antimalarials and RDTs: an update on ACTwatch Stephen Poyer, Deputy - PowerPoint PPT Presentation

Monitoring supply and demand for antimalarials and RDTs: an update on ACTwatch Stephen Poyer, Deputy PI, ACTwatch on behalf of the ACTwatch Group

What is ACTwatch ? Nigeria Cambodia Benin Uganda Myanmar Kenya DRC 10-country project Funded by the BMGF 2008-2013, Zanzibar and BMGF, DfID, and UNITAID from 2013-2015 Tanzania Objective Provide policy makers with evidence Zambia on trends in availability, price, Madagascar market share and use of antimalarials and diagnostics Partnership PSI, LSHTM and MoHs www.ACTwatch.info 2

Research Methods: Outlet Surveys • Clusters randomly selected proportional to population size; • Census of all outlets with the potential to stock antimalarials; • Over-sampling of public health facilities and pharmacies; • Audit of all antimalarials in stock: - generic name - brand name – manufacturer - formulation – strength – expiry date – price - volume (quantity) sold/dispensed in the last 7 days; • Additional focus on diagnostic testing ( RDT /microscopy); • Data are survey set to account for clustering and weighted to provide nationally representative estimates. www.ACTwatch.info 3

Internal capacity building: Local research teams • Benin • Nigeria • Martine-Esther Tassiba • Ekundayo D. Arogundade • Cyprien Zinsou • Chinazo Ujuju • Ghyslain Guedegbe • Uganda • Aristide Hontonou • Peter Buyungo • DRC • Simon Sensalire • Dr Louis Akulayi Tshisungu • Henry Kaula • Dr Godé Mpanya • Zambia • Willy Mpwate • Nicholas Shiliya • Madagascar • Felton Mpasela • Iarimalanto Rabary • Edward Ngoma • Jacky Raharinjatovo • Cambodia • Justin Rahariniaina • Sochea Phok • Sitraka Ramamonjisoa • Phou Mean www.ACTwatch.info 11/12/2013 4

Internal capacity building: PSI research process www.ACTwatch.info 11/12/2013 5

Internal capacity building: PSI research process Myanmar: Artemisinin Monotherapy Replacement Project www.ACTwatch.info 11/12/2013 6

Results: Availability Rural pharmacy depot , Madagascar, 2009 www.ACTwatch.info 7

Trends in availability of quality-assured ACTs in the private sector Availability of QAACTs among private for-profit outlets stocking antimalarials, 2009 and 2011 100 90 80 70 66 Percentage of outlets 60 51 50 40 30 27 23 20 20 16 11 9 8 10 6 0 N=632/914 N=1854/1632 N=1831/1379 N=1575/2331 N=258/490 Benin Madagascar Nigeria Uganda Zambia 2009/2010 2011 8 www.ACTwatch.info 11/12/2013 2009/2010 & 2011 Outlet Survey Results

Private sector availability of CQ, quinine, and SP Availability of non-artemisinin therapies among private for-profit outlets stocking antimalarials, 2011 100 95 93 92 90 80 77 69 70 Percentage of outlets 58 60 52 50 40 30 25 18 20 11 10 4 0 0 2011 2009 2011 2011 2011 2011 Benin DRC Madagascar Nigeria Uganda Zambia Chloroquine SP 9 www.ACTwatch.info 11/12/2013 2011 Outlet Survey Results

Results: Market share Informal outlet, DRC, 2010

Private-for-profit sector antimalarial market share 100% 90% 30% CQ 60% CQ 26% SP 34% SP 80% 70% 26% CQ 71% SP 25% AQ 42% SP 35% SP 60% 20% QN 50% 40% 30% 20% 10% 0% 2011 2009 2011 2011 2011 2011 Benin DRC Madagascar Nigeria Uganda Zambia QAACT non-QAACT non-artemisinin therapy non-oral artemisinin monotherapy oral artemisinin monotherapy www.ACTwatch.info 2011 Outlet Survey Results 11

Results: Price Pharmacy in rural DRC, 2010

Private sector quality-assured ACT price trends Median price of one adult equivalent tablet dose of QAACT (tablet) in the private sector, 2009 and 2011 13.00 12.00 $11.01 11.00 10.00 9.00 Price, 2010 $USD 8.00 7.00 $5.87 6.00 $4.87 $4.47 5.00 4.00 $2.79 3.00 $2.00 $1.96 $0.14 $0.60 2.00 $1.48 1.00 0.00 Benin Madagascar Nigeria Uganda Zambia n=353; n=854 n=380; n=1057 n=1001; n=1894 n=583; n=3291 n=89; n=253 2009 / 2010 2011 n = number of antimalarials www.ACTwatch.info 2009/2010 & 2011 Outlet Survey Results 13

External capacity building: Publicly-available data to support partner’s research programmes • A comprehensive picture of the antimalarial market in the focus country • A comprehensive picture of the malaria diagnostic market in the focus country • Trends in antimalarial availability and pricing • Provider practices regarding prescribing antimalarial medicines • Raw data for academics for additional analysis that will inform the NMCPs www.ACTwatch.info 14

“Knowing is half the battle” – use the information to address access to quality-assured ACTs in your country www.ACTwatch.info www.ACTwatch.info 15