A synthesis report from studies in Botswana, Sri Lanka, Uganda and Zambia by Karen Caines and Louisiana Lush.

This report provides an overview, with general conclusions and recommendations, from a series of studies of drug access programmes in selected countries, namely, Uganda (the pilot country) plus Botswana, Sri Lanka and Zambia. The studies were initiated by the Initiative on Public-Private Partnerships for Health (IPPPH), supported principally by the UK Department for International Development, and undertaken in association with the Institute for Health Sector Development based in London.

The country studies were undertaken in Botswana, Sri Lanka, Uganda and Zambia and examined PPPs supplying donated or discounted drugs for leprosy, lymphatic filariasis (LF), malaria, onchocerciasis, sleeping sickness, and HIV/AIDS (the Drug Access Initiative, Accelerating Access Initiative, the Diflucan® Partnership Programme and the Viramune® Donation Programme. The specific remit was to examine issues of ownership, integration, coordination, implementation and impact. A key question concerned the degree to which the involvement of multinational research and development-based pharmaceutical companies, as partners in supplying free or discounted drugs, facilitated better drug availability and access by the poor. Further questions included whether the availability of free or discounted drugs distorts decisions on priorities or prices, and the feasibility and sustainability of taking such initiatives to scale.