The Strategic Fund of the Pan American Health Organization (PAHO) is a regional technical cooperation mechanism for pooled procurement of essential medicines and strategic health supplies. Thus, the Fund is a central component of PAHO's strategy to move towards Universal Health.
The Strategic Fund strengthens strategic supply management systems, providing technical cooperation to plan demand, guarantee rational use and avoid stock-outs in the countries of the Americas.
The products purchased through the Fund meet international standards in safety, efficacy, and quality.
(Last updated January 2022.)
The PAHO Strategic Fund and PAHO Revolving Fund collaborated to develop a series of brief videos highlighting each fund's key benefits and unique advantages. This specific clip, focusing on the Strategic Fund, showcases how the mechanism leverages technical cooperation to help procure affordable and quality-assured essential medicines and supplies on behalf of Member States across the Americas region. Learn more about the critical role of these funds in improving the accessibility and affordability of health services in the Americas region.
Question: What has been the impact of the Strategic Fund of the Pan American Health Organization for your country in terms of medicine and supplies during the post-pandemic phase? Interviews are available in the original language in which health authorities responded.
Dr. Roshan Parasram, Chief Medical Officer, Trinidad and Tobago
Dr. Víctor Hernán Martínez, Vice Minister of Health of Paraguay
Dr. José Leonardo Ruales. Minister of Health of Ecuador
Dr. Marcelo Queiroga. Minister of Health of Brazil.
To achieve equitable delivery of health care services, access to affordable quality medicines and medical supplies is required. To achieve equitable delivery of health care services, access to affordable quality medicines and medical supplies is required. Access to quality medicines and health supplies can be facilitated if the selection process takes into consideration factors of quality, efficacy and cost, if transparent price information is available, if procurement mechanisms promote competition, and if planning systems ensure sustainable delivery.
To assist Member States in the acquisition of quality essential public health supplies at affordable prices, the Director of the Pan American Health Organization (PAHO) established the Regional Revolving Fund for Strategic Public Health Supplies (the Strategic Fund) during the 42nd Directing Council of the Pan American Health Organization, Washington DC, 25th - 29th September 2000. The Strategic Fund aims to build capacity in drug supply management and procurement programming and planning at the national level.
The PAHO Regional Revolving Fund for Strategic Public Health Supplies (Strategic Fund) was established during the 42nd Directing Council of the Pan American Health Organization (PAHO), in accordance with PAHO Financial Regulations and at the request of PAHO Member States, in September 2000. Link to Brief Overview for the PAHO Strategic Fund
Countries participating in the Strategic Fund are using the following technical guide to review the supply management system and develop a procurement plan. The technical guide promotes an integrated approach to procurement planning and highlights the importance of a consultative process in country, with the participation of all actors, to develop a procurement plan that will ensure continuous availability of products within the supply chain, and identify possible weaknesses within the supply chain that have to be addressed. The document has been jointly developed by PAHO, COHAN, and Management Sciences for Health.
A Practical Guide for procurement planning and management Of strategic public health supplies. (PAHO, 2006)
Operating Procedures for the Regional Revolving Fund for Strategic Public Health Supplies (Strategic Fund, Updated: September 2022)
Demand Forecasting Chagas LATAM (DNDi, PAHO, Médicos sin Fronteras) (Exel Tool, updated 2012)
Estimación de demanda de medicamentos antichagásicos en países de América Latina (Manual de usuario). (DNDi, PAHO, Médicos sin Fronteras , versión 3, junio 2013) (only in Spanish)
Any Member State can participate in the Strategic Fund by signing an agreement with PAHO. In doing so, Member States agree to follow established procedures for procurement through the Strategic Fund. PAHO will provide technical support to assist countries in achieving Strategic Fund objectives. The Member State will designate a focal point in the Ministry of Health who acts as the principal liaison with the Strategic Fund. The Member State is required to abide by financial rules and regulations of PAHO. Global Fund Recipients may also purchase essential public health supplies through the Strategic Fund. To do so they must also sign a 'memorandum' agreement with PAHO.
