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Predicting Global Fund grant disbursements for procurement of artemisinin-based combination therapies.

Cohen JM, Singh I, O'Brien ME - Malar. J. (2008)

Bottom Line: Predictions were compared against actual disbursements in a group of validation grants, and forecasts of ACT procurement extrapolated from disbursement predictions were evaluated against actual procurement in two sub-Saharan countries.These results indicate the utility of this approach for demand forecasting of ACT and, potentially, for other commodities procured using funding from the Global Fund.Further validation using data from other countries in different regions and environments will be necessary to confirm its generalizability.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinton Foundation HIV/AIDS Initiative, Center for Strategic HIV Operations Research, 383 Dorchester Avenue, Suite 400, Boston, MA 02127, USA. jcohen@clintonfoundation.org

ABSTRACT

Background: An accurate forecast of global demand is essential to stabilize the market for artemisinin-based combination therapy (ACT) and to ensure access to high-quality, life-saving medications at the lowest sustainable prices by avoiding underproduction and excessive overproduction, each of which can have negative consequences for the availability of affordable drugs. A robust forecast requires an understanding of the resources available to support procurement of these relatively expensive antimalarials, in particular from the Global Fund, at present the single largest source of ACT funding.

Methods: Predictive regression models estimating the timing and rate of disbursements from the Global Fund to recipient countries for each malaria grant were derived using a repeated split-sample procedure intended to avoid over-fitting. Predictions were compared against actual disbursements in a group of validation grants, and forecasts of ACT procurement extrapolated from disbursement predictions were evaluated against actual procurement in two sub-Saharan countries.

Results: Quarterly forecasts were correlated highly with actual smoothed disbursement rates (r = 0.987, p < 0.0001). Additionally, predicted ACT procurement, extrapolated from forecasted disbursements, was correlated strongly with actual ACT procurement supported by two grants from the Global Fund's first (r = 0.945, p < 0.0001) and fourth (r = 0.938, p < 0.0001) funding rounds.

Conclusion: This analysis derived predictive regression models that successfully forecasted disbursement patterning for individual Global Fund malaria grants. These results indicate the utility of this approach for demand forecasting of ACT and, potentially, for other commodities procured using funding from the Global Fund. Further validation using data from other countries in different regions and environments will be necessary to confirm its generalizability.

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Prediction of ACT procurement in two countries. Validation of predicted disbursements and ACT procurement for (a) a Round 4 grant to a country in East Africa and (b) a Round 1 grant to a country in Southern Africa with actual disbursement and ACT importation records.
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Figure 5: Prediction of ACT procurement in two countries. Validation of predicted disbursements and ACT procurement for (a) a Round 4 grant to a country in East Africa and (b) a Round 1 grant to a country in Southern Africa with actual disbursement and ACT importation records.

Mentions: This investigation constructed models to predict the rate at which grants were disbursed from the Global Fund to recipient countries, rather than the exact days and magnitudes of discrete disbursements. By predicting disbursement rate, rather than discrete disbursements, it is acknowledged that precise prediction of actual quarterly disbursements – with their stochastic temporal patterning (Figure 3) – is impractical. Predicting discrete disbursements may be the ultimate goal of forecasting efforts for the purpose of intervention planning at a country level, since knowing when resources will be available is crucial to planning efforts. However, the smoothed rates forecasted here, which distribute error across time rather than attempting to estimate specific days on which disbursements occur, appear to be sufficient for general prediction of ACT procurement. In the two countries for which validation data were collected (Figure 5), this approach appears useful for forecasting the significant portion of global ACT demand driven by Global Fund grants. The rate of grant disbursement is closely tied to the rate of ACT procurement because Global Fund grants are performance-based, meaning that the disbursement slope is an indicator of grant progress. As such, if a substantial portion of a particular grant is intended for ACT procurement, a large disbursement slope may be considered indicative of successful procurement, and the magnitude and timing of that procurement can be estimated as a function of the disbursement slope.


