Tackling the blind spot of poor-quality medicines in Universal Health Coverage

Table 3 Investments in selected technologies for the detection of SF medicines under three investment scenarios for all public secondary or tertiary hospitals cost at most 1% of the 2019 budget and, at a maximum of 0.3% of estimated economic losses due to SF antimalarials, represent savings for Congo, Nigeria and Uganda

Country	Equipment cost scenarios		Health facilities, n	Fixed cost [equipment cost for all health facilities], USD million	Pharmacist salary^,e,f USD million	Consumables USD million	Repeating Annual cost [salary+ consumables] USD million	Total cost (fixed cost + annual cost) USD million	Total cost (% of 2019 budget)	Total cost (% of estimated economic loss)
	Level^a	Cost USD
Congo
	High	90,000	400^b	36	3.4	0.1	3.5	39.40	0.67	0.26
	Medium	20,000	400	8	3.4	0.1	3.5	11.40	0.19	0.08
	Low	18,000	400	7.2	3.4	0.1	3.5	10.60	0.18	0.07
Nigeria
	High	90,000	107^c	9.6	1.3	0.1	1.4	10.90	0.04^g	0.01
	Medium	20,000	107	2.1	1.3	0.1	1.4	3.40	0.01	0
	Low	18,000	107	1.926	1.3	0.1	1.4	3.20	0.01	0
Uganda
	High	90,000	65^d	5.85	0.6	0.1	0.7	6.40	1.01	0.21
	Medium	20,000	65	1.3	0.6	0.1	0.7	1.90	0.30	0.06
	Low	18,000	65	1.17	0.6	0.1	0.7	1.80	0.28	0.06

^aCosts are derived from Table 2. The levels refer to a ranking from the most expensive to the least among the HPLC (high); UV-Visible spectrophotometer (medium) and low (Mini-Lab). For each of these devices the estimated cost of a dissolution apparatus (USD 10000) was added to give the cost in Table 3
^bSecondary health facilities [24]
^cTertiary health facilities, national [25]
^dAll public facilities – a mix of all 3 levels, primary secondary and tertiary [26]
^eStarting salaries for pharmacist, annualized [27,28,29]
^fRounded off to the nearest hundred thousand
^gNigeria budget for 2019: USD 28.89 billion (Naira 8.83 trillion). Sources: https://www.reuters.com/article/nigeria-budget/update-2-nigerian-president-offers-record-34-billion-budget-for-2020-idUSL5N26T4EA

ISSN: 2052-3211