Scaling up access to medicines exposes weaknesses in how developing countries procure and distribute pharmaceuticals to their citizens. Especially in countries that are expanding antiretroviral therapy programs or shifting standard malaria treatment to artemisinin-based combination therapy, the public sector is having to adapt existing pharmaceutical supply systems to manage greatly increased volumes of medicines and commodities.

Public sector institutions must play a major role in regulation and monitoring; but to accommodate scale-up demands, policy makers are exploring ways to work with the private sector to expand available resources. Many ministries of health in developing countries have limited experience in working with the private sector in support of public health goals. To demonstrate the benefits of such strategies, the Strengthening Pharmaceutical Systems (SPS) Program is providing technical support to help governments understand the financial, managerial, and political implications of working with the private sector in various capacities to build innovative pharmaceutical services networks, involving both the public and private sectors.

SPS is working with countries to develop innovative approaches to incorporating the private sector to increase access to medicines, including contracting out certain activities, developing training programs for private-sector health care providers, and using government accredited drug dispensing outlets to reach more people in rural areas.