Abstract
In an effort to increase competition and decrease price, the Global Fund to Fight AIDS, Tuberculosis and Malaria recently began asking some grant recipients to use international competitive bidding processes for certain drug purchases. Unfortunately, for countries like Kenya, this request has caused more harm than good. After awarding the tender for its annual supply of the anti-malarial artemether-lumefantrine to the lowest bidder, Ajanta Pharma, Kenya experienced wide stock-outs in part due to the company's inability to supply the order in full and on time. Similar problems could arise in Uganda. Despite Kenya's experience, Uganda has awarded its next tender for artemether-lumefantrine to Ajanta Pharma. Uganda is already facing wide stock-outs and risks exacerbating an already dire situation the longer it takes to fulfil the procurement contract. A tender process based primarily on price cannot account for a company's ability to consistently supply sufficient product in time.
Highlights
The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) spends millions of dollars every year to procure medicines for patients in developing countries [1]
GFATM procurement policies that encourage grant recipients to procure products based largely on price alone has placed less value on quality and reliability of supply. This has led to stock-outs and questionable tenders that may cost malaria control programmes more than is saved through open tenders
GFATM allows the procurement of drugs not yet approved by the World Health Organization (WHO) or a stringent regulatory authority (SRA) where there are fewer than two drugs available that meet one or both of these standards; these drugs should only be procured under exceptional circumstances since they have not yet passed the highest quality assessments and are possibly of inferior quality
Summary
The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) spends millions of dollars every year to procure medicines for patients in developing countries [1]. GFATM procurement policies that encourage grant recipients to procure products based largely on price alone has placed less value on quality and reliability of supply. This has led to stock-outs and questionable tenders that may cost malaria control programmes more than is saved through open tenders. GFATM has allocated millions of dollars for the procurement of life-saving medicines, and by its own measures has done a reasonably good job ensuring that the drugs reach the right people. Inconsistent reporting by grant recipients results in unreliable data, which compounds the problem [4]
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