TRIPS, Public Health Systems and Free Access
Edited by Benjamin Coriat
Chapter 11: Procurement Policies, Governance Models and ARV Availability in French-speaking African Countries: An Overview
11. Procurement policies, governance models and ARV availability in French-speaking African countries: an overview Mamadou Camara, Cristina d’Almeida, Fabienne Orsi and Benjamin Coriat With the implementation and increasing power of national AIDS control programmes (PNLS), the end of the 1990s saw a revival of procurement policies in French-speaking African countries. Two principles emerged. From this time on, procurement policies were organized around two objectives – on the one hand, an eﬀort to generalize the management independence of central buying agencies, with a view to increasing their eﬀiciency, and, on the other, whenever possible, to favour the prioritization of generic versions in drug supplier selection procedures. This new procurement policy, integrating ARVs, has gradually transformed the composition of the supply of available drugs, and is closely linked with the launch of national scaling-up programmes. Although consequences vary according to the country and the context, notably with regard to the methods of ﬁnancing the purchasing programmes (and the restrictions involved), the implementation of this new policy often induced remarkable changes to the running of the old structures, as much in all that concerns stock management as in drug purchasing/distribution policies. However, while progress was often observed, many problems remain, especially the fact that the implementation of the new policy is accompanied by a certain instability in procurement and distribution chains, resulting in noticeable consequences with regard to the availability of ARVs. The problems of availability concern both variety (the nature and quantity of molecules present in the area under consideration) and...
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