Procurement Mechanisms Research Articles

Procurement Mechanisms with Post-Auction Pre-Award Cost-Reduction Investigations

Integrating Cost Reduction and Supplier Selection Activities Manufacturers who outsource production may find ways to reduce suppliers’ cost to lower the contract price. Conventionally, this is done after supplier selection. However, in practice, a sizable portion of the degree to which the manufacturer can help a supplier reduce cost could be learned before the supplier starts production. This opens up a possibility to better integrate supplier selection and cost-reduction activities. In “Procurement Mechanisms with Postauction Preaward Cost-Reduction Investigations,” Chen, Beil, and Duenyas explore an alternative procurement process wherein, after suppliers’ initial pricing bids are collected, the manufacturer investigates suppliers’ cost-saving potential and then leverages this information to select the contract winner. They provide analytical and numerical evidence that this integrated procurement process not only helps the manufacturers reduce cost significantly, but also benefits the suppliers in many plausible scenarios.

Assessing perceptions of establishing a vaccine pooled procurement mechanism for the Western Pacific Region.

This study explored the demand and interest among countries in the World Health Organization Western Pacific Region (WPR) to establish and participate in a regional vaccine pooled procurement mechanism. National counterparts affiliated with Ministries of Health that are involved in the national procurement of vaccines within the WPR were identified and invited to complete surveys. Out of 80 counterparts invited, 17 (21%) responded, representing 13 of the 27 WPR countries. Five countries expressed interest in participating in a regional pooled procurement mechanism, 3 expressed lack of interest and 5 did not respond to the question. Preferred characteristics of the procurement mechanism, included flexible participation (i.e. non-compulsory), payment in local currency before receipt of goods and a fixed price for vaccines (i.e. not tiered pricing). Vaccine pricing disparities were noted among upper middle-income and high-income countries for five of the 13 routine vaccines surveyed. Eight countries listed budget planning, quality of vaccines, timely delivery, cost-saving and payment after receipt as potential benefits of pooled procurement.

Strengthening the Rule of Law and Good Governance amid COVID-19 Pandemic in the Global South

Disproportionate curtailment measures against the COVID-19 pandemic alongside compulsory vaccination (in the midst of rumours and conspiracy theories) have contributed to vaccination hesitancy, data and surveillance monitoring without due regard to civil and political rights. The absence of due regard to these rights by governments, undermine the observance of rule of law and good governance. Consequently, there have been sweeping implications on public order and security, disruption of electoral process and the right to dignity through torture and unlawful use of force. Socio-economic rights violations, relaxation of public procurement mechanisms, lack of capacity to deliver essential services, disinformation, perversion of justice, and gender-based violence have also overwhelmed the entire global health care system. The paper assesses curtailment measures against COVID-19 pandemic and its impact on rule of law and good governance in the Global South towards a better COVID-19 stimulus and recovery packages. It adopts doctrinal research method by relying on relevant statutes, international instruments, judicial decisions and literature. It finds that the discriminatory, inequitable curtailment measures and insufficient governmental social protections and economic supports, constitute “multiplier threat” that produces structural violence against vulnerable, marginalised communities and foreign nationals. The pandemic has created scientific uncertainty that necessitates global solidarity and scientific precautionary measures through digital and telemedicine leading to important health management. The paper calls for international democracy support for electoral reforms and United Nations oversight mechanisms for rule of law and good governance to promote transparency and accountability in the management of COVID-19 pandemic.

