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Table 1 Key features of the AMFm and CPM.

From: What happened to anti-malarial markets after the Affordable Medicines Facility-malaria pilot? Trends in ACT availability, price and market share from five African countries under continuation of the private sector co-payment mechanism

 

AMFm

CPM

Oversight responsibilities

A sub-committee of the Global Fund Board provided oversight of the Secretariat

The Country Coordinating Mechanism at country level provided oversight of implementation by the PR of the grant

Subsidy level

Set by the Global Fund Secretariat and applied across all pilots. The subsidy level under the AMFm was targeted at 95%, but in practice it differed by formulation and pack size

Since 2013, countries have set their own subsidy levels and these have evolved over time

Supplier management

Supplier management was handled centrally under the AMFm and the CPM

Price negotiations

A maximum price approach was outsourced to a negotiating agent

A competitive tender was managed by the Sourcing Department at the Global Fund Importantly, this resulted in a supplier- and product-specific reduction in prices of about 30%. This reduction has offset the falls in subsidy levels in some countries

First-line buyer responsibilities

The Global Fund determined first line buyer eligibility to participate and sent Local Fund Agents to conduct spot checks to monitor compliance with the terms and conditions of the agreement

PRs assessed first-line buyers, determined eligibility, maintained and oversaw agreements, and conducted spot checks for compliance with the terms and conditions of the agreement

Order approvals

The Global Fund AMFm Unit approved all orders, initially on demand, and then on a monthly basis

One to four rounds for ordering per calendar year per country, and the PR had to review, validate and approve each round of co-payment allocations before the Global Fund could notify manufacturers of orders approved for co-payment

Monitoring and evaluation

The Global Fund commissioned an independent evaluation and price-tracking surveys

PRs were responsible for tracking price and availability in the private sector