Abstract
BackgroundUniversal access to effective treatments is a goal of the Roll Back Malaria Partnership. However, despite official commitments and substantial increases in financing, this objective remains elusive, as development assistance continue to be routed largely through government channels, leaving the much needed highly effective treatments inaccessible or unaffordable to those seeking services in the private sector.MethodsTo quantify the effect of price disparity between the government and private health systems, this study have audited 92 government and private Drug Selling Units (DSUs) in Morogoro urban district in Tanzania to determine the levels, trend and consumption pattern of antimalarial drugs in the two health systems. A combination of observation, interviews and questionnaire administered to the service providers of the randomly selected DSUs were used to collect data.ResultsALU was the most selling antimalarial drug in the government health system at a subsidized price of 300 TShs (0.18 US$). By contrast, ALU that was available in the private sector (coartem) was being sold at a price of about 10,000 TShs (5.9 US$), the price that was by far unaffordable, prompting people to resort to cheap but failed drugs. As a result, metakelfin (the phased out drug) was the most selling drug in the private health system at a price ranging from 500 to 2,000 TShs (0.29–1.18 US$).ConclusionsIn order for the prompt diagnosis and treatment with effective drugs intervention to have big impact on malaria in mostly low socioeconomic malaria-endemic areas of Africa, inequities in affordability and access to effective treatment must be eliminated. For this to be ensued, subsidized drugs should be made available in both government and private health sectors to promote a universal access to effective safe and affordable life saving antimalarial drugs.
Highlights
Universal access to effective treatments is a goal of the Roll Back Malaria Partnership
“Secondline” treatment refers to the drug officially recommended as an alternative primarily to be used for treatment of patients in whom the first-line treatment failed to clear the infection and other select patients
Tanzania changed her antimalarial policy for the first time in 2001, when CQ first line was replaced by Sulphadoxine and Pyrimethamine (SP) as an interim first line policy, while evaluating a long term solution
Summary
Universal access to effective treatments is a goal of the Roll Back Malaria Partnership. “First-line” treatment refers to the drug officially recommended as the drug of first choice for the treatment of uncomplicated malaria. Few treatment failures are recognized and patients are often moved directly from first to third-line treatment, little second-line drug is used compared to the first-line drug. Tanzania changed her antimalarial policy for the first time in 2001, when CQ first line was replaced by SP as an interim first line policy, while evaluating a long term solution. AMFm is a financing mechanism designed to subsidize the most effective anti-malaria drugs, ACTs; Tanzania being among the 10 countries invited to pilot a first phase of this subsidy as from mid 2010. Through copayment and subsidy; first-line buyers, including incountry private sector wholesalers, hospitals and NGOs, will pass on the benefit to patients who will pay a price of $0.20–0.50 for ACTs, a price which is comparable to what they are currently paying for less-effective alternatives
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