РЕАЛІЗАЦІЯ ПОТЕНЦІАЛУ ВЕНЧУРНОГО КАПІТАЛУ У ЗАБЕЗПЕЧЕННІ ІННОВАЦІЙНОЇ МОДЕЛІ РОЗВИТКУ ЕКОНОМІКИ

The article analyzes the problems arising in the process of forming a market environment for realization of the investment potential of a venture business. It has been noted a defining role of venture capital in meeting the financial needs of business in risky investments, which is based on the availability of venture companies with qualified financial management and the experience in managing innovative projects. The importance of developing global trends in the financial market as one of the most important conditions for the formation and subsequent accumulation of venture capital has been determined and the characteristic features of this process have been specified. It has been emphasized the essential role of the venture capital institution in solving macroeconomic tasks of strengthening economic growth, intensification of updates and modernization of the production base of economic entities by creating conditions for the implementation of expanded structural reproduction of capital. It has been defined also the main factors that ensure the intensification of these processes. It has been noted that venture capital is aimed at meeting the capital needs of enterprises in the processes of their implementation of the projects in their initial stages related to the research and development and commercialization of the previous results. Efficiency at these stages, supported by competent project and financial management, allows the enterprise to attract larger investment resources on milder conditions against the background of reduced investment risks. It has been concluded that there is a low demand for innovations that creates significant problems for the formation of an innovative business model. The lack of the enterprise management’s understanding of the feasibility of investing in innovation, as the main prerequisite for strengthening their competitiveness, has been identified as the main reason of this situation. The objective need for a dialectical transition of business entities to an innovative business model as their reaction to the intensification of competition and the inevitability of using such a model as the only way to ensure their competitiveness has been underlined. The necessity to intensify the role of the state in stimulating the development of venture business by applying the mechanism of state procurement for innovative products as well as budget financing for the purchase of innovative technologies developed in Ukraine for the state enterprises has been emphasized. Another form of such activation is the financing of innovative developments of small and medium-sized businesses. The role of the state is to form an appropriate impetus to increase innovation activity of the SME entities with a further reduction in the severity of such influence as the venture capital market intensifies and the state focuses on improving the institutional support of the venture business model.

Public-Private Partnerships in Infrastructure Projects: The Role of Ida Status of a Country

Public-private partnerships (PPPs) are increasingly promoted by advocates as an innovative policy tool for redressing inefficiency in traditional public procurement mechanisms. Governments, operating on razor-thin budgets in many developing countries, also pursue PPPs on the grounds that they will bridge their countries' infrastructure gaps. This paper empirically investigates the main incentives that motivate both public and private entities to pursue PPPs as an infrastructure investment tool, focusing on the International Development Association (IDA) status of a country. This study uses a cross-country panel regression for 36 developing countries over 1990-2019, where the outcome variable is the project count as well as the level of PPP investment (PPI). For the regression of the former the study applies Zero Inflated Poisson (ZIP), while for the latter it uses tobit model. While IDA status is negatively associated with PPPs, GDP per capita, economic growth, market size, M2 money supply and inflation are all positively related with PPPs. While volatile exchange rates discourage risk-averse investors, fuel export and foreign aid encourage them to participate in PPPs. Findings also suggest that private investors are less inclined toward PPPs in highly indebted and effectively governed countries. Although the years of PPP experience initially attract more PPPs, further experiences are proving to be frustrating and discouraging of future PPPs. The size of the market, purchasing power in terms of per capita GDP, and inflation all emerge as the most relevant factors in attracting PPPI. Countries with substantial foreign exchange reserves and higher fuel exports are found to attract greater PPPI. Similarly, crisis-ridden nations also pursue more PPPIs. Finally, government effectiveness is found to exert a negative impact on PPPI. The findings could be useful for governments of these countries to guide the design and implementation of policies conducive to a sound investment environment. The prevalence of PPPs in richer countries and the private sectors' preference for higher inflation and less effective government hint a rent-seeking motive on the part of private entities. Alternatives should, therefore, be investigated before pursuing the PPP route. If governments opt to engage in PPPs, they have to pay attention to certain macro conditions.

Improving Public Health and Governance in COVID-19 Response: A Strategic Public Procurement Perspective.

Good governance is the basis of dealing with major emergencies and protecting public health. It has become a major issue of the central government to construct a scientific procurement and supply system of emergency supplies. This article constructs the analytical framework of strategic procurement and expounds the realization mechanism of strategic procurement under an emergency situation to reflect China's procurement practice in COVID-19 response and improve public health and governance. Using case study, semi-structured interviews, and the Nvivo text analysis, this study found that emphasizing the strategic function of securing the public health,the top status of MSG, cross-sector procurement team, strong procurement and supply integration, comprehensive and in-depth procurement synergy mechanism are the successful experiences of China's emergency procurement. However, due to the temporary nature of the emergency procurement mechanism, strategic procurement planning, procurement management specialization, and procurement supply integration still need to be improved. The findings of this study further suggest that to improve public health and governance, it is pivotal to reconstruct the government procurement law to make it compatible with the emergency procurement and transform the government procurement system into a strategic procurement in a consistent and coherent way.