The following are the key steps to be followed for procurement through the PAHO Strategic Fund:
The Member State or the Principle Recipient (PR) reviews needs in the public health supplies.
The Member State or the Principle Recipient (PR) defines and reviews the local procurement cycle.
The Member State or the Principle Recipient (PR) prepares a procurement plan.
Based on planning process, the Member State requests prices from the Strategic Fund.
The PAHO Procurement Services Unit at Washington DC requests information from different suppliers and provide prices through PAHO Country Offices.
The Member State or the Principle Recipient (PR) makes payment to PAHO.
PAHO purchases the product on behalf of the Member State and makes payment to the suppliers.
The Member State or the Principle Recipient (PR) receives quality products in accordance with the agreed shipping terms.
National laboratories execute quality control testing of products received. When necessary, PAHO may test the quality of a product in a PAHO/WHO selected laboratory.
PAHO evaluates and reviews the procurement planning process jointly with the Member State or the Principle Recipient (PR).
Additional details on ordering procedures, guidelines, agreement model, and participation
A Practical guide for procurement planning and management of strategic public health supplies. (PAHO, 2006)
Operating Procedures for the Regional Revolving Fund for Strategic Public Health Supplies (Strategic Fund, Updated: June 2010)
Demand Forecasting Chagas LATAM (DNDi, PAHO, Médicos sin Fronteras) (Exel Tool, updated 2012)
Estimación de demanda de medicamentos antichagásicos en países de América Latina(Manual de usuario). (DNDi, PAHO, Médicos sin Fronteras,versión 3, junio 2013) (only in Spanish)
Model agreement between a government and PAHO for participation in the Strategic Fund (updated Sep 2020)
Addendum No. [X] To the Agreement between The Government of [Country] and the Pan American Health Organization for the participation of [Entity] In The Regional Revolving Fund for Strategic Public Health Supplies.
All Ministries of Health and Government Institutions of the Public Health Services Network of the countries that are members of PAHO can purchase medicines and supplies through the Strategic Fund. To do this, you only need to sign an agreement with the Organization.
As of May 2021, 35 countries and territories in Latin America and the Caribbean have signed agreements with PAHO to use the mechanism, as well 14 health agencies. Responding to the increasing needs of Member States, the Strategic Fund has negotiated long-term agreements for WHO-prequalified HIV/AIDS and cancer treatments at substantially reduced prices, spearheaded a joint initiative for cardiovascular diseases, and strengthened in-country capacity-building for demand forecasting and inventory management.
The products purchased through the Strategic Fund meet international standards for safety, efficacy, and quality. The Fund provides medicines and supplies included in the World Health Organization (WHO) Model List of Essential Medicines and adheres to the recommended guidelines to strengthen
priority public health programs for communicable and noncommunicable diseases, neglected tropical diseases, vector control, and diagnostic kits and equipment.
By pooling resources, the Strategic Fund offers significant savings for Member States by securing prices that are often considerably lower than market rates. Moreover, through its wide-ranging technical cooperation, the Strategic Fund
supports national-level capacity-building for supply chain management, demand forecasting, and procurement planning, while ensuring a single fair price for all participating countries.
Available WHO-prequalified diagnostic tests:
Rapid tests for HIV
Rapid self-tests for HIV
Rapid dual HIV-syphilis tests
Rapid treponemal, and dual treponemal-nontreponemal tests for syphilis
Rapid tests for malaria
Rapid tests for hepatitis B and C
Rapid molecular tests for HIV, HPV, hepatitis B and C
Rapid molecular tests for TB (Xpert® MTB/RIF and Xpert® MTB/RIF Ultra)
View the complete list of medicines and supplies and the WHO-prequalified diagnostic test that can be purchased through the Strategic Fund, along with reference prices and information on ordering procedures.
Countries that purchase products through the Strategic Fund must transfer the funds to PAHO in accordance with the estimate of the purchase. Otherwise, they can access the credit line.
