MDGs and New Public-Private Partnerships Oladimeji Oladepo University of Ibadan David Peters Johns Hopkins University

Countries on Track to Reach MDGs Nigeria Nigeria Nigeria Nigeria Nigeria Nigeria Nigeria Nigeria

Under 5 Mortality Rates (2004)

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

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 Oladimeji Oladepo IPH, Uganda IIHMR, Afghanistan IIHMR, India CHEI, China ICDDR, B, Bangladesh

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 1 st and 2 nd line drugs Little known about the main source of treatment: Patent Medical Vendors (PMVs)

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 1 st and 2 nd line drugs

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

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

Percent of Patent Medical Vendor Shops with Anti-Malarial Drugs

Mean Price of Malaria Brands

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

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

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

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

FHS Nigeria: Developing Interventions New co-regulation with PMV Associations, citizens groups, government Mini-Lab testing of drugs Cell phone information on drugs, referrals

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

Mini-Lab testing of drugs

Cell phone information on drugs, referrals

Next Steps Abuja Meeting Making Health Markets Work for the Poor January 12-13, 2009 Innovators, potential collaborators, researchers to learn, gather resources and plan for implementation

Abuja Meeting

Making Health Markets Work for the Poor

January 12-13, 2009

Innovators, potential collaborators, researchers to learn, gather resources and plan for implementation

Website: www.futurehealthsystems.org Email: [email_address]