The Affordable Medicine Facility–malaria (AMFm) endangers public health, according to Oxfam. There are alternative approaches that can deliver better health outcomes for poor people, the agency said in a report released on 24 October 2012.
The AMFm is a subsidy programme for artemisinin-based combination therapies (ACTs) currently underway in seven pilot countries. A recently concluded independent evaluation termed the AMFm a “game-changer,” having successfully increased the availability and reduced the prices for quality ACTs among the private sector providers (see GFO article).
The Global Fund has hosted the AMFm as a pilot project since 2009. The Board of the Global Fund is scheduled to decide on the future of the AMFm at its meeting on 14–15 November.
According to the Oxfam report, increased availability is not proof that the medicines got to those in need or that treatments were given appropriately. The report blamed AMFm for causing “a crisis in the global market” by triggering excessive demand for ACTs, even among countries with low malaria prevalence.
The report warned of the danger of resistance as a result of excessive sale of ACTs, particularly now when malaria cases are known to be on the decline.
Oxfam also faulted the AMFm model’s reliance on the private retail sector. The report argued that such providers lack the incentive to carry out proper diagnosis and treatment. Instead, Oxfam recommended that community health workers be trained on diagnosis and treatment, and that private pharmacies only support public sector provision in towns.
Oxfam also recommended that the Global Fund stop hosting the AMFm and that UNITAID and the UK Department for International Development, two of the main donors, cease funding the project.
According to BBC News, the Global Fund issued a statement in response to the Oxfam report in which it said Oxfam's claims were “simply untrue.”
The Fund said, “Some Western aid groups oppose a pragmatic approach that includes any involvement of the private sector. But the reality of this programme is that it is getting life-saving medicine to people who need it most from the private sector outlets where they already seek treatment.”