The costs of acquiring products include the product price, freight, and insurance, plus 4.25% of each purchase order. This includes 1.75% directed to administration expenses and 2.5% for the capitalization account needed to finance the lines of credit.
CD58.R4 - Review of the Charge Assessed on the Procurement of Public Health Supplies for Member States
Here are some benefits of using the Strategic Fund:
The Strategic Fund ensures high standards and transparency in the procurement process, in line with the United Nations’ best practices.
The Fund signs long-term agreements (LTAs) with suppliers for many products of high interest to the countries, establishing prices for a specific period. LTAs improve the efficiency of purchases, set predictable prices, and help to ensure quick and timely delivery of quality-assured products.
To learn more about the Strategic Fund or to place an order, please contact the PAHO office in your country, or by email: firstname.lastname@example.org
1. What is the Strategic Fund?
2. Why is the Strategic Fund important?
3. What are the advantages for Member States in participating in the Strategic Fund?
4. What are the objectives of the Strategic Fund?
5. Does the Strategic Fund only focus on procurement of medicines?
6. What is the difference between the Strategic Fund and the EPI Vaccine Revolving Fund?
7. How does the Strategic Fund work?
8. What countries are currently participating in the Strategic Fund?
9. What is a "Strategic Public Health Supply"?
10. What kinds of products are included in the list of Strategic Fund Products List?
11. What technical support do Member States receive when they subscribe to the Strategic Fund?
12. How does the Strategic Fund ensure the quality of supplies?
13. What role does PAHO play in the management of the Strategic Fund?
14. What are the perspectives for the Strategic Fund in the future?
15. How can Member States participate in the Strategic Fund?
16. Can Global Fund Principal Recipients participate in the Strategic Fund?
17. How can countries acquire medicinal products through the Strategic Fund?
18. How do Member States pay for medical supplies?
19. Where can I find more information about the Strategic Fund?
A/ The Strategic Fund is a mechanism created in the year 2000 by the Pan American Health Organization (PAHO) to facilitate the acquisition of strategic public health supplies in the different Member States. Through technical support in procurement, the Fund promotes the continuous availability of quality strategic supplies at low cost. The Strategic Fund helps to build capacity in drug supply management and procurement programming and planning at the national level. The Strategic Fund is also known as the Regional Revolving Fund for Strategic Public Health Supplies.
A/ Access to public health essential medicines is a global priority. The emergence and re-emergence of transmissible diseases, the increasing mobility of populations across borders, and the need to reduce mortality and morbidity rates in the Region makes it vital that the Member States are able to access essential public health supplies. According to PAHO, the cost of medicines can represent up to 35% of national health budgets in Member States. In some countries, the cost of medicines can represent 50% - 60% of household health cost. In many cases, medicines are unaffordable and inaccessible for much of the population.
In addition, PAHO Member States face other important challenges in improving access in public health essential supplies. Some of these challenges include or are related to: the selection of quality products; limited public financing for medicines acquisition; insufficient information on product prices; intellectual property rights. Moreover, little attention has been paid to supply management systems and effective programming and planning that facilitates the continuous availability of public health supplies.
In this context, the Strategic Fund becomes an important initiative for the Region. The Strategic Fund links planning processes in strategic public health supplies with acquisition processes, promoting the availability of pharmaceutical supplies and quality medicines.
Through the Strategic Fund Member States can not only acquire public health supplies that meet PAHO/WHO quality standards, but also can avail of technical support in programming and planning processes. The Strategic Fund also assists Member States in the acquisition of public health supplies in emergency cases.
A/ The main benefit for a Member States participating in the Strategic Fund is PAHO technical support in procurement planning and programming to ensure continuous availability of essential public health supplies. In this way, national capacity in Member States to meet needs and acquire supplies is developed.
The Strategic Fund also guarantees the acquisition of quality essential public health supplies through a transparent process. In addition, the Strategic Fund uses prequalified suppliers who meet PAHO/WHO quality standards.
