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ADF mechanism
Quality assurance: Based on WHO norms & standards. Inhalers not part of WHO prequalification programme, so ADF organised qualification of manufacturers, sites and products. Contracts are for qualified product/site pairs.
Procurement strategies: Kept prices down by running limited competitive process. Pooled procurement. Clients paid in advance. Health service strengthening: Unions guidelines and training materials for standardised mgt of asthma, including an information system for monitoring outcomes and improving service. Tracking reduction in emergency visits and hospitalisations shows health and financial benefits of appropriate care & medicines.
Around 50% and higher reductions in annual costs for a patient with severe asthma when medicines purchased through ADF
(in Euros, based on 2009/2012 ADF prices)
90 80 70 62 60 50 40 30 20 10 0 BENIN SALVADOR SUDAN In 2012, ADF procurement 48 36 40 35 33 In 2010, ADF procurement In 2009, national procurement 79 83
ADF was a core contributor to Global Asthma Report 2011 (Union/ISAAC), presented at UN High Level Meeting on NCDs
www.globalasthmareport.org
ADF contributed to the NCD Alliance Briefing paper on Access to Essential Medicines, 2011
ADF prices are being used as references prices (ICS price much lower than Management Sciences for Healths IRP supposedly a reference for efficient procurement)
The Union and The University of Auckland, NZ in Global Asthma Report The Union, ISAAC, 2011
ISAAC research network and The Union) has adopted ADF-inspired targets, messages and activities. More info during plenary of Prof Innes Asher on 2nd Nov.
ADF model has attracted attention of those wanting to increase access to other NCD medicines. Requests for advice from those working specifically in diabetes, mental health and from others working on NCD movement.
Many have no real national consensus, and/or implemented guidelines, strategy or dedicated budget.
Some countries follow guidelines that are more for HICs. Essential Medicines Lists (EMLs) often not include inhaled corticosteroids; if they do, often not updated to include latest HFA strengths (HFA propellants replaced CFCs); some include very expensive medicines. Difficult to identify appropriate people in country: varied configuration of actors expert in and/or influential in decisions and policy related to asthma. Not like TB.
Asthma contacts