The AMFm and medicine diversion: good intent enabling corrupt practices

Article Highlights

  • Donated & subsidised medicines for #malaria are saving countless lives in #Africa

    Tweet This

  • Impact of #medicine diversion unknown, but potentially dangerous & may bolster criminal networks

    Tweet This

  • Medicines are valuable, portable & widely traded, & this is often done illegally & across national borders

    Tweet This

Abstract

Increased donated and subsidised medicines for malaria are saving countless lives in Africa, but there is probably increasing theft and diversion of those medicines. The impact of medicine diversion is unknown but potentially dangerous and may bolster criminal networks and increase medicine stock outs (1,2). This study demonstrates that diversion is widespread; diverted subsidised medicines were found in 11 of 14 cities investigated, and in four of those, over half the pharmacies researchers visited had diverted subsidised malaria products.

Introduction

The Affordable Medicines Facility - malaria (AMFm) is a financing mechanism run by the Global Fund to Fight AIDS TB and Malaria (GF). The AMFm is designed to expand access to the best treatments of malaria, artemisininbased combination therapies, or ACTs. AMFm donors subsidise the price of ACTs in the public and private sectors by negotiating a reduced price for ACTs with manufacturers.

Medicines are valuable, portable and widely traded, and this is often done illegally and across national borders.

Donors pay the majority of the reduced price of ACTs to manufacturers, lowering the cost to first-line buyers. Firstline buyers purchase ACTs directly from manufacturers. Since first-line buyers pay a lower price for ACTs, consumers should also pay a lower price, making ACTs more affordable. The AMFm aims to increase the availability and use of ACTs by reducing their cost and thereby driving oral artemisinin monotherapies, which should only be used as part of combination therapies, or poor-quality antimalarial drugs from the market. Additionally, the programme hopes to displace often used, but older and less effective, chloroquine and sulfadoxine-pyrimethamine (SP) treatments by making the more trustworthy ACTs equally affordable for patients (3).

Medicines are valuable, portable and widely traded, and this is often done illegally and across national borders (4,5).

One unintended consequence of all forms of malaria donation and subsidy programmes is an increase in product theft and diversion, which can lead to stock outs (6,7) and other health problems. The aim of this study was to assess

whether AMFm drugs have been stolen and diverted into other markets, since previous studies have shown that diversion of subsidised public sector products was a problem; most notably that in one study 28% of ACTs bought in the private sector had been stolen from the public sector (8).

...

Read the full paper. 

Roger Bate is the Legatum Fellow in Global Prosperity at AEI. 

Julissa Milligan is a research assistant at AEI.

Also Visit
AEIdeas Blog The American Magazine
About the Author

 

Roger
Bate
  • Roger Bate is an economist who researches international health policy, with a particular focus on tropical disease and substandard and counterfeit medicines. He also writes on general development policy in Asia and Africa. He writes regularly for AEI's Health Policy Outlook.
  • Phone: 202-828-6029
    Email: rbate@aei.org
  • Assistant Info

    Name: Katherine Earle
    Phone: (202) 862-5872
    Email: katherine.earle@aei.org

 

Julissa
Milligan

What's new on AEI

image The money in banking: Comparing salaries of bank and bank regulatory employees
image What Obama should say about China in Japan
image A key to college success: Involved dads
image China takes the fight to space
AEI on Facebook
Events Calendar
  • 21
    MON
  • 22
    TUE
  • 23
    WED
  • 24
    THU
  • 25
    FRI
Wednesday, April 23, 2014 | 12:00 p.m. – 1:30 p.m.
Graduation day: How dads’ involvement impacts higher education success

Join a diverse group of panelists — including sociologists, education experts, and students — for a discussion of how public policy and culture can help families lay a firmer foundation for their children’s educational success, and of how the effects of paternal involvement vary by socioeconomic background.

Event Registration is Closed
Thursday, April 24, 2014 | 12:00 p.m. – 1:30 p.m.
Getting it right: A better strategy to defeat al Qaeda

This event will coincide with the release of a new report by AEI’s Mary Habeck, which analyzes why current national security policy is failing to stop the advancement of al Qaeda and its affiliates and what the US can do to develop a successful strategy to defeat this enemy.

Friday, April 25, 2014 | 9:15 a.m. – 1:15 p.m.
Obamacare’s rocky start and uncertain future

During this event, experts with many different views on the ACA will offer their predictions for the future.   

No events scheduled this day.
No events scheduled this day.
No events scheduled this day.
No events scheduled this day.
No events scheduled this day.