Multiple factors have caused this shortage that mainly affects the Panamanian population, both insured individuals and private consumers. From the great demand accumulated globally after the resumption of production following the Covid-19 pandemic, the high costs of importing medicines into the country and the lack of national pharmaceutical infrastructure, to the complex bidding processes for the importation and distribution of medicines. This lack of public access to medicines has also generated a monopoly in the hands of the private market, which has led to price increases.
Direct procurement from the UN agencies would be an attractive and viable solution, for which there is evidence in other countries in the region. In 2022, the United Nations recognized that the purchase of medicines through the United Nations Office for Project Services (UNOPS) is the best procurement modality available due to its high impact, sustainability, timely implementation, proven benefits, best practices, added value for the environment and contributions to achieving the 2030 Agenda for Sustainable Development Goals.
This project has contributed enormously to Mexican public health, for example. UNOPS is responsible for 28% of the total expenditure of the Mexican public health system for the purchase of medicines and medical supplies. In only two years, the opening of the market, which in 2018 concentrated 80% of public spending in 18 suppliers, to 80% of public spending divided among 99 suppliers, was achieved. As a reference, in Panama 83% of the largest imports of medicines are concentrated in 8 companies.
In Mexico, this system has also promoted transparency and public information on purchases and has strengthened public health institutions. The Health for Wellness Institute (INSABI) of the Government of Mexico reported that: "the specific agreement with UNOPS includes an institutional strengthening component, so that our country can consolidate an international supply chain, which was achieved before the established deadline."
In Guatemala, the Ministry of Public Health and Social Assistance (MSPAS) has just approved the implementation of a system for purchasing medicines through UNOPS, a mechanism that had already been implemented through its Social Security since 2007 and which generated savings of US$200 without reducing the quality of the medicines. This system has also made procurement processes more efficient and transparent.
Honduras has also incorporated this procurement system through UNOPS with excellent results, generating a price reduction in reference medicines of between 40% and 300%. In addition, market participation was opened to a larger number of actors. The success of these agreements in neighboring countries, although with larger populations, but with similar problems, reaffirms that this is an encouraging solution.
Therefore, due to the instability of the Panamanian public system and its consequences on drug costs in the private market, I believe that direct purchases through the UN agency could be a good solution. A solution that would alleviate the already heavy burden of the Social Security Fund and benefit Panamanian public health.
Washington, DC, March 22, 2024. Panama will work with the World Bank to continue reducing emissions and adapting to climate change through a new project approved by the World Bank Group''s Board of Executive Directors today. The Panama Second Climate Resilience and Green Growth Development Policy Loan (DPL) will bolster reforms to decarbonize the transport and energy sectors and support Panama in building the capacity to adapt to climate change and mitigate its effects, benefitting the most vulnerable populations.
The second pillar will help Panama further develop its capabilities to manage its natural resources in a sustainable manner and plan for climate change. This includes support for instruments that enhance climate planning and governance, such as the National Climate Change Adaptation System and the Climate Change Scenarios, which will inform public and private investment planning going forward.
The operation builds on the previous Climate Resilience and Green Growth the Development Policy Loan (DPL), approved by the World Bank in April of 2023, and underscores Panama''s commitment to integrating sustainability and climate action in its economic and social policy management.
"Panama''s ability to sustain rapid economic growth and to further reduce poverty is interlinked with its ability to adapt to, and mitigate, the impacts of climate change," said Michel Kerf, World Bank Regional Director for Central America and the Dominican Republic. "This project demonstrates the country''s commitment to achieving a sustainable and resilient future in the face of climate change."
Climate change poses a significant threat to Panama''s economic growth, affecting the most vulnerable communities. The country is among the most exposed in the world to climate-induced natural hazards and altered weather patterns, including increased frequency and intensity of El Niño and La Niña events, which result in severe droughts and floods. Indigenous territories face heightened climate-related challenges, including rising sea levels and other hazards.
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