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Nov 14, 2012 by MAE CHAN
Joint Multi-Level Global Initiative Uses Coca-Cola Model To Deliver Drugs

A controversial program that uses the Coca-Cola model to provide malaria treatments to people in Africa continues and is up for renewal this November. The program funded in part by the Bill and Melinda Foundation supposedly enables reduced-price malaria drugs to be sold in shops and market stalls and is being broadened. The private-market approach — sometimes called the Coca-Cola model in reference to the soda’s apparent ability to reach remote areas of the world — aims to deliver drugs in regions where the majority of people obtain medicines from shops rather than from district hospitals or clinics.

“This experiment demonstrates that we can use private distribution mechanisms to make treatments available in rural areas,” said Laxminarayan, a research scholar in the Princeton Environmental Institute, lecturer in economics at Princeton University and director of the Center for Disease Dynamics, Economics and Policy in Washington, D.C.

The researchers found that the program, known as the Affordable Medicines Facility – malaria (AMFm), delivered malaria medicine, known as artemisinin combination therapy (ACT).

ACT prices were lowered by a range of US $1 to US $5 per dose in the five countries that substantially implemented the program, according to results published in the Oct. 31, 2012 issue of The Lancet. The price-reductions were achieved via negotiations with manufacturers and subsidies from donors. The program operated in seven African countries (Ghana, Kenya, Madagascar, Niger, Nigeria, Tanzania and Uganda) and was organized by the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Controversial when first proposed (see “Malaria Drugs, the Coca-Cola Way” in Science, Nov. 21, 2008), the private-market approach is a departure from government-run programs that rely on healthcare workers or clinics to distribute free or subsidized malaria drugs. Critics worried that the approach was unproven.

The future of the program is scheduled to be voted on this November by the Board of the Global Fund.

The authors recommended expansion of the program to a greater number of malaria-endemic countries. If the program were to be modified, price increases should be gradual rather than sudden to cushion the effect on the consumer.

One of the problems is that rapid diagnostic tests for malaria are not used to ensure that only malaria-infected individuals take the drugs which has led to non-infected individuals inadvertently taking the drugs. "Sometimes facilitating drug delivery and its exposure to less privileged populations works against them."

Mae Chan holds degrees in both physiology and nutritional sciences. She is also blogger and and technology enthusiast with a passion for disseminating information about health.

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