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Joint procurement: driving EU health solidarity

When the COVID-19 pandemic hit in March 2020, countries found themselves facing potential shortfalls of medical treatments and equipment. Amid this sudden shift in needs and the arrival of a threat that would not be contained by borders, the EU needed to act quickly. Fortunately, it already had a mechanism, the Joint Procurement Agreement, that could help member states to collectively overcome difficulties securing affordable medical supplies.

Partly developed to avoid a repeat of disparities that arose in the EU amid the 2009-10 H1N1 swine flu pandemic, the JPA gives EU countries the option to club together in the event of a serious crisis for the rapid purchase of essential supplies, when going it alone would present cost-based and logistical challenges. Ultimately, its aims are equity of access, improved supply security and more balanced prices for the participating EU countries. When COVID-19 took hold, requiring countries to acquire large quantities of drugs, medical equipment and personal protective equipment, the JPA emerged as an important tool for the 36 participating countries (comprising EU and European Economic Area member states and candidate states).

Countries participating in the Joint Procurement Agreement and signing dates

Within two weeks of the World Health Organization officially declaring the pandemic, the European Commission had issued four tender requests for JPA Framework Contracts, covering testing kits, ventilators and various PPE. Millions of doses of medicines and items of medical equipment were secured as the pandemic continued.1 For example, in November 2022 the EC secured almost 3.5 million five-day treatment courses of nirmatrelvir/ritonavir, a treatment intended for people at risk of developing severe disease.2 Previously, in July 2022, the EC secured a deal to provide 2.25 million vials of the antiviral treatment remdesivir, extending a deal that had ended that April.3 JPA Framework Contracts were also among the agreements that ensured the EU equitable, affordable access to vaccines and monoclonal antibodies.4

The JPA in action

The basic function of the JPA is relatively simple: individual member states opt into a Framework Contract for a specific item. The EU’s Health Preparedness and Response Authority then puts the contract out for tender to a handpicked list of producers, and the chosen supplier (or suppliers) agrees to make available a specified quantity of the item to the countries that have signed the Framework Contract.

“In retrospect, the JPA was most probably the right tool at the right moment to address the peaks of the pandemic in Romania,” says Cristian-Silviu Buşoi, a Romanian MEP sitting with the European People’s Party Group in the European Parliament. “From shaping our rapid response capabilities to ensuring [the] longer-term resilience of our health system, strongly hit by COVID-19, we can say now that the flexibility offered by JPA EC agreements was a critical piece in our fight to save thousands of patients’ lives.”

The aim of the JPA is to provide support in times of crisis by ensuring rapid, equitable access, balanced prices and improved security of supply for all countries, regardless of country size or the capacity of national infrastructure and regulatory bodies. Buşoi explains that, at the national level, mechanisms such as the JPA can reduce the length of access paths, ensuring treatments for critical patients are administered in a timely manner.

“Emergency response mechanisms like JPA are strengthening solidarity and trust among EU countries when it comes to addressing complex health challenges. During the pandemic, the execution of JPA was smooth and there was clarity about the contracts in place,” he adds.

A force for closer EU health cooperation

In the context of the COVID-19 pandemic, the JPA seems to have met its goals of providing valuable support in times of crisis. The Framework Contract for remdesivir, for example, provided 22 countries with reliable, affordable access to a therapy that, according to Copenhagen Economics, freed up more than 2 million hospital beds and more than 1.1 million intensive care unit beds in Europe in 2021-22. 5

Some organizations have drawn attention to challenges posed by joint purchasing that span various areas, from supply chain (the risk that they could drive market consolidation and cause shortages elsewhere) to legal and regulatory differences between countries.6 These are valid concerns that should be considered as the JPA evolves further. However, pandemic-era JPA contracts assisted with distribution of medicines and medical supplies to multiple countries, while fostering political will and trust.7 Overall, the JPA seems to help EU member states react with speed and agility to large-scale crises, even if there may be some creases to iron out.