Update on Co-Funding Grant to Population Services International Myanmar – April 2013

Editor’s note: This article was published under our former name, Open Philanthropy. Some content may be outdated. You can see our latest writing here.

This page gives an update on the Containment of Artemisinin Resistance in Eastern Myanmar project, which is being carried out by Population Services International (PSI) and was recommended to Good Ventures by the Gates Foundation. Good Ventures contributed to this project as part of an effort to learn from major foundations by co-funding projects with them.

Note: This update reflects the progress of the project as of September 2012. Information on recent progress of this project is forthcoming.

Summary

Project progress

In the first half of 2012, the project made slower progress than originally anticipated in the project plan, primarily due to:

• Delayed signing of a memorandum of understanding with the Government of Myanmar. The memorandum of understanding has now been signed.^[1]“The most critical challenge for this reporting period has been the impact of a delayed MoU with the GoM, although PSI worked hard to accelerate activity once the MOU was obtained.” PSI progress report form for the Gates Foundation (December 2012), Pg 10.
• PSI replaced its country representative in Myanmar in the summer of 2012^[2]“Linked to the delay in securing a MoU, PSI has had to deal with a transition in organizational leadership in Yangon with a new Country Representative, Barry Whittle, joining the office in the summer of 2012. This undoubtedly hampered managerial capacity for a few months during the reporting … Continue reading

We do not see either of these issues as cause for concern.

In the second half of 2012, PSI made more progress, including packaging and selling the first batches of subsidized ACT to its partner company^[3]“The first ACT orders were delivered to AA in the last month of this reporting period (September 2012). A table summarizing orders by AA to date, and their reported sales is attached (Annex 3).” PSI progress report form for the Gates Foundation (December 2012), Pg 6.

 and completing baseline surveys (some of which were, as of January 2013, still being analyzed).^[4]“A nationally representative household survey capturing treatment-seeking behavior and use of antimalarial drugs, as well as respondent knowledge of antimalarials, was conducted… The first annual (and therefore baseline) outlet survey has now been completed… The results from this survey, the … Continue reading

In the summer of 2012, PSI discovered that only one AMT (Artesunate), which is supplied by the company PSI has partnered with to supply ACT, had been banned. Artemether, a second AMT supplied by another company, had not been banned. This led Artemether to gain significant market share and PSI’s partner to lose market share. As a result, PSI was concerned that sales of its ACT, which came onto the market in October 2012, might be slower than expected.^[5]“At the start of the project, a rapid antimalarial supply chain assessment (conducted in three areas of eastern Myanmar) suggested that one company, AA Medical Products Ltd (AA), dominated the market, accounting for around 70% of all AMT national sales. In short, the antimalarial market seemed … Continue reading

PSI convened a meeting in August 2012 that resulted in a ban of the alternative AMT.^[6]“The meeting successfully concluded with the FDA publicly stating that oral Artemether monotherapy was also now banned, but it remains unclear as to how well this has been communicated to the major importers of this product, despite encouraging field observations suggesting that this AMT is … Continue reading

Room for more funding

When Good Ventures provided funding to this project in August 2012, we believed that it had significant room for more funding. We thought that the project needed funding to meet its goals and without additional funding it would fall short. Throughout the course of 2012, we learned that PSI’s future financial needs for this project could not be projected with sufficient precision to know whether or not it had needed (or would need) additional funds.^[7]“An ongoing challenge and learning has been the degree of flexibility and nimbleness needed by PSI in order to handle the highly volatile and unpredictable operational and policy environment. For example, the team does not yet know how much decentralization of health in Myanmar will help or … Continue reading

Sources