Member States also benefit from the PAHO Strategic Fund by purchasing essential public health supplies at low cost. The Strategic Fund negotiates with different international suppliers and offers supply alternatives when possible to Member States. Likewise, the Strategic Fund offers price estimates for products based on the average price of purchase orders executed or quotes offered by suppliers. As a result, Member States can additionally avail of a price reference list for key key products, which can be used in consultation during the procurement decision-making process.
A/ The objectives of the Strategic Fund are:
A/ Even if the main purpose of the Strategic Fund is to facilitate access to essential medicines and priority public health supplies to countries throughout the Region, this is not its only function. The Fund offers important technical support to participating countries in several ways:
A/ The Vaccine Revolving Fund is a mechanism for the acquisition of vaccines and related supplies. The Strategic Fund focuses on other essential public health supplies. The Strategic Fund was established based on the successful experience of the Vaccine Revolving Fund.
A/ Member States review needs (technical and otherwise) in the procurement of essential public health supplies. PAHO, through the Strategic Fund, offers technical support in procurement planning and supply management. Thereafter, the Member State can purchase through the Strategic Fund. Products required by the Member State should meet the criteria defined for a strategic public health supply and should be included in the Strategic Fund Product List. Strategic Fund suppliers are prequalified by PAHO/WHO and are selected based on the quality of their products and prices offered, and performance history. The Strategic Fund negotiates with different international suppliers to obtain low product prices. All products offered through the Fund meet PAHO/WHO quality standards.
The Fund is capitalized through the allocation of a portion of the 2.5% procurement service charge to the Fund's capital account. As countries purchase through the Fund, the purchasing power of the Fund will increase resulting in lower product prices for participating countries.
To place an order the Member State transfers funds to PAHO and requests PAHO to purchase required products. The products are then shipped from suppliers to the country.
Member States and/or the Principle Recipients (PR) participating in the Strategic Fund deposit funds with PAHO in order to purchase products through the Fund. Once the payment is received, PAHO deposits the funds in a separate Member State Account from which supplier invoices are paid. Any balances are retained in this account for future procurement by the Member States, or refunded as required. For some exceptions, as a procurement mechanism, the Strategic Fund allows participating members to utilize a common fund for payment of authorized purchases of essential public health commodities. Members make reimbursement to the fund for the cost of each purchase within a specified period of time.
A/ 27 As of June 2020, 34 countries in Latin America and the Caribbean have signed agreements with PAHO to use the mechanism (Argentina, Bahamas, Barbados, Belize, Bermuda, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, El Salvador , Guatemala, Grenada, Guyana, Haiti, Honduras, Turks and Caicos Islands, British Virgin Islands, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Dominican Republic, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, Uruguay and Venezuela).
A/ A Strategic Public Health Supply is a product that satisfies the following criteria: is listed, recognized and recommended by a WHO Expert Committee or Working Group (e.g. Essential Medicines, WHOPES recommended compounds, HIV Diagnostics etc). is included in WHO recommended protocols or diagnostic algorhythms and is considered highly effective in disease treatment or prevention. when continuously available, significantly contributes to improvements in mortality rates and patient quality of life, and/or minimizes possibilities of drug resistance in treatment. is subject to particular challenges in areas of product sourcing, pricing, forecasting, and purchasing. economies of scale are achievable as volumes purchased increase.
A/ Medicines related to HIV/AIDS: Medicines for HIV/AIDS opportunistic infections Antiretroviral medicines Diagnostics Anti-Chagas medicines Antituberculosis medicines Anthelmintics medicines Non-Communicable Diseases medicines Antimalarial medicines Insecticides Non-Communicable Diseases medicines
A/ In procurement and supply management, the following are some of the ways in which the Member States receive technical support by participating in the Strategic Fund: Development and review of procurement plans Capacity building in needs estimation, forecasting, purchasing, financing and pricing, and issues relating to intellectual property rights Procurement through the Fund mechanism Supply chain assessment, support and monitoring Linkages with other Global Procurement mechanisms In quality assurance and procurement, Member States receive technical support in: Supplier prequalification Quality control of medicines Technical support in procurement quality assurance Moreover, the Strategic Fund: Facilitates dialogue between suppliers and Member States Provides reference prices Facilitates the acquisition of products in emergency situations
A/ The quality of the supplies purchased through the Strategic Fund is ensured by: Pre-qualification of suppliers to ensure that supplies meet the quality criteria established by PAHO/WHO Quality Management in Procurement Support in quality control of products at the national level.
