Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries
<p>Abstract</p> <p>Background</p> <p>Artemisinin-based combination therapy (ACT) is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to a...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2011-10-01
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| Series: | Malaria Journal |
| Online Access: | http://www.malariajournal.com/content/10/1/326 |
| _version_ | 1818641543964131328 |
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| author | O'Connell Kathryn A Gatakaa Hellen Poyer Stephen Njogu Julius Evance Illah Munroe Erik Solomon Tsione Goodman Catherine Hanson Kara Zinsou Cyprien Akulayi Louis Raharinjatovo Jacky Arogundade Ekundayo Buyungo Peter Mpasela Felton Adjibabi Chérifatou Agbango Jean Ramarosandratana Benjamin Coker Babajide Rubahika Denis Hamainza Busiku Chapman Steven Shewchuk Tanya Chavasse Desmond |
| author_facet | O'Connell Kathryn A Gatakaa Hellen Poyer Stephen Njogu Julius Evance Illah Munroe Erik Solomon Tsione Goodman Catherine Hanson Kara Zinsou Cyprien Akulayi Louis Raharinjatovo Jacky Arogundade Ekundayo Buyungo Peter Mpasela Felton Adjibabi Chérifatou Agbango Jean Ramarosandratana Benjamin Coker Babajide Rubahika Denis Hamainza Busiku Chapman Steven Shewchuk Tanya Chavasse Desmond |
| author_sort | O'Connell Kathryn A |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Artemisinin-based combination therapy (ACT) is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to assess the current situation concerning quality-assured ACT supply. This paper presents supply side data from <it>ACTwatch </it>outlet surveys in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia.</p> <p>Methods</p> <p>Between March 2009 and June 2010, nationally representative surveys of outlets providing anti-malarials to consumers were conducted. A census of all outlets with the potential to provide anti-malarials was conducted in clusters sampled randomly.</p> <p>Results</p> <p>28,263 outlets were censused, 51,158 anti-malarials were audited, and 9,118 providers interviewed. The proportion of public health facilities with at least one first-line quality-assured ACT in stock ranged between 43% and 85%. Among private sector outlets stocking at least one anti-malarial, non-artemisinin therapies, such as chloroquine and sulphadoxine-pyrimethamine, were widely available (> 95% of outlets) as compared to first-line quality-assured ACT (< 25%). In the public/not-for-profit sector, first-line quality-assured ACT was available for free in all countries except Benin and the DRC (US$1.29 [Inter Quartile Range (IQR): $1.29-$1.29] and $0.52[IQR: $0.00-$1.29] per adult equivalent dose respectively). In the private sector, first-line quality-assured ACT was 5-24 times more expensive than non-artemisinin therapies. The exception was Madagascar where, due to national social marketing of subsidized ACT, the price of first-line quality-assured ACT ($0.14 [IQR: $0.10, $0.57]) was significantly lower than the most popular treatment (chloroquine, $0.36 [IQR: $0.36, $0.36]). Quality-assured ACT accounted for less than 25% of total anti-malarial volumes; private-sector quality-assured ACT volumes represented less than 6% of the total market share. Most anti-malarials were distributed through the private sector, but often comprised non-artemisinin therapies, and in the DRC and Nigeria, oral artemisinin monotherapies. Provider knowledge of the first-line treatment was significantly lower in the private sector than in the public/not-for-profit sector.</p> <p>Conclusions</p> <p>These standardized, nationally representative results demonstrate the typically low availability, low market share and high prices of ACT, in the private sector where most anti-malarials are accessed, with some exceptions. The results confirm that there is substantial room to improve availability and affordability of ACT treatment in the surveyed countries. The data will also be useful for monitoring the impact of interventions such as the Affordable Medicines Facility for malaria.</p> |
| first_indexed | 2024-12-16T23:28:51Z |
| format | Article |
| id | doaj.art-0b8ae8588a36452ca133a1c99fde94af |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-12-16T23:28:51Z |