Research on policy diffusion mechanism of Government Procurement of Public Services based on an MFCM

PurposeThe purpose of this paper is to show that research on policy diffusion mechanism of Government Procurement of Public Services (GPPS) is beneficial to improve the efficiency of policy formulation and implementation.Design/methodology/approachIn view of the four dimensions which are internal demand, external pressure, policy innovation environment and service characteristic, a system of factors affecting policy diffusion is established. On this basis, a Multilayer Fuzzy Cognitive Map (MFCM) model for policy diffusion of GPPS is constructed. Nonlinear Hebbian Learning algorithm and genetic algorithm are applied to optimize the two components of the MFCM model, which are relationship between nodes at the same layer and influence weights between nodes at different layers, respectively. Taking Nanjing municipal government purchasing elderly-care services in China as the empirical object, simulation of policy diffusion based on the MFCM model is carried out, aiming to obtain the key factors influencing policy diffusion and the dynamic diffusion mechanism of GPPS policy.FindingsResearch results show that, compared with monolayer Fuzzy Cognitive Map, the MFCM model converges faster. In addition, simulation results of policy diffusion indicate that economic development level of jurisdiction, superior pressure, administrative level and operability of services are key influencing factors which are under four dimensions correspondingly. And the dynamic influencing mechanism of key factors has also been learned.Originality/valueThis paper constructs the MFCM model, which is a new approach based on several monolayer FCMs, to study the policy diffusion mechanism.

Stochastic local flexibility market design, bidding, and dispatch for distribution grid operations

In order to unlock the flexibility potential of energy consumers and prosumers, the development of market mechanisms for flexibility planning and procurement is necessary. The authors propose a stochastic local flexibility market to solve grid issues such as voltage deviations and grid congestion in a distribution grid. Their proposed solution includes activation of flexibility assets at the consumers’ premises, using a stochastic local flexibility market design. They consider a pooled local flexibility market design under demand uncertainty and stochastic bidding process. Optimization models are used to determine flexibility demand and supply bids by the distribution system operator and the aggregator respectively. A stochastic AC-optimal power model to determine flexibility demand and a two-stage stochastic model to supply flexibility are implemented to simulate a stochastic local flexibility market. This allows to determine stochastic flexibility supply bid curves, and optimum flexibility supply dispatch. The analysis shows that the cost of grid operations is reduced when the system uses the local flexibility market. The proposed methodology is applicable for local flexibility market designs aiming to use potential end-user flexibility for grid operations.

A bottom-up approach for techno-economic analysis of battery energy storage system for Irish grid DS3 service provision

This paper presents a bottom-up approach for techno-economic analysis of a Li-ion battery based Energy Storage System (BESS) to provide grid ancillary services under the “Delivering a Secure, Sustainable Electricity System” (DS3) programme in the Irish market. There are two types of service procurement mechanisms that exist in the DS3 programme: volume capped and volume uncapped. A design methodology of the storage system is investigated to optimise the installed capacity and minimize the initial cost for volume capped DS3 services. Based on the real-life project assessment, three different cost models are considered to evaluate different investment indices. The goal is to assess the economic performance of BESS for different contracted capacity systems under the different operating and financial conditions. Extensive simulation and sensitivity analysis based on the Monte Carlo method have been carried out to compare the cost model outputs. The findings are expected to give a clear idea to the investors and decision-makers about the Irish DS3 ancillary service market and clarify specific concerns on the economic feasibility of BESS for DS3 services. Moreover, it discusses the risks and opportunities related to the high volatility of the system component costs. • A bottom-up approach for Techno-economic analysis of ESS to provide DS3 grid services. • A simplified optimal sizing method for a Volume Capped ESS-based DS3 providing unit. • Clarify specific concerns on the economic feasibility of ESS for DS3 Services. • Analyse the solution economic sensitivity towards equipment cost variations. • Provide a comprehensive perception to stakeholders into the Irish DS3 service market.

