Download Bad intentions - good policies

Bad intentions - good policies:
Who wins?
Case exercise and role play on drug
counterfeiting in an LDC context
World Bank Case Exercise – all names and
characters are fictional, possible similarities
with living persons or existing businesses
would be unintentional
Republic of Buwani, Central Africa
Kuwabashi
Seronego
Mfana
Aluna
Posi
Ngorone
Kaluni River
255,000 sqm
18 million inhabitants
GDP per capita USD 385
Key Facts
A typical young African democracy
History of postcolonial civil war
But now stable for almost 10 years
Low Income Country, 4% growth
35% urban/suburban population
18% wealthy, 42% very poor
Healthcare System
Majority gets care in the private sector
Public clinics/hospitals reach 15-20%
Cash-and carry system
Community insurance funds, covering
30% of Posi people
Malaria health priority #1
HIV infection rate estimated at 7%
Pharmaceutical Supplies
Public CMS – PMS system, yearly planning
Typical weaknesses: Corruption, stock-outs. Leading
to under-utilization of public providers.
Lively private sector market for medicines, through
pharmacies and street sellers.
Prescription drugs can be purchased without
prescription.
Usually good quality of drugs in public sector
No data on counterfeits, but anecdotal reports
Law and Regulation
Food and Drug law, regulatory approval
system, but illegal imports are possible
Limited enforcement capacity, inspectors
spend most of their time checking imported
drugs at customs.
No serious punishment for selling nonregistered drugs or violating trademarks.
No special legal provision dealing with
counterfeit drugs
Donor Support for Malaria
World Bank and Global Fund provide
USD 15 million
Education, prevention, treatment
Switch of first line therapy from
chloroquine to artemisinin combination
(ACT)
The Counterfeiters
Patrick Kafomo, rich businessman and owner
of an “informal” trade empire
History as arms dealer, now in “branded”
textiles and luxury goods, cosmetics etc.
Works through network of informal sellers
Invests in good relationships with officials
Owns a private security force
Get an offer to build a counterfeit drug
business, based on new treatment guidelines
The Government / MOH
Knows that 80% of malaria treatment is
in the private sector
Has to introduce ACT treatment
Gets financial support to cover
increased procurement costs and
implement information campaign
Needs to secure the distribution chain
to prevent counterfeits from entering
Questions to Answer – Bad Guys
Are counterfeit drugs good business?
What resources are needed to develop
this business?
What are strengths and weaknesses of
the counterfeiter’s operation?
How can the business risk be managed?
Questions to Answer – Good Guys
Will counterfeits become reality? Who
will be affected?
What is your defense strategy?
What are the obstacles you are facing
and how do you address them?
What resources do you need? How long
will it take?
Logistics
Breakout Groups 6-8 participants
Breakout rooms 3d/4th floor
Use flipchart for discussion
No presentations required
Facilitated discussion based on your answers
to the questions
Please be back at 12:00 for box lunch
Meeting resumes at 1:00 pm sharp