The private commercial sector distribution chain for antimalarial drugs in Madagascar: Findings from a rapid assessment

Abstract

ACTwatch is a research programme funded by the Bill and Melinda Gates Foundation that aims to provide and promote evidence and recommendations for policy makers on methods to increase availability and decrease the consumer price of quality‐assured Artemisinin‐based Combination Therapies (ACTs) throughout the private sector. Research has been carried out in seven countries (Cambodia, Uganda, Zambia, Nigeria, Benin, Madagascar and D.R. Congo) and encompasses Household Surveys, Outlet Surveys, as well as Supply Chain Surveys and Assessments.   As is the case in many developing countries, the private sector in Madagascar plays a pivotal role in facilitating access to malaria treatment. The Household and Outlet surveys conducted in Madagascar suggest that the general population tends to seek treatment through the private sector, and that private sector outlets make up a substantial portion of outlets that carry antimalarials.   In order to design future interventions that will improve access to diagnostic and effective treatment options, it is important to understand the structure of the private sector distribution chain for antimalarials, as well as the incentives, restrictions and challenges that actors within the market face. Despite the important role of the private sector in the supply of antimalarials, there is limited rigorous evidence on the subject. This report contributes to addressing this gap for Madagascar