Recorded presentation

Denis Broun, MD, Center for Pharmaceutical Management, MSH Europe, 13, chemin du Levant, 01210, Ferney-Voltaire, France and Owen Smith, MA, MPA, Partners for Health Reform plus, Abt Associates Inc., 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, 301-347-5388, Owen_Smith@abtassoc.com.

Issues: Approximately 50 percent of Global Fund money will be used to procure pharmaceuticals and commodities. This constitutes a substantial increase in the amount that recipient countries are spending on drugs. Description: The study questions include: (a) How have Global Fund supported activities affected the way in which pharmaceuticals are managed? (b) How have Global Fund supported activities affected the accessibility of pharmaceuticals in terms of their geographical accessibility, physical availability, financial affordability, quality and price? (c) How have Global Fund supported activities, and the corollary growth in government purchasing power affected the relative balance of power between developing country governments and drug manufacturers? The study addresses these questions for pharmaceuticals purchased under the Global Fund, but is particularly interested in potential spillover effects for drugs for non-focal diseases. The findings are based on document review, baseline facility surveys and one smaller scale follow-up survey, and in-depth interviews with key informants, in a total of six different countries. Lessons Learned: Despite the fact that all countries met the conditions required by the Global Fund procurement assessment, many still encountered significant delays in procuring pharmaceuticals. Problems also arose with respect to the supply and distribution of drugs. Limited capacity at the facility level to anticipate stock-outs, and order new drugs has led to stock-outs of key drugs including antiretrovirals. Recommendations: The Global Fund must continue to work with countries to develop stronger pharmaceutical procurement and distribution systems. The effect of these efforts on broader drugs supply have yet to be seen.

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