Latin American activists keep contraceptive supplies flowing

A Peruvian family on the way to the pharmacy to purchase contraceptives.

Advocates are using data to help governments adapt quickly to COVID-19 disruptions — and get families the health care products they need

Normally, it takes one month to manufacture a male condom; in the wake of COVID-19, it takes four months. Production times for other reproductive health commodities have been similarly prolonged: 8-9 months for a generic implant, a full year for emergency contraception. And even once production is complete, contraceptive suppliers need to navigate a shipping landscape confounded by labor shortages and national border closures. Altogether, these delays are a recipe for commodity stock-outs and a threat to the successes won by national family planning programs over many decades.

The consequences of these delays could be dire: in Peru, for example, experts estimated that without efforts to mitigate COVID-19 disruptions, as many as 731,000 women could be unable to use contraception, which would have resulted in hundreds of thousands of unintended pregnancies.

That’s why early in 2020, as COVID-19 began its rapid spread, advocates representing 14 Latin American and Caribbean countries got to work collecting data on national stocks of essential contraceptives such as condoms, contraceptives and morning-after pills. They projected new timelines for the arrival of additional supplies, taking into account anticipated manufacturing and shipping delays, and combined these data with existing information on planned government purchases and monthly consumption. The data fed into a simple Green-Yellow-Red tool to help governments quickly and easily determine when it was time to order new supplies. Peru and other regional governments have used the Green-Yellow-Red alerts to time their contraceptive orders and avoid potential stockouts during the pandemic.

“In just the last quarter of 2020, government decision-makers used our mapping tools more than a thousand times, helping them to secure their contraceptive supplies in the midst of the pandemic,” says Milka Dinev, ForoLAC Regional Advisor and Maternal Health Supplies Lead. “Keeping these supplies flowing is so important. We know that lack of contraception means more maternal mortality, more unsafe abortions, and more infant deaths.”

Advocates also went a step further, crowdsourcing a database of suppliers across Latin America who could help countries restock even while global production and shipping remained disrupted. Condoms from Brazil. Injectables from Peru. Birth control pills from Chile, Colombia, and Argentina. In all, they identified 60 pharmaceutical companies producing contraceptive supplies in the region. Dinev said there’s advocacy work ahead to ensure governments connect to these alternatives.

These efforts build on more than a decade of work by the global Reproductive Health Supplies Coalition and its network of members in Latin America and the Caribbean, ForoLAC, to strengthen global supply chains and increase access to a full range of affordable, quality reproductive health supplies in low- and middle-income countries. The Coalition’s sophisticated and transparent forecasting tools help procurers and manufacturers coordinate to match supplies and demand.

COVID-19 laid bare the fragility of global supply chains, leaving governments at all levels scrambling for basic supplies, from sexual and reproductive health commodities to PPE to medical oxygen. And advocates warn these same vulnerabilities now threaten the global rollout of COVID-19 vaccines. Tools like those developed by ForoLAC — which allow key players to share information, watch changes in the market and quickly adapt supply chains — could point the way toward solutions for keeping the clinic and pharmacy shelves stocked with affordable health supplies of all kinds.

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Sharing information across sectors and borders helps ensure that supplies are matched with demand.

A Peruvian pharmacy restocks contraceptive supplies.

 Peruvian family on the way to the pharmacy to purchase contraceptives.

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