Positive manipulation? Creating the market for ACTs The Affordable Medicines Facility for malaria (AMFm) has tried through subsidies to move consumption to artemisinin combination therapies (ACTs) and drive other products from the market. Professor William Brieger observes the positives and negatives of this pioneering initiative

bGetting the right malaria treatment on time has been a major challenge in the fight against this parasitic disease. Demographic and health surveys paint a serious problem as seen in the graph. Consequently, global and national malaria efforts have tried to devise various strategies to increase uptake of antimalarial drugs, with one of such being to make high-quality and appropriate anti-malarial medicines available to the public through various points of care and sale in a subsidised form. An example of this subsidised approach was promoted by the Tropical Disease Research programme of the UNDP/World Bank/UNICEF/WHO. Teams in Nigeria, Ghana, Burkina Faso, and Uganda experimented between 1998 and 2001 with promotion and acceptability of age-specific prepackaged drugs (PPDs), chloroquine and cotrimoxazole, in order to provide (at that time) the appropriate treatment for febrile illnesses. 1