US strikes $25M UNICEF deal to avert medicine shortages

UNICEF is the United Nations Children’s Fund. In this agreement, it will buy and arrange delivery of medicines, medical equipment, and some nutrition supplies for countries that previously relied on the U.S.-funded program. The arrangement matters because uncertainty followed the dismantling of USAID and the planned closure of its supply-chain program.

The State Department said UNICEF would procure the supplies. UNICEF valued the one-year agreement at $25 million. It covers at least 15 countries, including the Democratic Republic of the Congo, Haiti, and Mali. No orders had been placed yet, but UNICEF expected them shortly.

The agreement is a temporary bridge while countries negotiate new health-assistance arrangements with Washington and build their own systems. It does not replace all disrupted U.S. aid. Still, UNICEF’s role should help keep essential supplies moving and prevent another abrupt break in deliveries to health facilities.

The agreement provides $25 million for one year. UNICEF said it will support at least 15 countries previously covered by the program. Those countries include the Democratic Republic of the Congo, Haiti, and Mali. The money is intended to keep maternal, child-health, and some nutrition supplies available during a period of major transition.

The scale is significant for the facilities receiving these deliveries, but small compared with the broader U.S. aid system. Maternal and newborn health supplies represented less than 1% of more than $5 billion spent by the USAID Global Health Supply Chain Program between 2016 and 2023. The program also handled malaria and HIV supplies.

The $25 million therefore functions as a targeted bridge, not a full replacement for previous assistance. Countries are negotiating new bilateral health agreements with Washington. UNICEF said orders had not yet been placed, but expected them shortly.

The agreement covers supplies used in maternal and child health, along with some nutrition supplies. It also includes the medical equipment needed under the program’s procurement and delivery arrangements. UNICEF will handle purchasing and movement of these items to at least 15 countries.

The article gives two urgent medicine examples from eastern Congo. Oxytocin helps prevent and treat postpartum hemorrhage, or dangerous bleeding after childbirth. Amoxicillin is an antibiotic used in pediatric care and during childbirth. Health workers at Nyangezi General Hospital said both had run out after earlier USAID donations stopped.

The agreement is not described as covering every health commodity previously supplied by USAID. Separately, U.S. authorities extended Chemonics’ deadline for delivering some malaria and HIV supplies. Countries can also order new U.S.-funded HIV and malaria supplies through the Global Fund’s ordering platform.

Interrupted supplies can remove basic tools that mothers, newborns, and children need during childbirth and illness. The article reports shortages of oxytocin, which prevents and treats postpartum hemorrhage, and amoxicillin, used in pediatric care and during childbirth. A break in deliveries therefore threatens access to treatments that health workers describe as lifesaving.

At Nyangezi General Hospital in eastern Congo, midwife Alice Bulambo said the facility had no oxytocin or amoxicillin after previously receiving them through USAID. The main government warehouse had experienced stockouts for more than a year. Health facilities then had to buy medicines at market prices.

That replacement mechanism increased pressure on families and facilities. Olivier Kabarati Amani said the cost of care had doubled, if not tripled, over six months. The article does not quantify additional deaths, but it shows how interruptions can reduce availability and make care more expensive.

The contract created a risk because the existing agreement between the now-defunct USAID and its supplier was due to expire. That supplier had been part of a system that procured and delivered health commodities to vulnerable countries. Officials feared deliveries could stop before new arrangements were operational.

The danger was amplified by long procurement timelines. Five former USAID officials said orders for maternal and child-health needs can require a year or more. Countries may need to forecast demand, arrange funding, place orders, and organize delivery. If the old contract ends first, warehouses and health facilities can run out before replacement supplies arrive.

The gap was especially concerning because the U.S. had frozen and scaled back aid programs for nearly 18 months. Details of new bilateral agreements were still being worked out. The UNICEF agreement, extended malaria and HIV deliveries, and Global Fund ordering route were intended to prevent another sudden interruption.

The U.S. global health strategy aims to move recipient countries toward self-reliance. Under more than 30 new bilateral health agreements, countries are expected to contribute funding and gradually assume responsibility for ordering and supplying health commodities. These agreements are worth billions of dollars combined.

The Democratic Republic of the Congo illustrates the transition. Its government aims to take over responsibility by next year, according to Polydor Kabila, coordinator of the universal health care program in the president’s office. However, recent uncertainty has made the process difficult. Countries were already moving toward greater responsibility, but procurement schedules are long.

UNICEF is providing an interim bridge while countries build these arrangements. The U.S. also extended some malaria and HIV deliveries and enabled orders through the Global Fund. The transition could reduce reliance on U.S. contractors, but the article indicates that countries still face immediate supply and financing challenges.

International medicine supply chains move products from procurement organizations and manufacturers through warehouses to health facilities. They depend on forecasts, funding, purchase orders, transport, storage, and local distribution. The article specifically shows countries using USAID-linked suppliers, government warehouses, UNICEF, Chemonics, and the Global Fund’s ordering platform.

When a supplier changes, a country must identify needs, secure money, select or use a procurement channel, place orders, and schedule delivery. Products then have to pass through warehouses and reach facilities. The article reports that maternal and child-health orders can take a year or more. That long lead time makes an expiring contract dangerous if replacement orders are not ready.

The current response uses several bridges. UNICEF will procure supplies under a one-year agreement. Chemonics received more time for some malaria and HIV deliveries. Countries can also order through the Global Fund while negotiating longer-term bilateral agreements and greater self-reliance.