The global health community has set ambitious goals for 2030: To achieve universal health coverage, access to sexual and reproductive health services, and to end the AIDS epidemic. In order to realize these goals, we need to ensure that the available resources are spent efficiently. Applying an open contracting lens in healthcare procurement provides the opportunity to do so.
A lack of transparency in health has serious consequences. It creates markets for counterfeit and overpriced medicines, and undermines patients’ trust in health services. Responsible health funders and suppliers are deterred by unpredictable regulatory systems, and it gives rise to serious risks of mismanagement and corruption.
There are other challenges as well. In some countries, there is limited political will to address the health needs of populations whose voices are marginalized because of stigma, social discrimination and unequal gender norms. There is violence and discrimination against women, girls, and people of diverse sexual orientation, gender identity, expression, and sex characteristics. And conservative gender and social norms prevent self-determination and access to sexual health information and services.
Transparency, participation and accountability are essential in this: To build political will for investments, for better planning and implementation, corruption prevention, and to ensure services are responsive to people’s needs, including those most at risk of getting left behind.
Meaningful and inclusive participation from civil society in decision-making processes has proved to be both a necessary social justice imperative and a promising way to build more responsive health systems. People need information to make decisions about their own health. And if health services are to be responsive to their needs, they must be involved in planning, budgeting and monitoring them.