title: Artemisinin combination therapies price disparity between government and private health sectors and its implication on antimalarial drug consumption pattern in Morogoro Urban District, Tanzania.
abstract: BACKGROUND
  Universal access to effective treatments is a goal of the Roll Back Malaria Partnership. However, despite official commitments and substantial increases in financing, this objective remains elusive, as development assistance continue to be routed largely through government channels, leaving the much needed highly effective treatments inaccessible or unaffordable to those seeking services in the private sector.
  
  
  METHODS
  To quantify the effect of price disparity between the government and private health systems, this study have audited 92 government and private Drug Selling Units (DSUs) in Morogoro urban district in Tanzania to determine the levels, trend and consumption pattern of antimalarial drugs in the two health systems. A combination of observation, interviews and questionnaire administered to the service providers of the randomly selected DSUs were used to collect data.
  
  
  RESULTS
  ALU was the most selling antimalarial drug in the government health system at a subsidized price of 300 TShs (0.18 US$). By contrast, ALU that was available in the private sector (coartem) was being sold at a price of about 10,000 TShs (5.9 US$), the price that was by far unaffordable, prompting people to resort to cheap but failed drugs. As a result, metakelfin (the phased out drug) was the most selling drug in the private health system at a price ranging from 500 to 2,000 TShs (0.29-1.18 US$).
  
  
  CONCLUSIONS
  In order for the prompt diagnosis and treatment with effective drugs intervention to have big impact on malaria in mostly low socioeconomic malaria-endemic areas of Africa, inequities in affordability and access to effective treatment must be eliminated. For this to be ensued, subsidized drugs should be made available in both government and private health sectors to promote a universal access to effective safe and affordable life saving antimalarial drugs.
authors.affiliation: Department of Biological Sciences, Faculty of Science, Sokoine University of Agriculture, Box 3038, Morogoro, Tanzaia. amalisa@suanet.ac.tz
authors.forename: Allen Lewis
authors.initials: AL
authors.lastname: Malisa
authors.forename: Deodatus
authors.initials: D
authors.lastname: Kiriba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000191:economics / Q000600:supply & distribution* / Q000627:therapeutic use*; D037621:Artemisinins / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use*; D002947:Cities; D003710:Demography; D004359:Drug Therapy, Combination / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006076:Government; D019981:Health Care Sector / Q000191:economics*; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities / Q000191:economics; D006801:Humans; D008288:Malaria / Q000188:drug therapy* / Q000191:economics; D008297:Male; D008875:Middle Aged; D017149:Private Sector / Q000191:economics*; D013636:Tanzania; D055815:Young Adult
chemical_list: D000962:Antimalarials; D037621:Artemisinins; C031327:artemisinin