In November 2008, the Global Fund to Fight AIDS, Tuberculosis and Malaria launched the first phase of a new global subsidy on ACT, known as the Affordable Medicines Facility-malaria (AMFm). The primary objectives of the AMFm are:

1) To make ACT available and affordable to all patients through both the public and private sectors, and

2) To delay the onset of artemisinin resistance by displacing artemisinin monotherapies from the market.

Through a co-payment applied at the manufacturer level, the AMFm will enable public and private (both for profit and not-for-profit) suppliers in approved countries to purchase high-quality ACTs at a fraction of current prices. As a result, it is expected that ACT will be sold through private shops at a price similar to that of older and less effective drugs, thereby dramatically increasing patients’ capacity to purchase and use ACT.

The AMFm has been designed to ensure that primary suppliers – who operate at the top of the distribution chain and are the first point of entry for drugs into the country - maintain any preexisting purchasing relationships with manufacturers, and to minimize disruption to the operation of the distribution chain. Gaining a comprehensive understanding of public and private sector ACT distribution channels is therefore needed to ensure successful implementation of the AMFm, and ultimately to maximize ACT access in each country.

Cambodia is one of the 11 countries eligible to apply for the first phase of the AMFm that will operate for 18 months. The AMFm country application form requests a description of the current distribution chain for antimalarials across the public and private sectors. The description will serve as a key input into the selection and design of supporting interventions to ensure safe and effective distribution of co-paid ACTs under the AMFm. While there is information available on the public and NGO distribution chains, little is currently known and understood about the actors and operations of the private commercial sector distribution chain...