Health ministers from across the Western Pacific have backed further work on voluntary cooperation to improve access to essential medicines and other health products, including examination of a possible pooled purchasing pilot. The discussion at the World Health Organization’s regional committee in Manila was exploratory: no procurement scheme has been established, and further technical analysis and consultation are still required.
Malaysia proposed starting a pilot with a small number of essential medicines for which participating countries share clear needs. Papua New Guinea and the Marshall Islands offered to host pilot sites. Palau, Samoa, Tonga and Tuvalu also voiced support for the proposal, while Samoa stressed that Pacific island countries and areas should have an equitable voice.
The proposal emerged from a ministerial roundtable convened at the Philippines’ request during the committee’s 77th session. Delegates supported a country-led and voluntary approach that would complement, rather than replace, national health systems and existing arrangements. They also emphasised that strong national regulatory systems remain essential to ensure medicines and other products are safe, effective and of assured quality.
Five areas under consideration
The discussion went beyond pooled purchasing. The regional health body outlined five possible areas for cooperation: stockpiles of rare and critical products such as antidotes and antitoxins; regulatory reliance or recognition; shared intelligence on shortages and supply security; demand aggregation and collaborative procurement; and joint emergency preparedness.
These options address different points in the supply chain. A common view of shortages could help governments identify supply risks earlier. Regulatory cooperation could reduce duplicated assessment work, while still relying on national safeguards. Combining demand for selected products could potentially improve purchasing leverage, but would require countries to agree on needs, product specifications and the practical terms of a purchase. The discussion did not settle those operational questions.
Countries also raised demand forecasting and market transparency. Japan asked for greater clarity about the scope of any regional arrangement and how partners might fit into it. Several delegates pointed to subregional groupings, including the Association of Southeast Asian Nations, as a possible practical base for cooperation. Existing regional efforts on drug, vaccine and diagnostic security were cited as sources of experience.
Access pressures and next steps
The regional health body says nearly 600 million people in the Western Pacific Region, or 27 per cent of its population, face financial hardship linked to health spending. Medicine costs are a major driver of out-of-pocket payments. Economic and geopolitical pressures on supply chains and health budgets add to the difficulty of maintaining access, particularly where markets are small or supply is vulnerable.
Examples from other regions were discussed as possible lessons rather than templates. The Pan American regional revolving funds have decades of experience in pooled purchasing, while European initiatives and African regulatory cooperation were also described. Delegates were asked to consider which products and access problems might benefit most from joint action, where combining demand could make a measurable difference, and what governance, funding and regulatory safeguards would be needed.
The regional director said member states had asked for a concrete plan with clear milestones. The meeting record says further consultations are planned, with practical proposals to be presented to member states ahead of the next regional committee session. The health body says it will continue technical analysis and consultation, taking country needs and existing mechanisms into account.
That leaves the idea at an early stage. A pilot would still need participating governments to identify medicines with shared demand, determine how orders and financing would work, and agree how product quality and supply would be assured. The offers from Papua New Guinea and the Marshall Islands indicate interest in testing the concept, but do not constitute a launch or a commitment to buy medicines. The next test is whether countries can turn the broad support into a workable, voluntary arrangement that fits their national systems.
