Future-Proofing Health Procurement in a Post - US Aid World

The dust has begun to settle after a turbulent year in development financing, providing space to ask: what comes next?

As I discussed in one of my op-eds from last year, ‘A Wake-up Call? Radical Action for Smarter Medicine Access”, the past year has offered a stark lesson in fragility. When major funding streams were disrupted, the effects rippled across global health supply chains almost immediately. Hundreds of millions of dollars’ worth of life-saving medical supplies, were left stranded in warehouses and on ships. Patients and healthcare workers found themselves unable to access the tools they needed. Decades of progress in combatting infectious diseases came under threat. 

This crisis exposed a deeper vulnerability. Many governments and NGOs lacked the procurement and logistics capabilities to respond effectively. Supply chain inefficiencies, siloed procurement models, and fragmented last-mile distribution compounded the problem. The systems simply weren’t built to resist a crisis, nor to continue on their own. 

The most obvious lesson in the post US aid-based world is that health systems cannot depend so heavily on a single source of external funding, specially one that’s finite and vulnerable to political will and priorities. Just as important, yet less discussed, is that they cannot depend on a single procurement model.

Today, much of the debate about procurement still focuses on cost. And while making every dollar stretch is vitally important, Axmed’s conversations with policymakers in the markets we work in, point to a clear shift in approach. Leaders are becoming less focused on short-term savings and more focused on how to mobilize domestic capacity, and diversify procurement models, to meet their country’s health needs both now and in the future.

When it comes to the procurement of medicines and other healthcare products, resilience and adaptability are no longer aspirational concepts. They are survival necessities. This is about sovereignty, stability and sustainability. It is about building systems that can withstand the next global and local shocks, be it a pandemic, geopolitical shift, or a sudden change in donor priorities. 

At Axmed, this reality has shaped how we build and operate our digital procurement platform. We are not simply a transactional intermediary designed to fill short-term gaps. We are a strategic partner focused on strengthening national and regional health ecosystems.

Our platform is designed to help countries leverage and grow their own capacity. We connect institutional buyers not only with global manufacturers, but also with prequalified local and regional suppliers. This diversified approach supports domestic and regional manufacturing, keeps value within national economies, and reduces over-reliance on global supply chains.

In practice, this means procurement systems that are more flexible, more transparent and better aligned with national priorities. It means countries can chose what to procure, when and from whom, so they can respond faster to changing needs while building long-term resilience into their health systems. And it means that when funding landscapes shift, as they inevitably do, systems have a chance at resisting the shock.

This is the difference between procurement as a stopgap and procurement as long-term infrastructure. 

The themes emerging at Davos this year: resilience, adaptability, domestic capacity and smarter use of limited resources, are not theoretical to us. They are the realities we engage with every day across the markets where we operate. I can only hope stakeholders at Davos are biased toward action and ready to act fast, and quick, as soon as the conference is over.

While it might be tempting to stay in the comfort zone of analysis, conversation and incremental improvements, this moment demands more than better conversations, it demands, once again, radical action. There is already a desire for a fundamentally different approach to health procurement: one that strengthens systems for the long term rather than focusing on short-term fixes One that invests in tech-first infrastructure instead of relying on manual workarounds. One that brings to life value-chain transparency and unlocks data-driven decision making. And one that recognizes local capacity as a critical asset, not an afterthought. Ultimately, procurement should be treated as a strategic lever for building resilient health systems, not simply as a mechanism for cost control.

As global conversations unfold in Davos and beyond, I hope this perspective resonates with leaders and practitioners facing the same questions we hear every day. The future of global health depends on systems designed to adapt, and many of us out there are no longer talking about this, but are already building them, together.