Malaria Medicines, Markets, and Public Policy

This chapter is an exploration of the conceptual origin, design, implementation, governance, and lessons learned from the Affordable Medicines Facility for Malaria (AMFm), with emphasis on the political economy of decision making around findings from its independent evaluation. Its first two sections draw upon the literature, especially but not only Frost and Reich’s report on the origins of what became the AMFm. It gives the reader a driver’s seat perspective of the dynamics of a disruptive innovation in global health. The chapter highlights the failures of the legacy architecture of development assistance for health, including how the United States Agency for International Development (USAID) and United States President’s Malaria Initiative (US-PMI, an initiative led by USAID) undermined the health interests of the poor in countries that USAID and US-PMI claimed to serve. It recalls published evidence of the empirical success of the AMFm. It examines the strategic failure of the Global Fund Board, lessons learned, the potential applicability of the private–public approach to other health commodities and countries, and the implications of this experience for evidence-based decisions in global health and development assistance.