By Dr. Bruno Moonen, Director, Malaria Control Team, Clinton Health Access Initiative (CHAI)
In 2011, the Roll Back Malaria Partnership set new goals for further scale-up of impact by 2015. The goals comprise ambitious targets for malaria case management, including in the private sector, which is increasingly recognized as an important point of care for common febrile illnesses. The Affordable Medicines Facility for malaria (AMFm), currently being piloted in seven countries, is a novel financing mechanism established to dramatically increase access to quality assured, artemisinin-based combination therapy (ACT), especially in the private sector, by applying a factory-gate subsidy at the top of the supply chain. The Global Fund to Fight AIDS, Tuberculosis and Malaria, host of the first phase of the AMFm, has commissioned an independent evaluation of the pilot. The evaluation draws on, among other sources, PSI’s ACTwatch market survey data. By the end of 2012, based on the evidence from the evaluation, the Global Fund Board will decide whether to continue hosting this innovative but, to some, controversial mechanism for improving access to malaria treatment.
Even without results from the evaluation being available, opinions on the AMFm have been polarized, and this may jeopardize a purely evidence-based decision on the mechanism’s future. Despite the controversy, the global malaria community should not lose sight of the targets it has set for universal coverage of both diagnosis and treatment in the private sector. The issue is not whether the AMFm is categorically good or bad; rather, what matters is how we will ensure access to high-quality diagnosis and treatment for all, and whether the AMFm, or some derivation of this mechanism, may be a relevant tool in certain settings. Two main points are important to highlight: