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Transforming the Market for Quality Malaria Medications
additional doses of quality-assured ACT entering the DRC’s private sector in one year
Upwards of 6.5 million cases of malaria are reported in the Democratic Republic of Congo every year, making it the second most malaria-affected country in the world. The majority of individuals seek care and treatment for suspected malaria in private clinics and pharmacies, yet uninformed consumers often receive poor quality and ineffective malaria treatments. With funding from the UK’s Department for International Development (DfID), PSI and network member Association de Santé Familial (ASF) are working to transform the market and ensure all consumers in Kinshasa, DRC, have access to affordable quality malaria medications in the private sector.
The program incentivizes manufacturers of quality-assured artemisinin-based combination therapies (ACTs), the recommended treatment for malaria, to enter the market by making a subsidy available. This also makes the medicines affordable to consumers. Pharmacists and consumers can then identify quality-assured malaria medicines by their “Green Leaf” logo. A strong promotional campaign featuring the “Green Leaf” logo on billboards, radio and TV ads, and grassroots marketing is making both pharmacists and consumers more aware of the importance of quality-assured ACT and increasing demand. By increasing demand and growing the category for “Green Leaf” products, the price of these medicines will be kept low and will gradually allow the subsidy to be phased out, thus, creating demand and a more sustainable market for ensuring access to all quality-assured medicines. By working with manufacturers on the supply side as well as demand creation for the category, PSI achieves market development.
The World Health Organization recommends that all fever should be confirmed before treatment with the recommended artemisinin-based combination therapies (ACT). However, in the private sector of Kinshasa— where 90% of malaria medications are procured — uninformed consumers continue to receive malaria medications that lack quality assurance or that are no longer considered effective. Furthermore, with 42% of the population of Kinshasa living on less than $1 a day, higher quality treatments are often out of reach for most of the population, causing consumers to opt for the cheaper, less effective malaria medications. Ineffective treatments not only fail to treat the disease, but also contribute to the spread of artemisinin resistance.
Although quality-assured ACTs are the gold-standard in malaria treatment, the market in the DRC has struggled to be developed.
Our Partners: National Malaria Control Program (PNLP) | The Global Fund
Funder: DfID
Delve Deeper: Quality Malaria Medications to Congolese Through the Private Sector
Photo Credit: Alena Sims
Monitoring Modern Family Planning Markets
outlets, such as clinics and pharmacies, surveyed for quality, quantity and variety of contraception offered across Ethiopia
To help inform program and policy decision-making, PSI aims to understand the total family planning market in high-priority FP2020 countries. FPwatch, a multi-country research project, uses standardized tools and approaches to provide comparable data for modern family planning methods across countries and time. Launched with funding from the Bill & Melinda Gates Foundation, and later from the Three Millennium Development Goals Fund, the project has been implemented in five countries: Ethiopia, Nigeria, the Democratic Republic of Congo, Myanmar and India.
Data collectors conduct quantitative, cross-sectional surveys from a sample of public and private outlets with the potential to sell or distribute modern contraceptives and/or offer family planning services. These outlets include health facilities, community health workers, pharmacies, drug stores, retail outlets, market stalls and mobile providers. Sampling public and private sector outlets allows PSI to understand the total market for FP products and services.
FPwatch audits all modern contraceptives available and interviews providers at eligible outlets to learn the quantity available, consumer price and sale/distribution volumes for each product. Additionally, brand types and prices for male and female condoms are collected. Findings provide an estimate of contraceptive availability and relative market share across the entire market, as well as within key market segments.
FPwatch is designed to provide timely, relevant and high-quality market evidence to inform national and global policy, strategy and funding decisions for family planning markets. The program monitors family planning markets to promote strategic investments in family planning as part of the FP2020 Initiative, a partnership aiming to expand access to family planning information, services and supplies to an additional 120 million women and girls in 69 of the world’s poorest countries by 2020.
Think you know the FP2020 objectives for Ethiopia?
Funders: Bill & Melinda Gates Foundation | Three Millennium Development Goals Fund
Delve Deeper: www.fpwatch.info
Photo Credit: Jake Lyell
Eliminating Malaria in the Greater Mekong Subregion
PSI’s Three-Pronged Approach
Improve case management to rapidly test, treat and track every malaria case
Establish state-of-the-art surveillance procedures to report case data directly into the national systems
Use data to drive decisions, course correct and build up the evidence to inform private sector strategies more widely
Across the Greater Mekong Subregion (GMS), the private sector remains the source of health care for a sizeable proportion of the population and therefore, failing to address poor case management in the private sector poses a serious threat towards malaria elimination goals.
PSI launched a $20 million project, funded by the Bill & Melinda Gates Foundation, to improve malaria case management in the private sector in four key countries: Cambodia, Lao PDR, Myanmar and Vietnam. Building on a strong foundation of PMI-funded quality assurance innovations and mHealth tools, this new funding will ensure that all cases are rapidly detected and appropriately treated; establishing reporting systems that will accurately track each case and reporting this data into the national health system; as well as building resources to inform private sector strategies in other malaria-endemic countries aiming for elimination.
