Partnerships for malaria control : engaging the formal and informal private sectors
Overview
A review / commissioned by the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), in collaboration with the Working Group on Financing and Resources of the Roll Back Malaria Partnership, chaired by The World Bank.
The review presents the market and policy context of nets, insecticide treatment and antimalarial drugs, and summarizes the evidence regarding access and equity issues. The bulk of the evidence presented comes from sub-Saharan Africa due to the abundance of literature. Country experiences are used to illustrate strategic options, integrated approaches and PPP arrangements in specific market contexts.
The review emphasizes that malaria control interventions must take into account health care utilization patterns of poor people, the widespread poverty in developing countries and the limited capacity of governments to provide quality services, enforce regulatory control and protect consumers’ rights. Routes to market are well developed for mosquito nets, but require government intervention for insecticide-treated nets (ITNs) and insecticide retreatment, such as market priming. Provision of antimalarial treatment is dominated by the the informal and formal private sector, and suffers problems such as inefficiency, profit motivation of PSPs, low-quality commodities and counterfeit drugs. Due to emerging antimicrobial resistance, many disease endemic countries have integrated artemisinin-based combination therapy (ACT) into their treatment policy, despite high drug costs.
The document discusses key strategic options for private sector engagement in order to scale up malaria prevention and treatment. On the demand side, these include voucher schemes, packing inserts, IEC material, verbal instructions and insurance schemes. On the supply side, key options include pre-packaging of antimalarial drugs, bundling of nets and insecticide, product branding, promotion of rapid diagnostic tests, peer education and training, social marketing and social franchising. Presented strategic options for policy makers are removal of taxes and tariffs, a variety of regulatory controls, price control (including recommended retail prices and differential pricing), promotion of generic drugs and strategic market analysis and development.