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Revisiting the AMFm Controversy

Paul Kartchner contributes this guest blog via the SBFPHC Policy Advocacy Blog.For years, a major obstacle to controlling malaria in developing countries has been the high cost of effective medications. Yet in recent years a coalition of public health agencies and organizations are targeting this problem by subsidizing the most effective medications. Called the Affordable Medicines Facility – malaria (AMFm), the project hopes to make these medications more available and affordable to hospitals, physicians, and local pharmacies in developing countries.

amfm-2010-04-23_malaria-shipment-abuja-novartis.jpgPhoto shows Workers load AFMm medications in Abuja, Nigeria (courtesy Novartis International AG)

Yet even though the project has been found to increase the supply of medications, criticisms have been raised regarding the program’s long-term benefits. A recent report by Oxfam, an international aid group, claims that although these medications are now broadly available, they are not being used appropriately to treat patients with malaria. They also claim that many patients that do need these medications, including women and children, still do not have access to them.

Another aid group, Doctors without Borders/Médecins Sans Frontières (MSF), claims that a project like AMFm cannot be successful if it is not carefully integrated into a larger strategy to combat malaria. Instead MSF recommends a plan whereby not only the medication but also treatment by knowledgeable providers is subsidized.

These criticisms raise important questions about the nature of complex global diseases such as malaria. Focusing efforts and resources on a particular aspect of a problem without considering the larger context may not only fail to improve the situation, but potentially make it worse.

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