mdgs and new public-private partnerships

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MDGs and New Public-Private Partnerships

Oladimeji OladepoUniversity of IbadanDavid PetersJohns Hopkins University

Countries on Track to Reach MDGsSub-Saharan Africa

by number of countries

-100%

-50%

0%

50%

100%

P overty Malnutrition Completion Gender Childmortality

Births Water Sanitation

48 countries

NoteAchieved

On track

Off track

Seriously off track

No data

Nigeria

Nigeria

Nigeria

Nigeria

Nigeria Nigeria Nigeria Nigeria

Under 5 Mortality Rates (2004)

0

50

100

150

200

250

High income Middle income Low income Sub-SaharanAfrica

Nigeria

Un

der

5 M

ort

alit

y R

ate

(200

4)

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Purpose of Future Health Systems Research Consortium

To generate knowledge that shapes health systems to benefit the world's poor

To translate political and financial commitments to meet the health needs of the poor into sustainable improvements in health and reductions in poverty

JHSPH, USA

IDS, UK

University of Ibadan, Nigeria

OladimejiOladepo

IPH, Uganda

IIHMR, Afghanistan

IIHMR, India

CHEI, China

ICDDR, B, Bangladesh

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Study Background: Importance of Malaria in Nigeria Malaria a major cause of mortality and

morbidity (About 25-35% of child deaths) and poverty

Resistance to conventional drugs (CQ, SP); Many substandard drugs available

New policy to provide ACTs as 1st and 2nd line drugs

Little known about the main source of treatment: Patent Medical Vendors (PMVs)

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54 Different Types of Anti-malarial Drugs Found in Oyo, Enugu & Kaduna

8

Percent of Patent Medical Vendor Shops with Anti-Malarial Drugs

0

10

20

30

40

50

60

70

80

90

100

ACTs Monotherapyartusenates

Chloroquine Sulfadoxine-pyrimethamine

Other

Per

cen

t o

f S

ho

ps

9

Mean Price of Malaria Brands

504

393

83 91

272

0

100

200

300

400

500

600

ACT AS-Mono CQ SP Other

Nai

ra

10

Study Findings

Low quality drugs cited as major problem by households, PMVs and Associations, government officials

Low confidence in government to regulate, but wide regional variation

PMVs know little about malaria policy change

Gov’t officials know nothing about PMV Associations

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What are the Options?

Business as usual Educate parents, PMVs Subsidize all ACTs Support low-cost diagnostics Support local institutions that work:

civil society, PMV associations, gov’t regulators, industry, to monitor treatment/quality of drugs

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FHS Nigeria: Developing Interventions

New co-regulation with PMV Associations, citizens groups, government

Mini-Lab testing of drugs Cell phone information on drugs,

referrals

Next Steps

Abuja MeetingMaking Health Markets Work for the Poor

January 12-13, 2009

Innovators, potential collaborators, researchers to learn, gather resources

and plan for implementation

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Website: www.futurehealthsystems.org

Email: fhsnigeria2007@yahoo.co.uk