FIGURE 3-3 Price benefits of splitting tenders. Despite an initial investment of approximately $2 million for a premium price, this strategy led to a broader supply base and significant and sustainable price reductions.

SOURCE: Ripin, 2012. Presentation at IOM workshop on Developing and Strengthening the Global Supply Chain for Second-Line Drugs for Multidrug-Resistant Tuberculosis.

combination therapies, or ACTs) was too expensive to treat the large numbers of patients in need. Olusoji Adeyi, Sector Manager, Health, Nutrition, and Population, World Bank, offered some lessons from AMFm that could be relevant to the treatment of MDR TB. The functions of AMFm include


•   reducing prices via negotiations with manufacturers;

•   subsidizing buyers from the public, NGOs, and the private sector26; and

•   providing in-country supporting interventions such as promoting uptake and ensuring proper use.

Public- and Private-Sector Interaction

The involvement of the private sector is crucial in provision of supporting interventions because 40–90 percent of treatment, depending on the country, is carried out in the private sector. Adeyi stressed that engaging


26 Essentially, AMFm makes a copayment to registered suppliers on behalf of the buyer.

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