The limited resources available for the procurement of antiretroviral medicines (approximately 19 mil MDL or $1 million) is necessitating careful consideration of quantities and needs prior to placing an order as the local market is small and there exists increasing competition on international markets for available medication.

Sorina Vesiolii is a health expert at the Positive Initiative NGO which is a leading patient organisation that advocates for a decent and healthy life for persons living with HIV.

She believes that it is essential that procurement is predictable and sustainable, which means that life-saving medicines are available when needed and in required quantities. To achieve this goal, the national authorities need to predict patterns and determine which quantities are required, as well as when and to whom these should be provided to. “Both insufficient and excessive stocks are not desirable, as this implies on the one hand that patients are under risk, and that on the other hand there may be an inefficient use of resources and that medication might expire,” says Sorina.

In tandem with the planning of needs, a reasonable consumption of health commodities is essential. “Enormous amounts of products are consumed daily, such as alcohol swabs, gloves, medical caps, and syringes. A huge amount of waste is generated that subsequently harms the environment and contributes to climate change, biodiversity loss, as well as air and water pollution, says Sorina. “Thus, one of the main goals when procuring health commodities should be to produce less waste and to use fewer natural resources that would reduce the negative impact on the environment and human health.”

Supported by UNDP’s Global Project for Sustainable Health in Procurement (SHiPP), Sorina’s NGO “Positive Initiative” analysed during the 2018-2021 period sustainable procurement practices in Moldova. The report concludes that implementing sustainability criteria shall be approached with due complexity, which implies changes in legislation, training of contracting authorities, as well as implementing a monitoring system.

Sorina sees this process as vital to implementing the sustainability criteria in the medical field which will increase savings to the state budget. These savings can then be redirected to other critical needs that will improve the population’s quality of life.

The report recommends developing an electronic stock management system, which will allow the monitoring of all health commodities that are available in medical institutions across the country.

Following the report’s recommendations, the centralized health procurement regulations were improvised in September 2020 to streamline the procurement cycle of health commodities. In practical terms, the necessary quantities will be purchased in a timely fashion, and it will be possible to monitor the quantities in medical institutions and adjust the planning if needed.