Scaling Up A ccess and Rational D rug U se
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Transcript of Scaling Up A ccess and Rational D rug U se
Scaling Up Access and Rational Drug Use
Anthony D. So, MD, MPAProgram on Global Health and Technology Access
Sanford School of Public PolicyDuke University
ICIUMNovember 2011
Hurdles to Drug Access
Therapeutic
Financial
Structural
Source: Health Action International-Peru
R&D Pipeline
Marketplace
Delivery System
Where in the value chain to intervene?
Pharmaceutical Manufacturer
—SupplierLocal Buyer
Provider
Pharmacy Consumer
Community management
Global Drug FacilityGreen Light Committee
Gupta et al. “Responding to Market Failures in Tuberculosis Control.” Science (2011) 293 (5532): 1049-1051.
Affordable Medicines Facility for Malaria
Pharmaceutical Manufacturer
—SupplierLocal Buyer
Provider
Pharmacy Consumer
AMFm Co-Payment Fund US$216 million Financed by UNITAID, Gates Foundation, DFID
Supporting Interventions Up to US$ 126.7 million Financed by Global Fund
AMFm: Issues of Supply and Demand
11%
22%
16%
20%
6%
25%
Sanofi-Aventis NovartisAjanta CiplaGuilin Ipca
Source: AMFm, 2001.*These figures do not count co-payments through AMFm's Voluntary Pooled Procurement mechanism or ACTs purchased through the President's Malaria Initiative.
Multinational corporations supply roughly one-third of
co-pay approved treatments*
Supply Demand
36%
63%
1%
Approved ACT orders,
by sector
PublicPrivate, for-profitPrivate, not-for-profit
Source: Olusoji Adeyi, Affordable Medicines Facility-malaria (AMFm): Achievements to date, UNITAID Consultative Forum, October 4, 2011, Geneva.
No. of treatments approved for co-payment
Source: Rutta, Edmund, et al. Increasing Access to Subsidized Artemisinin-based Combination Therapy through Accredited Drug Dispensing Outlets in Tanzania. Health Research Policy and Systems 2011; 9:22