Expanding access to artemisinin-based combination therapies (ACTs) has been pivotal in reducing the global malaria burden. From 2000-2013, major investments have successfully dropped the mortality by 47%, but progress is fragile. The Greater Mekong Subregion is the historical starting point for drug resistance and artemisinin-resistant parasites have been detected in Cambodia, Laos, Myanmar, Thailand and Vietnam. Should resistance spread, it has the potential to derail recent successes both within the region and on the African continent with devastating effect. Malaria elimination in the GMS will not only eliminate the roughly 1.8 million annual cases in the region, but will stop resistance popping up independently and spreading. Early detection, strong surveillance and patient follow up in both the public and private sectors will be the key.
Think you know about the fight against malaria?
Our Partners: PLAN, University of Baltimore | PATH |
Ministries of Health: Cambodia, Lao PDR, Myanmar and Vietnam
Funder: Bill & Melinda Gates Foundation | President’s Malaria Initiative (PMI)
Delve Deeper: Malaria Elimination Efforts in the Greater Mekong Subregion – PSI Impact
Photo Credit: Jake Lyell
2015 Health Impact
The Scale of PSI Programming In 2015
3,896,671 unintended pregnancies prevented.
9,246 maternal deaths prevented.
379,286 deaths due to malaria, diarrhea & pneumonia prevented.
234,367 HIV infections prevented.
694,301 long-acting, reversible contraceptives inserted (including implants and intrauterine devices), empowering women and couples to plan for the families they desire.
282,018 voluntary adult medical male circumcisions performed, preventing HIV and other sexually transmitted infections (STIs).
1,578,027 voluntary testing and counseling sessions for HIV and other STIs conducted, reducing transmission rates and increasing access to treatment through referrals.
44,221,302 long-lasting insecticide-treated nets, protecting families from malaria.
1,137,857,646 male and female condoms, preventing transmission of HIV and other STIs and empowering women and couples to plan for the families they desire.
3,395,326 diarrhea treatment kits, saving children’s lives by reducing the severity and duration of diarrheal disease.
24,298 courses of directly observed therapy, saving lives by treating tuberculosis.
1,274,413 pre-packaged antibiotics, saving lives by treating pneumonia.
11,121,111 courses of artemisinin–based combination therapy, saving lives by treating malaria.
10.6 billion liters of water treated with water treatment products.
In 2015, PSI added an estimated 44.9 million years of healthy life with our products and services.
PSI estimates the impact of its health interventions using the Disability-Adjusted Life Year (DALY), a unit of measurement developed by the World Bank and the World Health Organization to estimate years of life lost due to death and disability. We track each product we deliver and service we provide. We then use mathematical models to calculate the DALYs averted by our work.
OUR IMPACT: Years of Healthy Life Added
About PSI
At PSI, we believe that extreme poverty can be eradicated in our lifetime only by breaking the traditional development model. Together with our partners, we develop and test breakthrough concepts that actually have the potential to go to scale and make it easier for people in the developing world to lead healthier lives.
ONLY PSI HAS
A global network structure of more than 65 member organizations.
A 45-year track record of developing cutting-edge health solutions.
The ability to take proven health interventions to scale.
ONLY TOGETHER WITH OUR PARTNERS CAN WE
Invent effective health solutions.
Test concepts and bring investments to the right ideas.
Free 1.2 billion from poverty within our lifetime.
Learn more about our Board of Directors, Senior Staff and Country Leadership.
Financial Statements
With every $41.76 you invested in PSI in 2015, you gave a mother and her two children a year of healthy life.
2015 REVENUE BY DONOR
EXPENSES BY YEAR (IN MILLIONS)
REVENUE BY YEAR
DONORS*
Anonymous
Bill & Melinda Gates Foundation
Caitlin Heising
Civil Society Fund
Global Fund to Fight AIDS, Tuberculosis and Malaria
Government of India
Government of the Netherlands
Government of South Africa
Indrani’s Light Foundation
Pfizer Inc.
Swedish International Development Cooperation Agency
UNITAID
United Kingdom Department for International Development
United Nations Children’s Fund
United Nations Office for Project Services
United Nations Population Fund
United States Agency for International Development
United States Centers for Disease Control and Prevention
United States Department of Defense
World Bank
* Donors listed contributed a minimum of U.S. $1 million in 2015. Contributions received not recognized according to Generally Accepted Accounting Principles.
The figures on this page are excerpted from statements and schedules issued by PSI’s external auditors. Copies of audited statements are available upon request from PSI in Washington, DC. Please email [email protected].
Past Issues of PSI Pulse
A Major Shift for HIV Testing in Africa
A Smartphone App that Delivers Vital Maternal Health Information in Myanmar
Building a Market for Toilets to End Open Defecation in India
Reversing the Rise of Cardiovascular Disease in Kenya
HIV Cyber-Support Reaches At-Risk and Hidden Populations in Central America
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