Dear UK Parliament,

I am submitting this evidence as the founder of Unifix Care, a social enterprise focused on providing sustainable, high-quality surgical instruments to low- and middle-income countries (LMICs). Our approach, which emphasizes cost-effective procurement, evidence-based decision-making, and sustainable partnerships, offers valuable insights into improving the Value for Money (VfM) assessment in Official Development Assistance (ODA). The experience of Unifix Care aligns closely with the inquiry’s goals, particularly in understanding how strategic investments, partnerships, and monitoring can enhance VfM.

1. Defining Value for Money in ODA

The Foreign, Commonwealth & Development Office (FCDO) currently defines Value for Money using a framework that includes the dimensions of economy, efficiency, and effectiveness. However, in practice, VfM assessments often overlook key qualitative aspects, such as sustainability, local capacity building, and resilience. Additionally, the context in LMICs often demands a broader lens that captures the long-term impact of investments.

Recommendation:

• Incorporating Quality Metrics: VfM should account for the durability and lifecycle cost of interventions. For example, Unifix Care’s surgical instruments last up to seven times longer than standard products. This longevity reduces replacement costs and minimizes operational disruptions, which are critical in resource-constrained settings.
• Holistic Impact Assessment: VfM frameworks should include metrics that evaluate contributions to systemic resilience, such as training programs that empower local stakeholders to independently maintain quality standards.

2. Impact of the DFID-FCO Merger on VfM

The merger of DFID and FCO into the FCDO was intended to create a more cohesive approach to foreign policy and development assistance. However, the integration has also led to challenges in harmonizing priorities and maintaining a consistent focus on development outcomes. From my perspective this has at times diluted the development focus by emphasizing short-term diplomatic wins over long-term value creation.

Recommendation:

• Strengthen the governance structure to ensure that VfM evaluations prioritize long-term developmental objectives, such as improved health outcomes and economic resilience.

3. Monitoring and Oversight Mechanisms

Effective monitoring and evaluation (M&E) are crucial for ensuring that ODA investments achieve intended outcomes. However, fragmented data systems and insufficient feedback loops often hinder comprehensive oversight.

We implemented an iterative monitoring system in East Africa, providing local stakeholders with portable quality-testing kits and training. This approach allowed us to collect granular, real-time data on surgical instrument performance and adjust our processes accordingly.

Recommendation:

• Enhanced Data Infrastructure: Develop AI-augmented knowledge management systems that enable the integration of local and global data to track program performance in real-time.
• Stakeholder Feedback Loops: Formalize feedback mechanisms involving end-users and delivery partners to continuously refine interventions and promote adaptive learning.

4. Partnerships and the Best Buys Alliance

Collaborative partnerships amplify the impact of ODA. Evidence shows that pooled resources and shared infrastructure reduce per-beneficiary costs significantly. Unifix Care’s partnership with Joint Medical Stores (JMS) in Uganda demonstrated that coordinated procurement efforts can enhance cost efficiency and quality. By pooling resources and adopting scientifically validated products, we achieved cost reductions of up to 60% compared to bilateral procurement models.

Recommendation:

• Best Buys Alliance: The FCDO should establish a Best Buys Alliance to coordinate funding for cost-effective interventions across sectors. This alliance could build on the success of partnerships like Gavi and the Global Fund, focusing initially on health and education, where the evidence base is robust.

5. Utilization of Financial Instruments

The FCDO’s use of financial instruments, such as debt relief and guarantees, plays a critical role in enhancing aid effectiveness. However, there is room to improve their alignment with programmatic goals.

Recommendation:

• Guarantees for Social Enterprises: Develop guarantee mechanisms that support high-impact social enterprises like Unifix Care, enabling them to scale without excessive financial risk.
• Strategic Use of Special Drawing Rights (SDRs): Allocate SDRs toward initiatives that demonstrate long-term cost-efficiency, such as supply chain innovations for essential medical supplies.

6. Alignment with Finance Delivery Partners

Effective ODA requires alignment between the FCDO and its financial delivery partners, such as British International Investment (BII) and Multilateral Development Banks (MDBs). This alignment ensures that funding models are consistent with VfM principles. The lack of harmonized evaluation frameworks can lead to inefficiencies and misaligned priorities.

Recommendation:

• Establish shared VfM criteria and data-sharing protocols to ensure that investments are evaluated consistently across delivery partners.
• Promote joint initiatives that leverage the expertise of delivery partners while maintaining a strong focus on developmental impact.

Conclusion

To achieve greater Value for Money, the FCDO must adopt a more holistic approach that emphasizes long-term impact, sustainability, and adaptive learning. Unifix Care’s experience demonstrates that strategic partnerships, evidence-based decision-making, and robust monitoring systems can significantly enhance cost-effectiveness and resilience. By integrating these principles into its ODA strategy, the FCDO can maximize its transformative impact in LMICs and contribute to the achievement of global health and development goals.

For further information or to discuss this submission, I am available for consultation and would welcome the opportunity to provide additional details or participate in future hearings.