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