Organising Access to Treatment: An analysis of the procurement of HIV/AIDS medicine in Uganda
The purpose of this visit to Geneva/Switzerland was to establish first contacts to the major international health organizations like the Global Fund to Fight HIV/AIDS, Malaria, Tubercolusis, the World Health Organisation (WHO), and Medecins-Sans-Frontiere (MSF). During the one-week fieldwork I conducted four interviews with official representatives of these organisations on the topic “drug procurement” and “HIV/AIDS medicine”. Unfortunately some of the planned interviews had to be cancelled due to time constraints.
All interview partners work in the Supply-Chain-Management of one of the international health organisation and provided first-hand facts and figures on the technical, legal, and political dimensions of the procurement of HIV/AIDS medicine. In general, the interview partners openly discussed their problems, which the respective organisations had experienced over the last few years. The interview partners, coming from diverse organisational backgrounds, emphasised different constraints and possibilities, which altogether provided a multifaceted picture of the current developments in the field of drug procurement and HIV/AIDS medicine. For instance the interview partner at MSF provided a detailed account of the practical and organisational constraints of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) for his department in relation to the envisioned price developments for essential medication. Or, officials at the Global Fund provided important insights into the future policy changes and goals, which for instance comprised models of, centralised purchasing activities at the Global Fund coupled with the further privatisation of procurement agencies in the recipient countries.
During the interviews I was interested to identify the general thematic scope and the key aspects of procurement by conducting semi-structured interviews and asking broad questions on procurement practices and administrative standards. All interviews provided important data, which afforded the personal interaction with the interviewer. The choice of different international health organizations should moreover reveal the diverging perspectives in these organizations. Through these ethnographic interviews the research proposal on “Organising Access to Treatment” became much more precise and focused. In regards to the future empirical research it will be important to complement these initial interviews with a long-term visit at one particular organisation and follow the procurement activities in more detail. Further the first interviews with representatives of the major international health organisations are one of the starting points for an extended fieldwork visit to Uganda, where this interview data will be triangulated with additional observations and interviews at Ugandan procurement agencies.