In November 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. AMFm aims to reduce significantly 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 subsidized
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 subsidized 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 AMFm.
The objective of the rapid supply chain survey was therefore to assist Benin, which is one of the 11
countries invited to apply to the first phase of 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.
At the time of the survey, antimalarial products sold in the private commercial sector were procured
from international and domestic manufacturers by 3 active registered wholesalers and Benin’s public
sector procurement agent: the Centrale d’Achat des Médicaments Essentiels et des Consommables
médicaux (CAME). Manufacturers do not have sole distributorship agreements for registered
pharmaceuticals, or other special relationships with particular wholesalers. Consequently, each
wholesaler regularly stocks a large proportion of the antimalarials registered in Benin. CAME is
responsible for procuring the generic medicines on the National Essential Medicines List. In practice
CAME procures and supplies antimalarials not included on the National Essential Medicines List, as it
is currently out of date
