The Affordable Medicines Facility for Malaria (AMFm)
- AMFm workstream
- Making the AMFm
The Affordable Medicines Facility – malaria (AMFm) was an initiative hosted by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and piloted in 2010-2012. Its objective was to look at the impact of a manufacturer-level co-payment system on the accessibility and affordability of effective antimalarials in both the public and private sectors.
The AMFm principles, objectives and technical design were developed by the Roll Back Malaria AMFm Taskforce based on the recommendations of Economy Nobel Prize winner Pr Kenneth Arrow's report "Saving lives, buying time" published in 2004. He recommended that a global subsidy should be introduced to enable patients and their carers to access ACTs at prices similar to chloroquine or SP. This proposal was taken up by the Roll Back Malaria (RBM) Partnership who developed the concept and then by the Global Fund, who agreed to host an initial pilot. This became known as the Affordable Medicines Facility – malaria (AMFm).
The Affordable Medicines Facility – malaria (AMFm) was designed to overcome three main challenges to the effective use of Artemisinin-based Combination Therapies (ACTs).
- Accessibility: In many countries, the private retail sector (including informal outlets) is an important source of antimalarials, being the most convenient place to buy drugs. Before AMFm, the high price of ACTs and regulatory restrictions meant that they were unavailable in the retail sector.
- Affordability: The high cost of manufacture of ACTs meant that the price to patients was unaffordable to most, especially the most vulnerable and those living in remote areas.
- Sub-standard & counterfeits: Sub-standard & counterfeit drugs are a major concern because they lead both to ineffective treatment and to the development of drug resistance. If high quality antimalarials can be made more widely available at affordable prices, then they could drive out the poor quality products.
The AMFm Phase 1 ran between June 2010 and December 2012 in seven Sub-Saharan African countries (eight pilot programmes). An Independent Evaluation (IE) of its success in reaching key preset success parameters was reported in the second half of 2012. The Global Fund reviewed the results of the AMFm Phase 1 and the findings of the IE in November 2012 and agreed to incorporate its principles into its new core financing model, with the subsidy (or co-payment model) being restricted to the private retail sector.
Since its inception in November 2008, the AMFm workstream has held regular teleconferences, and has convened a number of workshops to support proposal development for accessing the AMFm and rolling-out supporting interventions.
AMFm Workstream Planning Workshop, 31 October 2009, Nairobi
An AMFm Workstream planning workshop was held in Nairobi on October 31st where the nine countries whose proposals had been approved by the Global Fund Board were invited to formulate their needs, if any, for support with the negotiations of their grant amendments and the roll out of the AMFm.
AMFm M&E Workshop, 10-11 June 2009 in Dar es Salaam, United Republic of Tanzania
The countries and their RBM Partners were then joined by their colleagues from the Global Fund for a Monitoring and Evaluation (M&E) workshop on June 10th and 11th. This workshop focused on the M&E requirements and on updating the Grant Performance Frameworks of the "host grants" for the AMFm.
AMFm Mock TRP Workshop, 8-9 June 2009 in Dar es Salaam, United Republic of Tanzania
The AMFm workstream re-convened the same countries in Dar es Salaam on June 8th - 9th for a Mock Technical Review Panel workshop. Countries peer-reviewed each other's draft proposals and with the inputs from their peers further developed them.
AMFm Orientation Workshop, 12-14 February 2009 in Nairobi, Kenya
On February 12th to 14th, the eleven countries selected by the Global Fund Board for implementing Phase One of the AMFm were convened for an orientation workshop in Nairobi. The purpose was to inform and request feedback from the countries on the principles, objectives and technical design of the AMFm and the modalities to access it. More in particular they were introduced to the AMFm proposal forms and established the process and timelines for their completion and submission.
AMFm Technical Design
Additional Design Recommendations:
Letter from the RBM Executive Committee Chair to the Executive Director of the Global Fund
as of 17 February 2008
as of 19 August 2008
Access to malaria treatment among the poor: what can the AMFm contribute? (September 2008)
The Global Fund:
The Global Fund Summary Report on Co-paid ACTs (AMFm)
Phase one proposal form and guidelines
The GF Board AMFm decision points
22nd Board Meeting
21st Board Meeting
20th Board Meeting
19th Board Meeting
Report of the AMFm Ad Hoc Committee
18th Board Meeting
Report of the AMFm Ad Hoc Committee
17th Board Meeting
16th Board Meeting
Resolutions of the 9th UNITAID Executive Board Meeting