# A Gavi-style pooled purchaser for radiotherapy equipment and service

Source: https://onco.cc/ideas/idea-acc-pooled-procurement-radiotherapy/  
OnCo record `idea-acc-pooled-procurement-radiotherapy` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Summary

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.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- 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.
- Proposed test: 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
- Actor: policy

## Sources

- IAEA Rays of Hope: https://www.iaea.org/services/rays-of-hope

## Connected records

- fronts: [Radiation Therapy](https://onco.cc/fronts/radiation/)
- companies: [Elekta](https://onco.cc/companies/elekta/), [Varian (Siemens Healthineers)](https://onco.cc/companies/varian/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Prices and value](https://onco.cc/bottlenecks/b-drug-pricing/)
- roadmaps: [Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation](https://onco.cc/roadmaps/global-access-roadmap/), [Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH](https://onco.cc/roadmaps/radiation-roadmap/)

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