A/ Technical and administrative units in PAHO perform specific functions to ensure operations of the Fund. Procurement and Supplies Management (PRO) manages the procurement process and facilitates the shipment of products to consignees reviews and authorizes the payment of supplier invoices. Communicable Diseases and Health Analysis (CHA) Provides technical support in medicines and supplies used in the management and control of vector borne diseases such as tuberculosis, malaria, chagas, and leishmaniasis Family, Gender and Life Course Department (FGL) Provides technical support in medicines and diagnostics management in HIV/AIDS, child and adolescent, and maternal health Health Systems and Services Department (HSS) Provides technical support in supply management, quality, and rational use of essential medicines and health technologies Financial Resources Management (FRM) manages deposits to the Member State accounts makes payments to suppliers maintains the Fund accounts prepares financial statements/ invoices for purchases as necessary provides financial statements to Member States Legal Counsel (LEG) drafts country agreements approves bid documents supports procurement contractual agreements provides other legal services. Planning, Budget, and Resource Coordination (PBR) Supports the development of the Fund, its orientation, and operation in accordance with Mandates of the PAHO Governing Bodies.
A/ The Strategic Fund has been structured through a series of internal (within PAHO) and external partnerships to maximize support to participating countries. The PAHO Working Group is an internal body that was established in 2004 by the Director of PAHO to support and implement activities of the Strategic Fund. It is composed of technical and administrative units at PAHO and meets at least twice a year to review actions and progress of the Fund. Technical staff in medicines, procurement officers, financial staff, legal personnel, and project management staff in PAHO dedicate time to supporting activities of the Strategic Fund. The Working Group under the coordination of the Medicine Project team implements the work program through partnerships established in the region. Key partners include (but are not limited to): BDS (Barbados Drug Service) ENSP (Fiocruz, Brazil; PAHO/WHO Collaborating Center in Pharmaceutical Policies) MSH (Management Sciences for Health) GDF (Global Drug Facility)/ GLC (Green Light Committee) Global Fund (Particularly Principal Recipients) UNITAID Clinton Foundation
A/ Member States may participate in the Fund by entering into an agreement directly with PAHO. The intention of this agreement is to commit participating Member States to abide by the requirements set out for procurement through the fund, as well as to provide and promote technical cooperation necessary to fulfill the objectives of the fund.
A/ The Principal Recipients (PR) of projects financed by the Global Fund against AIDS, Tuberculosis, and Malaria (GFATM), may also use the Strategic Fund for procurement of Strategic Fund products by signing a Memorandum of Understanding (MOU) with PAHO.
A/ The Ministry of Health or Principal Recipient will work directly with the PAHO country office in the selection of products and product forecasting. The request for procurement is sent to PAHO Country Office. Once received, the Strategic Fund will consolidate requests from different countries. Prices offered by suppliers are issued to the Member State through the PAHO Country Office. To place an order the Member State transfers funds to PAHO and requests PAHO to purchase required products. The products are then shipped from suppliers to the country.
A/ The financial management of the Strategic Fund is governed by PAHO Financial Rules and Regulations. Member States and/or the Principle Recipients (PR) participating in the Strategic Fund deposit funds with PAHO in order to purchase products through the Fund. Once the payment is received, PAHO deposits the funds in a separate Member State Account from which supplier invoices are paid. Any balances are retained in this account for future procurement by the Member States, or refunded as required.
A/ The technical document: "Operating Principles for the Regional Revolving Fund for Strategic Public Health Supplies", provides more information on the Strategic Fund. The document can be downloaded from the Internet (Operating Procedures for the Regional Revolving Fund for Strategic Public Health Supplies (June 2010)) Contact the Strategic Fund using the following email address: email@example.com