Wednesday July 18, 2007APPMG Meeting ACT Global Subsidy: Perspective from Diagnostics Vinand M Nantulya FIND Foundation for Innovative New Diagnostics
ACT Global Subsidy Wide access to ACT is of interest and we fully endorse that. But diagnostics needs to be included in this debate. It is important to link malaria diagnosis tothesubsidized ACT to avoid misuse and wastage of ACT. Misuse of current drugs is a major problem in both public and private sector and change may be more difficult in the informal sector.
Key issues at Country Level Bundling ACT with RDTs Ensuring quality of RDTs. Ensuring affordability of proper diagnosis and treatment.
Issue: Bundling ACT and RDTs Examine Uganda’s practical approach known as HOMAPAK. Originally designed to use Chloroquine/SP for home-based management of malaria fever in children using community health workers. ACT can be introduced into the kit together with RDTs.
Issue: Ensuring Quality of RDTs FIND is examining the possibility of tools to evaluate quality of RDTs, through the use of positive wells. These would empower governments to evaluate RDTs close to the point of actual use in the field. These tools could be available in 6 months.
Issue: Affordability of current RDTs For current RDTs, there is adequate competition in the market place. Local production could further bring down the price. For new RDTs that FIND is developing, the strategy is different as these will start as single or limited source.
But the cost of diagnostics has two vital components Cost to Serve (up to 20% of cost of dx) Cost of Goods • Training • Quality assurance • Maintenance • Provide solutions to bridge gaps and reduce costs + • Hardware • Laboratory strengthening (infrastructure) • Partners • Governments • Bilateral organizations • NGOs/Donors • Link price to volume (using GAMMSMor Global Accelerated Market Maturation) Software Quality Standardization Accountability ?Laboratory accreditation