Availability, Accessibility and Affordability of Antimalarial Drugs in Benue State, North Central Nigeria

Title: Availability, accessibility and affordability of antimalarial drugs in North Central Nigeria

Objectives: To assess the availability and affordability of antimalarial drugs in healthcare facilities as well as compare prices and affordability within and between sectors.

Background: Malaria is endemic in all parts of Nigeria and transmission occurs throughout the year. In north central Nigeria transmission is intense during the rainy season between April and October. Prevalence of malaria remains high; the prevention and treatment of clinical cases has been the focus of several ongoing interventions. The availability and affordability of recommended Artemisinin combination therapies (ACT) are both critical to the success of malaria control efforts.

Methods: This was a cross sectional healthcare facility study design in Benue State North Central Nigeria using WHO/HAI methodology. The study was carried out in three urban and three rural areas of the State between the rainy months of April and July.

Results: Artemisinin monotherapies and non artemisinin monotherapies accounted for the greater percentage of antimalarial medications recorded during the survey. Over 70% of both monotherapies and ACTs were found in private healthcare facilities. In-spite of the high availability of monotherapies, majority of patients purchased low priced generic versions of ACTs indicating increasing awareness and improvement in the implementation of antimalarial treatment policy at healthcare facility level. Innovator brands of antimalarial drugs were more than 200% more expensive compared to their low priced generic versions making them less affordable.

Conclusion: Monotherapies remain highly available in private healthcare facilities compared to ACTs; this poses serious challenge to the success of antimalarial treatment policy. Innovator brands of antimalarial drugs which are still widely available are less affordable than their low priced generic version. This has the potential to reduce financial access in areas where options are limited.