Medicines regulation, pricing and reimbursement in Brazil

Brazil is an upper-middle-income country with a high human development index (HDI) of 0.765 (2019). The Unique Health System (SUS) is a universal, decentralised system, free at point-of-care, although 27% of Brazilians have voluntary supplementary health insurance. Medicines are provided free-of-charge through the SUS, though there are a few exceptions where co-payment is required. Around 87% of the country’s expenditure with medicines and medical devices corresponds to out-of-pocket, highlighting the importance of price regulation. Marketing authorisation and maximum price approval are mandatory market entry requirements for medicines. Pricing policies include maximum price approval, regulation of mark-ups, tax exemption, annual price adjustment and a mandatory discount for government procurement and enforcement mechanisms. The pricing of new drugs considers the patent status and added therapeutic benefit. It is a combination of health technology assessment and external or internal reference pricing, while drugs with active ingredients in the market follow internal reference pricing. The maximum price of generics must be up to 65% of the reference’s price. The maximum approved prices and public procurement prices are publicly available. Brazil has a value-based decision-making process for incorporating medicines and other technologies at the SUS. Current areas of work include horizon scanning, participation of patients in decision-making and re-assessment of technologies. As a decentralised system, medicines are procured by the Ministry of Health, states and municipalities, according to their level of responsibility. Pricing and reimbursement policies, including a consolidated generics policy, have been important in promoting transparency, predictability, and price stability, in turn contributing to cost-containment and access. Ongoing challenges include high rates of judicialisation, medicines with excessive prices not commensurate with their clinical benefits, no provision for pricing review, problems related to governance and politics. To address these challenges, the authors have three main recommendations. First: improving regulatory governance, second: incentivising the development and promoting access to medicines with stronger evidence, added clinical benefit and fair prices, and third: increasing awareness among stakeholders, avoiding judicialisation and minimising its impact; contributing to closing the gap between innovation and access to medicines.

COVAX, vaccine donations and the politics of global vaccine inequity

BackgroundIn 2021, donor countries, the pharmaceutical industry, and the COVAX initiative promoted vaccine donation or “dose-sharing” as a main solution to the inequitable global distribution of Covid-19 vaccines. COVAX positioned itself as a global vaccine-sharing hub that promised to share doses “equitably, effectively and transparently,” according to rational criteria overseen by independent scientists. This article provides a critical analysis of the principles and practice of “dose-sharing,” showing how it reveals the politics at play within COVAX.ResultsDonated doses were an important source of COVAX’s vaccine supply in 2021, accounting for 60% of the doses the initiative delivered (543 million out of 910 million). However, donations could not compensate fully for COVAX’s persistent procurement struggles: it delivered less than half of the two billion doses it originally projected for 2021, a fraction of the 9.25 billion doses that were administered globally in 2021. Donor countries and vaccine manufacturers systematically broke COVAX’s principles for maximizing the impact of dose-sharing, delivering doses late, in smaller quantities than promised, and in ad hoc ways that made roll-out in recipient countries difficult. Some donors even earmarked doses for specific recipients, complicating and potentially undermining COVAX’s equitable allocation mechanism.ConclusionsCOVAX’s pivot from global vaccine procurement mechanism to dose-sharing hub can be seen as a “win-win-win” solution for COVAX itself (who could claim success by having access to more doses), for donor countries (who could rebrand themselves as charitable donors rather than “vaccine hoarders”), and for the pharmaceutical industry (maintaining the status quo on intellectual property rights and protecting their commercial interests). Although dose-sharing helped COVAX’s vaccine delivery, its impact was undermined by donors’ and industry’s pursuit of national security, diplomatic and commercial interests, which COVAX largely accommodated. The lack of transparency and accountability mechanisms within COVAX’s overly complex governance structure as a global public-private partnership enabled these practices.

At scale adoption of battery storage technology in Indian power industry: Enablers, frameworks and policies

• We evaluate cost effectiveness of renewable plus battery storage technology over new coal. • We define targets and policy frameworks for scale adoption of battery storage technology in Indian power industry. • Renewable plus battery storage technology cost competitive over new coal power starting 2022. • First study to suggest battery portfolio standard linked to existing renewable portfolio standard. • First study to suggest renewable dispatchable generation power purchase agreement for battery procurement. India's envisages uptake of 450 Giga Watt (GW) of renewable energy capacity by 2030. The resulting system flexibility needs can be met by 50 GW of 4-hour energy storage. However, system flexibility has historically been met by coal power plants, and India also plans to install 50 GW of new coal power capacity during 2022–27. Our paper answers three related questions that would maximize deployment of battery storage with appropriate policy design. First, what is the cost-competitiveness of renewable energy and battery storage compared to new coal-based power? Second, what should be the high-level policy framework for ensuring necessary deployment of battery storage? Third, what should be the appropriate procurement mechanisms for battery storage along with renewable energy? To answer these questions, we first compare forecasted levelized cost of energy for renewable energy and battery storage with coal power, and then use two frameworks to investigate policies. Our findings are as follows. First, renewable energy and battery storage is cost-competitive over new coal starting 2022. Second, India should adopt a battery portfolio standard (BPS) that is linked to existing renewable portfolio standard (RPS). Third, India should adopt the renewable dispatchable generation (RDG) power purchase agreement (PPA) to ensure that multiple policy criteria are met.

