ACAME, the initiator and promotor of the bulk purchasing initiative in the African Region, should take the responsibility of the development and the implementation of the bulk purchasing system.

WHO, within the framework of its regional support programme to the pharmaceutical sector, can play an important technical advisory role, and a role of co-promotion and co-ordination. Its technical and financial assistance to the process, through the executive secretariat of ACAME, is strongly recommended and lies within the mandate of the organization. WHO is further invited to assist in the mobilization of partners and funds to cover the costs for the initial phase of the system.

To conclude, it should be stated that the members of the study team started the mission with different opinions. There was enthusiasm and optimism, but also a certain reserve and scepticism towards the feasibility of such an initiative. The survey has resulted in a common conviction that bulk purchasing is feasible and positive results have been obtained in the regions visited.

The study team hopes that the report will contribute to the implementation of bulk purchasing among ACAME countries, an idea that from the start was far from evident.