Abstract
Recent years have witnessed a dramatic decline in the burden of malaria in endemic countries. The scale-up of effective tools to diagnose and treat malaria has played a significant role in this public health achievement, and continued availability of proven products for malaria case management is essential to sustaining and extending the gains. However, markets for malaria treatments and diagnostics face a number of challenging market dynamics that have in the past generated inconsistent product supply, volatile demand, significant price swings, and suboptimal allocation of resources. Given the size of the market for malaria case management commodities and its importance to public health, finding ways to ensure greater stability in this market is critical for a broad array of stakeholders including policymakers, market participants – and most importantly – malaria patients.
The Malaria Diagnostics and Artemisinin Treatment Commodities Forecasting Consortium (“the Forecasting Consortium”) was established by Unitaid to provide better information to policymakers, market participants, and other stakeholders about the size of and trends in the global markets for malaria case management commodities. The Forecasting Consortium comprises the Clinton Health Access Initiative, Inc. (CHAI), IMS Health, and University of California San Francisco (UCSF) Global Health Sciences, is funded by Unitaid, and reports to a Steering Committee made up of Unitaid, the Global Fund to fight AIDS, Tuberculosis, and Malaria (Global Fund), the World Health Organization’s Global Malaria Program (WHO-GMP), the President’s Malaria Initiative (PMI), and Medicines for Malaria Venture (MMV).
This forecast represents the third in a new series of projections that will be made over the next year. The forecast presented in this report provides an update to the baseline projection of the size of the malaria commodity market that was presented in the prior published report (www.unitaid.eu/en/actforecasting) and shifts the forecast period from 2016 – 2019 to 2017 – 2020. Future reports will update and extend the baseline forecast, and also assess scenarios and events that could impact the market. This forecasting consortium builds on previous models for estimating the size of the market for artemisinin-based combination therapies (ACTs), including WHO-prequalified ACTs (quality-assured ACTs; QAACTs) and ACTs that are not WHO-prequalified (non-quality assured ACTs; non-QAACTs), introduces new information around other categories of antimalarial medicines, such as quality-assured injectable artesunate (QAINJAS) and oral artemisinin monotherapies, and estimates the size of the market for malaria rapid diagnostic tests (RDTs).
Two key points about nomenclature warrant emphasis. 1) This forecasting report distinguishes three terms that often are used interchangeably but mean very different things: “need”, “demand,” and “procurement”. For this report, “need” represents our projection of the total number of febrile cases where the patient carries malaria parasites currently detectable by microscopy or rapid diagnostic tests (including cases where the fever may be caused by a separate infection); “demand” represents the number of cases where a consumer would seek treatment for a suspected case of malaria-caused fever (including cases where the fever is not caused by malaria); and “procurement” represents the number of quality-assured products that we estimate will be ordered by public or private sector purchasers in the given timeframe. 2) For our demand forecasts, we have divided the private sector into formal and informal channels, with the formal private sector including private not-for-profit and for-profit hospitals and clinics, and pharmacies, and the informal private sector including private drug shops, vendors and general retailers that sell medicines. For our QAACT procurement forecasts, we’ve divided the private sector market by those settings where the Global Fund co-payment mechanism allows for marketing of subsidized ACTs in the private sector, and those settings where co-paid ACTs are not formally part of the private sector market landscape (the premium private sector). By differentiating these concepts in our terminology we hope to clarify how evolving market dynamics are impacting different decisions around malaria case management.