Comparative Study of Medical Equipment Procurement in Selected Countries

Background: Despite the fact that medical equipment is critical for providing good health services and also incurs significant expenditures for the health system, little is known about how to procure it effectively. To date, only a few comparative studies on the procurement framework for medical equipment between nations have been conducted. Thus, the purpose of this study was to examine this issue between the leading countries. Methods: To conduct this comparative study, Canada, the United Kingdom, Australia, Spain, Italy, Turkey, Thailand, and Iran were selected. Medical devices, medical equipment, procurement, purchasing, and acquisition were keywords considered to search PubMed, ProQuest, Web of Science, Scopus, Science Direct, and Google scholar databases. Also, the websites of the related organizations, such as the World Health Organization (WHO), the World Bank, and the Ministry of Health of respective countries were searched for the gray literature. Providing information about the procurement framework and availability of evidence in the English language was considered as the inclusion criteria and the lack of access to full texts, letters, and commentary article designs were the exclusion criteria. The results were summarized and reported using comparative tables. Results: Most of the countries involved in this study are trying to align procurement activities with national health care priorities. In view of this, there is a trend toward centralized procurement, especially in Italy, Spain, England, Italy, Canada, and Iran. While a range of actors participate in the procurement process, a greater role for physicians and patients is necessary to be defined to meet patient needs. Moving from price-based approaches to value-based approaches is in the agenda to consider a broader range of criteria to achieve value for money and support patient access to innovations. Conclusion: Most of the countries have reorganized the mechanism of medical equipment procurement. The price of products is the important factor, and recently the value factor has become more important in procurement. Reinforcing the role of decision-making teams and hospital committees in the procurement of medical equipment is suggested. Further studies are needed on the application of value-based approaches to evaluate their effects in hospitals.

The costs and constraints of pandemic response in Mali*

The costs and constraints of pandemic response in Mali*

Human-centered artificial intelligence for the public sector: The gate keeping role of the public procurement professional

The increasing deployment of artificial intelligence (AI) powered solutions for the public sector is hoped to change how developing countries deliver services in key sectors such as agriculture, healthcare, education, and social sectors. And yet AI has a high potential for abuse and creates risks, which if not managed and monitored will jeopardize respect and dignity of the most vulnerable in society. In this study, we argue for delineating public procurements’ role in the human-centred AI (HCAI) discourses, focusing on the developing countries. The study is based on an exploratory inquiry and gathered data among procurement practitioners in Uganda and Kenya, which have similar country procurement regimes: where traditional forms of competition in procurement apply compared to more recent pre-commercial procurement mechanisms that suit AI procurement. We found limited customization in AI technologies, a lack of developed governance frameworks, and little knowledge and distinction between AI procurement and other typical technology procurement processes. We proposed a framework, which in absence of good legal frameworks can allow procurement professionals to embed HCAI principles in AI procurement processes.

SOCIAL PARTNERSHIP AS A TOOL FOR UNIVERSITY TRAINING OF SOCIAL WORKERS

Decentralization and democratization of public and state relations affects today’s social work in Ukraine. Universities should be the source which with the help of social partnership can change the status of a future social worker. The purpose of the article is to study social partnership as a tool for training social workers in higher education. The study used the analysis of educational and methodological practice of professional development of social work on the basis of social dialogue at universities. Teaching the discipline "Social Partnership" for students majoring in "Social Work" must be consistent with the requirements of the time, which are set before higher education. First, it is the importance of the transition of higher education institutions to formal partnerships with employers, which would include the training of professionals needed for the social services market. Secondly, the fixation of the "teacher – student" partnership in the syllabus as a reflection of the agreement on the organization of the educational process in the specialty "social work" and other specialties inthe humanities cycle. Thirdly, it is necessary to actively involve scientific and scientific-pedagogical staff in the study of the mechanism of social procurement and to ensure its proper understanding and use by practicing specialists in our country. Among other important factors there are consideration of social partnership as an integrative quality of personality, which allows to interconnect the interests of different groups of socially divided society and develops in students through the acquisition of relevant knowledge and skills, the formation of attitudes to the world. These factors form the basis for claiming that teaching partnership is both a process of learning to use this tool in social services, and its use in the educational process. The tools for training future social workers include the development of a system of active civic participation, support for student participation in the case movement, social order, and the syllabus of the discipline.

