Implementation of the Affordable Medicines for Malaria Facility (AMFm) in Ghana: processes, challenges and achievements.

In 2004, Ghana adopted Artemisinin-based Combination Therapy (ACT) for the treatment of uncomplicated malaria. The use of ACTs had been low, especially in the private sector, because of higher prices of ACTs. The Affordable Medicine Facility for Malaria Initiative, in which international organizations subsidize ACTs to make them affordable locally, is being implemented in Ghana. We document the processes, challenges, and achievements of this initiative in Ghana based on a review of policies, guidelines, reports, meeting minutes, and an internet search. The review spanned activities from July 2009 to December 2011. Ghana was the first country to receive these subsidized ACTs (called 'co-paid'), and availability of ACTs increased from 31 per cent to 83 per cent nationwide. The price of ACTs dropped from about US$7 to $0.75 for adults and from $5 to $0.5 for children. Misuse of anti-malarials so that they fail to improve health and can spread resistance may occur if the initiative is not well managed. Collaboration with stakeholders, especially the private sector, and implementation of appropriate supportive activities is important with this initiative.