Aligning health, industry, and innovation through public procurement

Background: This article examines how public procurement of pharmaceuticals can serve as a tool to advance both access to medicines and industrial development, in line with the Health in All Policies (HiAP) and Health for All Policies (HfIAP) agendas. Methods: We draw on four illustrative, purposefully selected cases -- the pneumococcal Advance Market Commitment, emergency procurement of the Ebola vaccine, Operation Warp Speed for the accelerated production of COVID-19 vaccines, and Brazil’s Partnerships for Productive Development. Through configurative analysis, we identify distinct procurement models and assess their contributions to health and industrial objectives. Results: The analysis highlights several procurement models: anticipatory, reactive, emergency-driven, innovation-enabling, and capability-building. These cases demonstrate how procurement can generate co-benefits across Sustainable Development Goals (SDGs) 3 (health) and 9 (industry, innovation, infrastructure), while also revealing implementation gaps and structural constraints. Conclusion: Realizing the potential of procurement as a dual health–industrial tool requires linking it to capability-building, tailoring instruments to local and industrial contexts, and confronting structural asymmetries that limit national ownership. By treating procurement not as an administrative task but as an industrial strategy, governments can better operationalize HiAP/HfIAP and make progress toward more equitable and sustainable health innovation systems.