OnCo
ideasIdea

A Gavi-style pooled purchaser for radiotherapy equipment and service

Countries buying radiotherapy machines one at a time pay high prices and get poor service. A single global buyer negotiating for dozens of machines a year could cut prices and demand long-term support.

Gavi and the Global Fund demonstrated that aggregated demand and multi-year volume guarantees lower prices, stabilise supply, and shape products. Radiotherapy has no equivalent: each ministry negotiates alone, with limited technical capacity, and often receives a machine without a bunker, staff, or service plan. A pooled purchaser (hosted, for instance, alongside the IAEA's Rays of Hope) would set standard specifications, bundle service and training, and publish prices.

Hypothesis
Pooled procurement will reduce the delivered cost per treatment unit, including ten years of service, by at least 30% against the median bilateral price and shorten install-to-first-patient time to under twelve months.
Rationale
Aggregation works when the product is standardisable and demand is predictable; radiotherapy capital needs in LMICs are both, and the global vendor base is small enough for volume commitments to matter.
What would test it
Commission a market-shaping analysis and a first pooled tender for ten machines across three countries with published unit prices and installed-to-operational timelines compared with recent bilateral purchases.
Maturity
speculative
Who has to act
policy
Cost to try
Large (over $50M)
Years to first evidence
5
Bottlenecks it attacks
  • Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
  • Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.

Connected

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