Predicting Global Fund grant disbursements for procurement of artemisinin-based combination therapies.

Cohen JM, Singh I, O'Brien ME - Malar. J. (2008)

Prediction of ACT procurement in two countries. Validation of predicted disbursements and ACT procurement for (a) a Round 4 grant to a country in East Africa and (b) a Round 1 grant to a country in Southern Africa with actual disbursement and ACT importation records.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2570684&req=5

Figure 5: Prediction of ACT procurement in two countries. Validation of predicted disbursements and ACT procurement for (a) a Round 4 grant to a country in East Africa and (b) a Round 1 grant to a country in Southern Africa with actual disbursement and ACT importation records.
Mentions: This investigation constructed models to predict the rate at which grants were disbursed from the Global Fund to recipient countries, rather than the exact days and magnitudes of discrete disbursements. By predicting disbursement rate, rather than discrete disbursements, it is acknowledged that precise prediction of actual quarterly disbursements – with their stochastic temporal patterning (Figure 3) – is impractical. Predicting discrete disbursements may be the ultimate goal of forecasting efforts for the purpose of intervention planning at a country level, since knowing when resources will be available is crucial to planning efforts. However, the smoothed rates forecasted here, which distribute error across time rather than attempting to estimate specific days on which disbursements occur, appear to be sufficient for general prediction of ACT procurement. In the two countries for which validation data were collected (Figure 5), this approach appears useful for forecasting the significant portion of global ACT demand driven by Global Fund grants. The rate of grant disbursement is closely tied to the rate of ACT procurement because Global Fund grants are performance-based, meaning that the disbursement slope is an indicator of grant progress. As such, if a substantial portion of a particular grant is intended for ACT procurement, a large disbursement slope may be considered indicative of successful procurement, and the magnitude and timing of that procurement can be estimated as a function of the disbursement slope.

Bottom Line: Predictions were compared against actual disbursements in a group of validation grants, and forecasts of ACT procurement extrapolated from disbursement predictions were evaluated against actual procurement in two sub-Saharan countries.These results indicate the utility of this approach for demand forecasting of ACT and, potentially, for other commodities procured using funding from the Global Fund.Further validation using data from other countries in different regions and environments will be necessary to confirm its generalizability.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinton Foundation HIV/AIDS Initiative, Center for Strategic HIV Operations Research, 383 Dorchester Avenue, Suite 400, Boston, MA 02127, USA. jcohen@clintonfoundation.org

ABSTRACT

Background: An accurate forecast of global demand is essential to stabilize the market for artemisinin-based combination therapy (ACT) and to ensure access to high-quality, life-saving medications at the lowest sustainable prices by avoiding underproduction and excessive overproduction, each of which can have negative consequences for the availability of affordable drugs. A robust forecast requires an understanding of the resources available to support procurement of these relatively expensive antimalarials, in particular from the Global Fund, at present the single largest source of ACT funding.

Methods: Predictive regression models estimating the timing and rate of disbursements from the Global Fund to recipient countries for each malaria grant were derived using a repeated split-sample procedure intended to avoid over-fitting. Predictions were compared against actual disbursements in a group of validation grants, and forecasts of ACT procurement extrapolated from disbursement predictions were evaluated against actual procurement in two sub-Saharan countries.

Results: Quarterly forecasts were correlated highly with actual smoothed disbursement rates (r = 0.987, p < 0.0001). Additionally, predicted ACT procurement, extrapolated from forecasted disbursements, was correlated strongly with actual ACT procurement supported by two grants from the Global Fund's first (r = 0.945, p < 0.0001) and fourth (r = 0.938, p < 0.0001) funding rounds.

Conclusion: This analysis derived predictive regression models that successfully forecasted disbursement patterning for individual Global Fund malaria grants. These results indicate the utility of this approach for demand forecasting of ACT and, potentially, for other commodities procured using funding from the Global Fund. Further validation using data from other countries in different regions and environments will be necessary to confirm its generalizability.

Show MeSH
Related in: MedlinePlus