Donor funding

Donor funding for and donations of medicines can have an impact on health in low- and middle-income countries in the short term. In the medium term these donations should be targeted at specific diseases and planned as additional supplies integrated into the national medicines supply system. But in the long term, self-sufficiency is the only viable means to tackle increasing disease burdens. 

Infrastructure Donor funded schemes may -l-develop feeder roads and bridges None 0 Forest plantation scheme develops infrastructure, e.g., roads and bridges ++... 

L is the number of standard loads of supplies that can be procured per dollar of the donor fund. Therefore, NGO 1 s profit is expressed as... 

BRR claimed that the reconstruction of houses in Aceh and Nias was the fastest in the world (Multi Donor Fund for Aceh Nias 2007). Some NGOs also claimed that reconstruction and rehabilitation of Aceh and Nias was... 

UNDP (2006) Tsunami recovery waste management programme multi donor fund for Aeeh and Nias. UNDP, Indonesia... 

The Tanzania Food and Drug Authority (TFDA) presses for GMP adherence. Tanzanian firms either have attained locally acceptable GMP standards or are working towards them with TFDA support. Manufacturers agreed that TFDA required standards rise over time, just as do the standards achieved by international competitors and the expectations of international buyers. None, when interviewed, had WHO prequalification of individual products to allow them to tender for donor-funded contracts. 

For Tanzania, the domestic market size for medicines was estimated at around US 250 million in 2011-12. Of this market, public wholesaler (MSD) sales were aroimd 50% (US 125 million), of which 70% in turn were donor-funded vertical programme sales (MSD, 2013). That leaves just US 37.2 million as government-funded MSD procurement, or 15% of the total market. However, the Ministry of Health and Social Welfare has estimated that only aroimd 30% of the pooled public funds held by public health facilities in accounts at MSD for medicines and medical supplies were locally tax funded, equating to around US 11.3 million, the rest coming from donor basket funds (MoHSW, 2013 4-5). The implication is that just 5% of Tanzanian medicines were tax-funded in 2011-12. 

A parallel calculation for Kenya could only be drawn from the most recent Kenyan National Health Accoimts (MMS and MPHS, nd). They show total health spending (THE) for 2009-10 as US 1.62 billion. The Kenyan National Pharmaceutical Policy (NPP) (MoMS and MPHS, 2010 53-54) estimates total pharmaceutical expenditure (TPE) at around 20% of THE, or US 324 million of that about 15-20% was public expenditure, or around US 64.8 million. Finally, the same document states (p. 53) that government spending was estimated in 2005-06 at 21.6% of public spending on medicines, the rest being donor funded. If that percentage were stable over time, it would imply a government tax-funded share of the Kenyan domestic medicines market in 2009-10 of under 5%. 

In both countries, many private wholesalers are also importers, who act as representative agents for Indian and European manufacturers. If margins are better on imported items, then importers will lack incentives to source and distribute local manufactures. Some large wholesalers/ importers supply only imported products, while others also deal in local products. Some importers, such as Phillips, have worked closely with a number of donor-funded projects, for example distributing imported... 

However in this case, purposive support for local manufacturing was provided. The Extended Support Programme funded by the European Union and DFID (the UK Department For International Development) supported local manufacturers CAPS Pharmaceuticals and Varichem in Zimbabwe to manufacture and supply medicines to the local health system during the era of economic collapse (Table 13.1). This example shows that donor-funded programmes can support local industry and operate as an effective industrial policy tool. Table 13.1 shows that CAPS and Varichem were contracted to supply more than US 4 million worth of drugs to the programme. The contract value shows the values... 

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