| publishDate | 2011-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-0b8ae8588a36452ca133a1c99fde94af2022-12-21T22:11:56ZengBMCMalaria Journal1475-28752011-10-0110132610.1186/1475-2875-10-326Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countriesO'Connell Kathryn AGatakaa HellenPoyer StephenNjogu JuliusEvance IllahMunroe ErikSolomon TsioneGoodman CatherineHanson KaraZinsou CyprienAkulayi LouisRaharinjatovo JackyArogundade EkundayoBuyungo PeterMpasela FeltonAdjibabi ChérifatouAgbango JeanRamarosandratana BenjaminCoker BabajideRubahika DenisHamainza BusikuChapman StevenShewchuk TanyaChavasse Desmond<p>Abstract</p> <p>Background</p> <p>Artemisinin-based combination therapy (ACT) is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to assess the current situation concerning quality-assured ACT supply. This paper presents supply side data from <it>ACTwatch </it>outlet surveys in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia.</p> <p>Methods</p> <p>Between March 2009 and June 2010, nationally representative surveys of outlets providing anti-malarials to consumers were conducted. A census of all outlets with the potential to provide anti-malarials was conducted in clusters sampled randomly.</p> <p>Results</p> <p>28,263 outlets were censused, 51,158 anti-malarials were audited, and 9,118 providers interviewed. The proportion of public health facilities with at least one first-line quality-assured ACT in stock ranged between 43% and 85%. Among private sector outlets stocking at least one anti-malarial, non-artemisinin therapies, such as chloroquine and sulphadoxine-pyrimethamine, were widely available (> 95% of outlets) as compared to first-line quality-assured ACT (< 25%). In the public/not-for-profit sector, first-line quality-assured ACT was available for free in all countries except Benin and the DRC (US$1.29 [Inter Quartile Range (IQR): $1.29-$1.29] and $0.52[IQR: $0.00-$1.29] per adult equivalent dose respectively). In the private sector, first-line quality-assured ACT was 5-24 times more expensive than non-artemisinin therapies. The exception was Madagascar where, due to national social marketing of subsidized ACT, the price of first-line quality-assured ACT ($0.14 [IQR: $0.10, $0.57]) was significantly lower than the most popular treatment (chloroquine, $0.36 [IQR: $0.36, $0.36]). Quality-assured ACT accounted for less than 25% of total anti-malarial volumes; private-sector quality-assured ACT volumes represented less than 6% of the total market share. Most anti-malarials were distributed through the private sector, but often comprised non-artemisinin therapies, and in the DRC and Nigeria, oral artemisinin monotherapies. Provider knowledge of the first-line treatment was significantly lower in the private sector than in the public/not-for-profit sector.</p> <p>Conclusions</p> <p>These standardized, nationally representative results demonstrate the typically low availability, low market share and high prices of ACT, in the private sector where most anti-malarials are accessed, with some exceptions. The results confirm that there is substantial room to improve availability and affordability of ACT treatment in the surveyed countries. The data will also be useful for monitoring the impact of interventions such as the Affordable Medicines Facility for malaria.</p>http://www.malariajournal.com/content/10/1/326 |
| spellingShingle | O'Connell Kathryn A Gatakaa Hellen Poyer Stephen Njogu Julius Evance Illah Munroe Erik Solomon Tsione Goodman Catherine Hanson Kara Zinsou Cyprien Akulayi Louis Raharinjatovo Jacky Arogundade Ekundayo Buyungo Peter Mpasela Felton Adjibabi Chérifatou Agbango Jean Ramarosandratana Benjamin Coker Babajide Rubahika Denis Hamainza Busiku Chapman Steven Shewchuk Tanya Chavasse Desmond Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries Malaria Journal |
| title | Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries |
| title_full | Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries |
| title_fullStr | Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries |
| title_full_unstemmed | Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries |
| title_short | Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries |
| title_sort | got acts availability price market share and provider knowledge of anti malarial medicines in public and private sector outlets in six malaria endemic countries |
| url | http://www.malariajournal.com/content/10/1/326 |
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