Subsidising quality-assured artemisinin combination therapies (QAACTs) for distribution in the for-profit sector is a controversial strategy for improving access. The Affordable Medicines Facility—malaria (AMFm) was the largest initiative of this kind. We assessed the equity of AMFm in two ways using nationally representative household survey data on care seeking for children from Nigeria and Uganda. First, the delivery of subsidized drugs through the for-profit sector via AMFm was compared with two alternative mechanisms: subsidized delivery in public health facilities and unsubsidized delivery in the for-profit sector. Second, we developed a novel extension of benefit incidence analysis (BIA) methods based on the concept of pass-through, and applied them to Uganda. In Nigeria, the use of subsidized QAACTs from both public health facilities and for-profit outlets was concentrated among the rich, while in Uganda, the use of QAACTs from both sources was concentrated among the poor. Similarly, the BIA of AMFm found that the intervention was pro-poor in Uganda. Unsubsidized antimalarials from for-profit outlets were distributed equally across wealth quintiles in both countries. Private sector subsidies may have a role in bolstering access to effective malaria treatments, including among the poor, but the equity impact of subsidies may depend on context.

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补贴私营营利部门是否使穷人受益？来自尼日利亚和乌干达国家抗疟补贴的证据

补贴有质量保证的青蒿素联合疗法 (QAACTs) 以供营利性部门分销，这是一项有争议的提高可及性的策略。负担得起的药物设施——疟疾 (AMFm) 是此类计划中最大的一项。我们使用关于尼日利亚和乌干达儿童寻求护理的全国代表性家庭调查数据，以两种方式评估了 AMFm 的公平性。首先，将通过 AMFm 通过营利部门提供的补贴药物与两种替代机制进行比较：在公共卫生设施中提供补贴和在营利部门中提供无补贴。其次，我们开发了一种基于传递概念的收益关联分析 (BIA) 方法的新扩展，并将其应用于乌干达。在尼日利亚，来自公共卫生设施和营利性机构的补贴 QAACT 的使用集中在富人中，而在乌干达，来自这两个来源的 QAACT 的使用集中在穷人中。同样，AMFm 的 BIA 发现干预在乌干达是有利于穷人的。来自营利性商店的无补贴抗疟药在两国的财富五分之一之间平均分配。私营部门补贴可能有助于促进获得有效的疟疾治疗，包括穷人，但补贴的公平影响可能取决于具体情况。来自营利性商店的无补贴抗疟药在两国的财富五分之一之间平均分配。私营部门补贴可能有助于促进获得有效的疟疾治疗，包括穷人，但补贴的公平影响可能取决于具体情况。来自营利性商店的无补贴抗疟药在两国的财富五分之一之间平均分配。私营部门补贴可能有助于促进获得有效的疟疾治疗，包括穷人，但补贴的公平影响可能取决于具体情况。