2004年首次提出了以青蒿素为基础的联合疗法(ACTs)的私营部门补贴计划的想法。从那以后,世界上一些国家已经主办了关于有补贴的ACT和/或负担得起的药品机制-疟疾计划(AMFm)的试点项目或计划。总体而言,私营部门对ACTs的补贴方案有效地增加了私营部门ACTs的供应,并降低了平均价格,但难以排挤抗疟单一疗法。从这一雄心勃勃的战略中获得的结果应该为决策者设计旨在控制疟疾发病率和死亡率的未来干预措施提供信息。在最近提出的干预措施中,政府和国际捐助者建议在私营部门提供快速诊断测试(RDTs)补贴,以应对ACTs的过度治疗,并延迟对青蒿素产生抗药性。为了提高共同付费RDT的成本效益,我们应该借鉴我们从疟疾流行国家近10年的私营部门对联合应用技术的补贴方案中吸取的教训。
The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries.