Barriers to Access: An Assessment of Stakeholder Risks and Incentives in the Value Chain for Artemisinin Combination Therapy (ACT) Treatments

Abstract

Artemisinin combination therapy is being widely advocated as a first line treatment for malarial in Sub-Saharan Africa and other parts of the world where traditional chloroquine therapies are no longer effective. Various bilateral and multilateral donors assist countries in procurement of treatments, but serious barriers prevent increase in patient access. These barriers are related to the dysfunctional global health value chain of ACTs and by the risks and incentives faced by a range of stakeholders in this value chain, from manufacturers to health service providers. This analysis uses value chain expertise to examine the ACT market by systematically analyzing how risks and rewards are shared among stakeholders in the public sector value chain for ACTs and proposes ways to correct imbalances which will result in increased access to these life saving drugs.