutrition-related products that can save and improve lives. However, they are frequently out of reach for children and adults who need them the most.
This is often the result of breakdowns in markets and systems. Essential commodities may not be available in low- and middle-income countries due to insufficient supply capacity, inadequate financing, inefficient procurement processes and outdated policies. Even when commodities are available in a country, they may be of inconsistent quality, they may be priced too high or they may not be appropriately used.
R4D works with change agents to ensure that markets are transformed sustainably to drive increased access to (and improve appropriate use of) essential commodities, such as childhood pneumonia diagnosis and treatments, maternal health supplies, anti-malarial bed nets, HIV/AIDS medicines, nutrition supplements, and books. R4D achieves this by aligning priorities and incentives of key market actors including policymakers, procurers, manufacturers and financiers at the global and country levels to develop and execute solutions for underserved markets at scale.
Specifically, R4D leverages four core technical approaches to systematically identify and holistically address market and system barriers:
- Market analysis: We examine regulatory, demand, supply and financing barriers to understand the challenges to increasing access to, and improving appropriate use of, a given essential commodity. We use a range of techniques including market sizing, demand forecasting, financing gap, cost-effectiveness and return on investment analyses, among others.
- Strategy development: Based on in-depth market analysis, we develop targeted strategies to inform government, donor and/or R4D decisions to efficiently and holistically shape markets through recommendations around rationalized product categories/specifications, improved supply base, enhanced procurement practices, optimized pricing, increased regulatory and financing efficiencies, and measures to strengthen appropriate use etc.
- Catalytic implementation: We implement catalytic market shaping activities in partnership with key market actors to address barriers to shape a sustainable market and strengthen overall systems.
- Evidence generation for continuous learning: We apply a range of monitoring, evaluation and learning methods, such as surveys, clinical studies, focus groups, rapid feedback cycles and structured learning, to generate timely evidence around the impact of market shaping interventions and allow for iterative improvements.
Since 2008, R4D has developed market shaping strategies at the global level and provided on-the-ground catalytic support to local change agents to achieve transformational impact domestically. Some examples include:
- Designing and implementing a program to avert hundreds of thousands of child deaths from pneumonia in high-burden countries via the delivery of roughly 7.5 million treatments in Ethiopia and Tanzania, while shaping the local markets and systems to ensure sustainable access in the future. As part of this work, R4D is also conducting formative research to assess current levels of diagnoses and prescriptions, as well as designing and piloting potential cost-effective interventions to improve appropriate use of treatments as well as overall quality of care.
- Developed purchasing strategies for long-lasting insecticide-treated bed nets to save the global community up to $630 million over five years, which could in turn be used to purchase an additional 300 million nets.
- Developed recommendations to both address supply- and demand-side inefficiencies and increase the availability of high-quality, affordable maternal health commodities. These recommendations have formed the basis for a series of global- and country-level advocacy briefs developed by PATH and the Reproductive Health Supplies Coalition.
- Helped to reshape the Global Fund’s approach to its $7+ billion investments in health products through developing concrete strategies that optimize “value for money.” These led to the Global Fund’s adoption of a market shaping strategy, which experts cited as having the potential to save an initial $500 million, enabling the Global Fund to reach many more patients.