In November of 2008, the Global Fund to Fight HIV/AIDS, TB and Malaria announced that it would
administer the first phase of an ambitious scheme to increase the availability of effective treatment
for malaria, the Affordable Medicines Facility-malaria (AMFm). Artemisinin-based combination
therapies (ACTs) are highly effective, but remain prohibitively expensive for those who are most
vulnerable to malaria infection.1
The AMFm aims to significantly reduce the price of ACTs by offering
a co-payment for ACTs purchased by eligible buyers at the top of the supply chain.
Recognizing that the public and private sectors are important sources of antimalarials in most
endemic countries, both public and private sector buyers will be entitled to purchase subsidised
ACTs. The involvement of the private sector is an innovative element of AMFm, as many countries
already have experience distributing ACTs in the public sector. To ensure that subsidised ACTs reach
patients at the lowest possible cost, it is necessary to gain a better understanding of the private
sector supply chains for antimalarials in each country participating in the AMFm.
The objective of the rapid supply chain survey was therefore to assist Nigeria, which is one of the 11
countries invited to apply to the first phase of the AMFm, in the development of an effective
implementation plan by providing an understanding of the current supply chain for antimalarials,
and the way in which subsidised ACTs are likely to travel through this chain to reach patients. This
report presents the findings of a series of semi-structured interviews conducted with government
officials and private suppliers of malaria treatment operating at the various levels of the chain.
Supplemental sections include brief discussions on the Nigerian drug monitoring system, on the
proposed tax exemption for subsidised ACTs under the AMFm, and also on the private sector
capacity to repackage and re-label imported subsidised ACTs. In addition, data from the December
2008 report on the first round of the ACTwatch Outlet Survey in Nigeria were used to estimate key
variables, such as antimalarial market shares