Kumaresan J, Smith I, Arnold V, Evans P
Stop TB Partnership Secretariat, World Health Organization, Geneva, Switzerland.
Int J Tuberc Lung Dis. 2004 Jan;8(1):130-8.
The Global TB Drug Facility (GDF) is a new initiative to increase access to high quality tuberculosis drugs. The GDF, a project of the Global Partnership to Stop TB, is managed by its secretariat, in the World Health Organization (WHO), Geneva. It aims to provide tuberculosis drugs to treat up to 11.6 million patients over the next 5 years and to assist countries to reach the WHO global TB control targets by 2005. The GDF was launched on 24 March 2001. Six rounds of applications have been completed, with 46 countries and non-governmental organisations (NGOs) approved for support. The GDF is not a traditional procurement mechanism. It has adopted an innovative approach to the supply of drugs, by linking demand for drugs to supply and monitoring, using partners to provide services, using product packaging to simplify drug management and linking grants to TB programme performance. This paper describes the GDF operational procedures and experience gained so far. Key achievements to date are also outlined, including the creation of a flexible supply system to meet differing programme needs, rapid establishment of procedures, reduction in TB drug prices--a catalyst for DOTS expansion in countries, standardisation of products, and collaboration with partners. The GDF is flexible enough to meet the needs of countries with a TB burden. The GDF experience could be used as an example for global procurement of drugs and commodities for other diseases, such as HIV/AIDS and malaria. In the future it is likely that the GDF will expand to include second-line drugs and diagnostic materials for TB and could assist other partnerships to develop similar mechanisms and facilities to meet country needs.
全球结核病药物基金（GDF）是一项旨在增加高质量结核病药物可及性的新举措。GDF是全球防治结核病伙伴关系的一个项目，由其秘书处设在日内瓦世界卫生组织（WHO）进行管理。它旨在在未来5年内为多达1160万患者提供结核病药物，并协助各国到2005年实现WHO全球结核病控制目标。GDF于2001年3月24日启动。已完成六轮申请，46个国家和非政府组织（NGO）获得了支持批准。GDF不是一个传统的采购机制。它采用了一种创新的药物供应方式，将药物需求与供应及监测相联系，利用合作伙伴提供服务，利用产品包装简化药物管理，并将赠款与结核病项目绩效挂钩。本文描述了GDF的运作程序及迄今所取得的经验。还概述了迄今为止的主要成就，包括建立了一个灵活的供应系统以满足不同项目需求、迅速确立程序、降低结核病药物价格——这是各国扩大直接督导下的短程化疗（DOTS）的一个促进因素、产品标准化以及与合作伙伴开展协作。GDF足够灵活，能够满足结核病负担较重国家的需求。GDF的经验可作为全球采购用于其他疾病（如艾滋病毒/艾滋病和疟疾）的药物及商品的范例。未来，GDF可能会扩大，将结核病二线药物和诊断材料纳入其中，并可能协助其他伙伴关系建立类似机制和设施以满足各国需求。
