The WHO Regional Committee for Africa is an ideal forum to present the bulk purchasing initiative and obtain the political commitment of Member States and to promote active participation in it.

The support of AFRO through its Essential Drugs Programme could play an important role in the development of the initiative. This would figure within the framework of its regional support plan for the pharmaceutical sector. Its role of technical assistance to the process through the executive secretariat lies within the mandate of the organization and is strongly recommended.

The WHO Representation in Saudi Arabia may facilitate the transfer of the report and the conclusions of a similar study tour by Jordanian consultants, and facilitate the exchange of information and the dissemination of the documents that have been consulted during the mission (list of consulted publications in annex 3).

In order to build on the enthusiasm for the initiative launched by the ACAME with the support of WHO, and to avoid discouragement, it would be preferable to prepare a realistic timetable for the development of bulk purchasing.

A deadline of six months for the realization of a framework agreement after obtaining the political agreement from the health authorities, and of one year for the launching of the first tender, may be optimistic but remains within the range of possibilities.

The number of products to include in the first tender should be limited in order to allow the execution of a test within a reasonable time. A number of 20-50 products does not seem too ambitious. The same remark is valid for the number of participating countries. Although it seems that several countries have indicated serious interest, the number of countries should be limited to not more than six. The selection of the countries should be based on the level of commitment, taking into account the different existing supply systems, and the discipline required for the efficient implementation of the first tender process.