The characterisation of ceramic production from the central Levant and Egyptian trade in the Pyramid Age

A recent petrographic study of ceramic jars from Giza imported into Egypt during the 4th Dynasty of the Pyramid Age (c. 2613–2494 BCE) identified the original production zone as the Lebanese coast generally between Beirut and Tripoli, including the region of Byblos. The jars and their contents were imported to Egypt by maritime trade expeditions conducted at the behest of the Egyptian state. This study analyses a selection of these ceramic samples using ICP-AES and -MS for comparison with published data from the region of Byblos. The results not only confirmed the underlying petrography, but together with new evidence from Lebanon suggests the vessels likely belonged to specialised workshop production in the Byblos environs and were made specifically for export to Egypt. The finding sheds new light on the relationship between the Egyptian state and the polity of Byblos in the Early Bronze Age, indicating the presence of standardised local production and commodity procurement mechanisms tailored to the needs of a large trade entity. This relationship in turn delivered significant prestige and status to local elites in an environment of competitive local peer-polity interactions.

Promoting Access to Health Technologies in the Post-pandemic Era: Gavi, Global Fund, Unitaid, and Access to COVID-19 Tools Accelerator (ACT-A) Programs

Purpose: Global collaboration to accelerate development and equitable access to COVID-19 tests, treatments, and vaccines was launched with the name of the Access to COVID-19 Tools Accelerator (ACT-A), and this initiative owes its expertise to the lessons learned of the global health organizations. To date, the comprehensive mechanisms and potential effects of the initiative remain largely unknown. Methods: This study reviewed the programs of Gavi, the Global Fund, Unitaid, and ACT-A, which mitigating barriers to greater use of health technology with an analytic framework. Results and conclusion: The study findings are as follows. First, programs to alleviate the absence of necessary technology include the International Finance Facility for Immunization and Covax Facility. Second, Pooled Procurement Mechanism and Accelerated Order Mechanism are examples of mitigating the inability to access technology. Third, programs to overcome reluctance to adopt accessible technology include health system strengthening efforts such as the capacity-building health workforces. Further actions of Korea are needed to collaborate with the initiatives to enhance health outcomes.

Robust mechanism design and production structure for assembly systems with asymmetric cost information

We consider the design of a robust procurement mechanism for an assembler who must procure multiple complementary components under limited information regarding the unit production costs of the potential suppliers. We abandon the standard assumption that there exists a common prior distribution for the suppliers’ costs and we employ the max-min criterion in which we design a mechanism to maximize the assembler’s worst-case expected profit when only the means of the suppliers’ costs are known. We formulate this problem using a linear semi-infinite programming model and we apply a primal-dual approach to reduce the problem to a single joint optimization model. We characterize the optimal procurement mechanism (payments and ordering quantities) under the assumption of balanced ordering and uncertain end-customer demand. We use these results to compare the performance of component production, under which the components are sourced from separate suppliers, and integrated production, under which the components are sourced from the same supplier. We find that component production is preferred when the production costs of the components are heterogeneous. We also propose two heuristic mechanisms which are easier to compute and implement in practice, particularly when the number of components is large. Finally, we extend our analysis to the case in which the average and variance of the suppliers’ costs are known.

European collaborations on medicine and vaccine procurement.

To ensure equitable access to medicines and vaccines, organizational efforts and purchase volumes have been pooled in joint procurements and negotiations for decades in some regions of the world, as well as globally through supranational procurement mechanisms. In Europe, countries started to collaborate on procurement and negotiations recently when it became increasingly difficult to ensure access to high-priced medicines, even in high-income countries. Two European country collaborations (the Nordic Pharmaceutical Forum and the Baltic Procurement Initiative) have successfully concluded at least one joint tender process for medicines and vaccines and the Beneluxa Initiative has concluded its first successful joint price negotiation. This article describes the experiences of these country collaborations. Challenges observed included: legal barriers; institutional and organizational differences between health-care systems in member countries; and the risk that suppliers will be reluctant to cooperate with country collaborations. Although these collaborations helped improve access to medicines and vaccines for the countries involved, in situations such as a global health crisis, larger-scale, more-inclusive initiatives are needed. In the current coronavirus disease 2019 (COVID-19) pandemic, COVID-19 Vaccines Global Access (COVAX) initiative established a global procurement mechanism to ensure the equitable distribution of COVID-19 vaccines globally. Despite differences in organization and scale, the European country collaborations and COVAX have some similarities: (i) their success depends on the increased purchasing power associated with pooled order volumes; (ii) expert knowledge and previous procurement experience is pooled; (iii) they perform other collaborative activities that go beyond procurement alone; and (iv) they actively involve external partners and stakeholders.