Four private wholesalers feed into 650 pharmacies that sell drugs to consumers and also, in rural areas, to private chemists who sell, officially, a limited line of medications to consumers (however, much more variety is usually available). These networks represent nearly 65 percent of the total sales value of antimalarials in the country (excluding the illegal market). The private market is efficient at maintaining stocks, especially for urban pharmacies, which may be supplied daily.

Most of the products in the private sector come from France and are marketed under brand names, but essential generic medications—mostly locally produced—are sold under standard International Nonproprietary Names (INNs). Since June 2003, private networks also have distributed generic medications under INNs that they purchase at the PNA, which appear on the limited list of thirty medications, including three antimalarials (chloroquine tablets and two dosages of injectable quinine).

About 50 registered pharmaceutical wholesalers and distributors import drugs into Zambia to supply the private market, which consists of private clinics, hospitals, and retail pharmacies. Unlike the situation in Senegal, the private sector cannot purchase drugs from the public sector to sell in private outlets.

Private distributors deliver drugs only within Lusaka, the capital, and to towns on the railway line to the Copper Belt and the Southern province. Depending on the location of the provider, a drug may go through two or three wholesalers before it arrives at its final place of sale.

Drug Flow through the Churches Health Association of Zambia

The Churches Health Association of Zambia (CHAZ)—the largest private not-for-profit organization in Zambia—includes more than 100 church-administered hospitals, health centers, and community programs, which operate as part of the public health system. Mission hospitals serve as district hospitals where there is no Ministry of Health hospital, mostly in poor rural areas.

CHAZ procures drugs quarterly, using a restricted tender system from suppliers pre-qualified by WHO. CHAZ is exempt from registration fees and various duties on imported drugs and medical equipment. The main suppliers are the International Dispensary Association in the Netherlands

Front Matter (R1-R20)

Executive Summary (1-16)

Part 1: A Response to the Current Crisis1 Malaria Today (17-60)

2 The Cost and Cost-Effectiveness of Antimalarial Drugs (61-78)

3 The Case for a Global Subsidy of Antimalarial Drugs (79-111)

4 An International System for Procuring Anitmalarial Drugs (112-122)

Part 2: Malaria Basics5 A Brief History of Malaria (123-135)

6 The Parasite, the Mosquito, and the Disease (136-167)

7 The Human and Economic Burden of Malaria (168-196)

8 Malaria Control (197-251)

9 Antimalarial Drugs and Drug Resistance (252-298)

Part 3: Advancing Toward Better Malaria Control10 Research and Development for New Antimalarial Drugs (299-311)

11 Maximizing the Effective Use of Antimalarial Drugs (312-328)

Acronyms and Abbreviations (329-333)

Glossary (334-346)

Index (347-364)