mdgs and new public-private partnerships
DESCRIPTION
This presentation was made to a delegation of Nigerian National Assembly House Committee on MDGs, led by Hon. Saudatu Sani, who visited Johns Hopkins Bloomberg School of Public Health on December 1, 2008. This was part of a study tour of 18 parliamentarians plus staff to examine strategies to improve MDG outcomes in health, and to explore the roles that legislators may play in this process. This is a presentation from the Future Health Systems Research Programme Consortium (www.futurehealthsystems.org).TRANSCRIPT
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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)
4
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)
7
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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