Portal de Periódicos da CAPES

Editorial: Commercial sector partnerships for malaria control

1999; Wiley; Volume: 4; Issue: 5 Linguagem: Inglês

10.1046/j.1365-3156.1999.00414.x

1365-3156

Michael B. MacDonald, Drew McGuire,

Mosquito-borne diseases and control

Tropical Medicine & International HealthVolume 4, Issue 5 p. 319-321 Free Access Editorial: Commercial sector partnerships for malaria control First published: 09 October 2008 https://doi.org/10.1046/j.1365-3156.1999.00414.xCitations: 4 correspondence Dr Michael B. Macdonald, BASICS, 600 Wilson Blvd., Suite 300, Arlington, VA 22209, USA. E-mail: mmacdona@basics.org AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat The WHO-led ‘Roll Back Malaria’ (RBM) initiative opens the possibility for malaria control programmes to look to new and broader strategies in the fight against malaria. Through the RBM movement there is closer collaboration with UNICEF, World Bank, UNDP and other public organizations involved with health, economic and community development ( Nabarro & Tayler 1998). The commercial sector represents another force that can be tapped by national malaria programmes to increase the reach and sustainability of both preventative and curative services. Here we outline a model for engaging the commercial sector in launching a nationwide insecticide-treated materials (ITM) initiative in Ghana, and how the model can be used with the pharmaceutical sector to promote a national malaria drug policy. Common principles: Mutual benefit, market segmentation, neutral task force, consumer-driven Commercial sector partnerships for insecticide-treated materials in Ghana In January 1998 a global task force formed with representatives from WHO, UNICEF, the World Bank, the USAID BASICS project, representatives from insecticide manufacturers (AgrEvo, Bayer, Zeneca, Cyanamid, SC Johnson Wax Co.) and mosquito net manufacturers (Chemdol, South Africa, Siam-Dutch Mosquito Net Co.). Through a series of discussions, a consensus developed that the public sector and Ministry of Health cannot on its own adequately promote and distribute ITMs on a large scale. Likewise, the financial risk was too great, and the profit margins too narrow, for individual manufacturers to create a retail market for their products. Strategic partnerships between the commercial and public sectors could be formed to share the investments initially needed to research and build a market environment that would result in the mutual benefits of increased product use, access and sustainability. This strategy requires a shift of donor support away from commodity procurement and distribution to sharing the costs of market analysis, initial health education and promotion to grow the overall market. This donor investment may only be required for the first few years, after which the commercial partners continue promoting the issue of malaria control and marketing their individual products. ITMs are not the first for this type of initiative: successful partnerships for ORS ( Slater & Saade 1996), contraceptives (K. Willson, personal communication), latrines and soap (C. Saade, personal communication) show that commercial/public partnerships can provide sustainability (decreased long-term donor dependence); coverage (cost-effective sharing of resources), and equity (market segmentation and decreased burden on the public sector). Steps in the partnership model While each partnership is unique, they were established using a common model, with guidelines and protocols available for each step ( Slater & Saade 1996). The steps include first selecting the relevant public health need, in this case ITMs; then compiling an inventory of company capacities and the competitive market; developing consensus in the public sector and establishing a commercial/public task force under the chair of the Ministry of Health; then developing a marketing plan, contracting market research, finalizing marketing strategy, developing promotional materials and launching the campaign. Finally, there are the steps of monitoring and evaluation of public health impact and programme management. Initially consensus was built on the global level among insecticide and net manufacturers, donors, UNICEF and the WHO Roll Back Malaria Task Force for ITMs. The model is now being applied by the Ministry of Health in Ghana. Ghana is the initial focal point for both health and commercial reasons. Malaria is the priority health issue, accounting for 40% of hospital admissions and an estimated 25% of deaths in children under five ( MoH Ghana 1998). There is solid technical capability for malaria research, with one of the initial ITM efficacy trials conducted in the northern part of the country ( Binka et al. 1996 ), and numerous social scientists and health economists working on malaria-related issues. There is also strong political commitment: the Ministry of Health embraces commercial sector partnerships, wants to set policy and be involved with promotion and monitoring, but not be burdened with the logistics of marketing and distribution. It has petitioned the Ministry of Finance to waive the 25% import duty and 15% VAT on nets and insecticides. Ghana, with a population of 20 million, has a vibrant economy and is a commercial hub for the region, offering the potential to roll out the ITM marketing strategy to neighbouring countries. Initial steps: Assessing capabilities, establishing a task force, marketing plan and provisional budget The Ministry of Health convened a round table with donors and commercial sector partners in January 1999. A provisional budget was developed for market research and a two-year, nationwide promotional campaign using radio, TV, ‘road-shows’, print and interpersonal communication. The campaign will be two-phased: donors and the four commercial partners will pool their resources to conduct the market research and implement a generic ‘umbrella’ campaign for malaria awareness and the importance of ITMs. In the second phase, nets and insecticides will be promoted directly, possibly under a ‘seal of approval’ for the range of ITM products endorsed by the Ministry. The individual companies will then promote their own brands that fall under this umbrella campaign, thereby competing for their share of a growing market. In the first half of 1999, the Minister of Health will convene a task force, the workplan will be finalized, memoranda of understanding drafted and tenders issued for pricing studies and other market research. Contracts will then be awarded for generic advertising and promotion, and it is projected that within the year, the four commercial partners will launch their products and begin competing for market share. As the commercial sector begins to meet the needs of the middle and higher economic strata, the public sector, the Ministry of Health and NGOs are expected to be able to focus their resources on those at the very bottom, and strike a balance for a commercially viable, nondonor-dependent, long-term and equitable access to ITMs in Ghana. Curative services: Working with the pharmaceutical sector and private providers Underlying these two areas of intervention there needs to be the realization that, for better or for worse, the commercial and private sectors do provide health services for a large part of the population. Secondly, the private sector can be engaged as an extension of the national health policy, rather than as a competitor or a substitute. Finally, when we speak of ‘community’ in ‘community-based’ or ‘community participation’, the local shop keeper, drug vendor, traditional healer or private practitioner is an active participant. We need to expand our public health definition of ‘community’ beyond caretakers, households and social organizations to include the private and commercial sector. They are an important force and can be mobilized to meet mutual business and public health objectives. References Binka FN, Kubaje A, Adjuik M et al. (1996) Impact of permethrin-impregnated bednets on child mortality in Kassena-Nankana District, Ghana: a randomized trial. Tropical Medicine and International Health 1, 147 183. Wiley Online LibraryCASPubMedWeb of Science®Google Scholar Ministry of Health Ghana (1998) Medium Term Strategic Plan for Malaria Control in Ghana (1998–2001) Draft Document. Ministry of Health, Accra. Google Scholar Nabarro DN & Tayler EM (1998) The ‘Roll Back Malaria’ Campaign. Science 280, 2067 2068. CrossrefCASPubMedWeb of Science®Google Scholar Population Reference Bureau (1993) Indonesia: The Blue Circle and Gold Circle Campaigns. PRB, Washington, DC Google Scholar Slater S & Saade C (1996) Mobilizing the Commercial Sector for Public Heath Objectives: a practical guide, Full text available at: HYPERLINK http://www.basics.org/Publications/Mobilizing/Mobilizi UNICEF and BASICS, New York and Arlington Google Scholar Michael B. Macdonald 1 and David J. McGuire 2 1 BASICS/Johns Hopkins University, Baltimore, USA 2 BASICS/Academy for Educational Development, Baltimore, USA Citing Literature Volume4, Issue5May 1999Pages 319-321 ReferencesRelatedInformation