A new market intelligence study by Enda Santé, KELIN and ITPC, conducted as part of the Make Medicines Affordable campaign, analyses the procurement, prices and volumes of antiretrovirals, tuberculosis medicines, anti-cancer drugs and vaccines in Senegal in 2023. The objective of the report is to identify how the procurement system affects the availability and affordability of treatment.
Senegal relies on several procurement mechanisms depending on the disease area. For HIV, medicines are procured through two channels: government funding via the National Supply Pharmacy (PNA) using international tenders, and pooled procurement through the Global Fund’s Wambo procurement platform. HPV vaccines are purchased through the UNICEF central procurement mechanism, requiring WHO-prequalified suppliers. Cancer medicines are generally supplied by the PNA in collaboration with the National Cancer Control Program (NCCP), mainly through international tenders. Tuberculosis treatment also follows two channels: first-line medicines are procured through international tenders, while second-line medicines for drug-resistant TB are obtained through international mechanisms such as the Global Drug Facility and Wambo pooled procurement.
Despite several procurement mechanisms and actors, the report highlights that national programmes for HIV and tuberculosis provide structured coordination and have helped minimise stock-outs. The centralized role of the PNA also supports planning and distribution across the public sector. However, procurement and stock management constraints can still lead to interruptions in supply.
The report also identifies affordability gaps, in particular for vulnerable populations. High prices – particularly for newer tuberculosis medicines and cancer treatments – are highlighted in the price analysis. For tuberculosis, newer medicines such as bedaquiline remain expensive – around USD 340 per box – despite small quantities. The HPV vaccine manufactured by Merck represents a substantial national procurement, with 382,460 doses purchased at around USD 4.5 per dose. Cancer medicines also have very high unit prices, with products such as bevacizumab and rituximab raising affordability concerns, reaching approximately USD 825 per dose for bevacizumab (400 mg.) and about USD 330 for rituximab (500 mg). For HIV, the standard first-line regimen (tenofovir-lamivudine-dolutegravir) is procured in very large volumes, but pooled procurement enables lower prices than national tenders.
Overall, the study highlights the need to strengthen efficiency and coordination of procurement and supply systems, alongside broader efforts to improve affordability and access to essential medicines.