District: Outlet code: 1 Total number of medicines - items, rows filled For area supervisor use (fill in after completing whole survey form) PART 2 ANSWER ALL QUESTIONS – IF NO RESPONSE STATE “not PART 3 applicable” …or “no response obtained” …or another reason

1 Date:

2 District

3 County

4 Sub-county 5 Parish

6 Town/village

7 Outlet name

8a Is the outlet from one of the sampled parishes or the YES NO district capital? 8b GPS location identification number: North FILL ALL BOXES East

9 Type of outlet (code - see table at bottom of this page)

NOTES

10

Parts 1,2,3 4 of the data collection form are completed and correct – UNIT price calculations checked

Data collector names and signatures: 11 1 2

Verification (forms checked including UNIT price calculations)

Name 12 Signed: Date:

Coding for question 9

Public sector: 1 Public health facility 2 Community-directed distributors

Private sector 3 Retail pharmacies (licensed by NDA within last 3 years) 4 Drug shops (licensed by NDA within last 3 years)

5 Private clinics/dispensing doctors

6 Retail stores and general provisions stores, kiosks (fixed structures)

7 Market stalls/mobile hawkers and other informal distribution points (temporary structures/mobile)

Not-for profit sector 8 NGO/mission health facilities 2

13 Name of owner/manager of the facility: (OPTIONAL)

Background of owner/ manager: Pharmacist Pharmacy technician the items listed to the right should not be read out, they Doctor 14 are for the data collector to use to code the response; although prompts can be made to assist the person Clinical officer/medical being interviewed) assistant Nurse Tick one Nursing assistant (trained)

Other health

other (Specify)

Name of person(s) who provided information on medicine prices and 15 availability (OPTIONAL)

Background of the person Pharmacist providing the information? Pharmacy technician the items listed to the right Doctor should not be read out, they are for the data collector to use to Clinical officer/medical assistant code the response; although 16 Nurse prompts can be made to assist the person being interviewed) Nursing assistant (trained)

Other health

other (Specify)

Tick one

Describe main items for sale in Medicines outlet: Food (for the private sector outlets) Soft drinks the items listed to the right should Toiletries not be read out, they are for the data collector to use to code the Household goods response; although prompts can Alcoholic drinks 17 be made to assist the person being interviewed) Mobile phone airtime

Newspapers Tick as applicable Cosmetics

Cigarettes Other (specify)

18 Do you sell medicines to others to re-sell (e.g. to other outlets, vendors) YES NO 3

Where does the Write name and/or tick the type of outlet that source is outlet/facility buy/obtain its anti-malarial Name Wholesaler Pharmacy other 19 medicines from? (OPTIONAL) (name and place of top 3)

How do you the Medicines recommended by Ministry of Health manager/ owner/ in- charge decide which Customer demand type of anti-malarial Most profitable medicines to stock? Recommended by local health professional the items listed to the right should not be Special purchase terms offered read out, they are for the data collector to Lowest priced 20 use to code the Drug company/rep influence response; although prompts can be made Influence of the pricing of same therapeutic group to assist the person being interviewed) Location of pharmacy and type(wealth) of customer Country of origin of product

Tick as applicable Season disease patterns

Other (state)

If more than one anti- Recommended by Ministry of Health malarial is stocked, how do the staff in the Customer demand outlet decide which to Most profitable sell /dispense Personal preference of staff member

Tick as applicable Recommended by local health professional

Special purchase terms offered

Lowest priced

Appearance of the patient 21 Fast moving brand

Patient awareness/perceptions of drug quality and preference for some brands/countries of origin Patient perception that if price too low, that must be poor quality

Time of the day, week, month

Short shelf life

Drug company/rep influence

other (state)

Approximately how many people bought an anti-malarial medicine yesterday 22 - e.g. 1, 5, 10, 20, 50, >50 4

Out of patients/customers you served yesterday, how many would you say do not buy a full 23 course of anti-malarial medicine e.g. 1,2,3,5,6,10

Approximately how many people bought an anti-malarial medicine in the last week 24 - e.g. 1, 5, 10, 20, 50, >50

If the patient does not have enough Sell as many tablets as have money for money for the full course of anti-malarial treatment, what do you do? Give credit Offer cheaper alternative the items listed to the right should not be 25 read out, they are for the data collector to Refuse to sell use to code the response; although prompts can be made to assist the Refer elsewhere person being interviewed) other (state) Tick as applicable

26 Were the anti-malarial medicines on open display? All types Some types None [OBSERVATION] (vs. hidden out of sight) Tick one

What are your sources of information Own knowledge about anti-malarial medicines? Box/leaflet with medicine the items listed to the right should not be read out, they are for the data collector to Drug company information use to code the response; although prompts can be made to assist the Ministry of Health guideline 27 person being interviewed) Medical reference book Tick as applicable Workshops, seminars, CME Media (print, radio, TV) other (state)

28 Are used to treat ? YES NO

29 Is co-trimoxazole used to treat malaria? YES NO

30 How do customers/patients ask for medicines for malaria? by something for malaria/ fever Tick one by a specific medicine name 5

Sales/dispensing and storage area Adequate storage conditions and handling of medicines - checklist - for the outlet and the area where the medicines are stored [A]

1. There is a method in place to control temperature (e.g. roof and ceiling with space between them in hot climates). (1=there is a method) 2. There are windows that can be opened or there are air vents. (1=there are windows) 3. No direct sunlight can enter the area where the medicines are stores (1= no sunlight) 31 4. Area is free from moisture (e.g. leaking ceiling, roof, drains, taps) True=1, False=0 (1=no moisture)

[ASSESSMENT] 5. Medicines are not stored directly on the floor. (1= not on floor) 6. There is no evidence of pests in the area (1=no pests) 7. Loose tablets/capsules are not manipulated by naked hand. (1= not handled) 8. Premises can be secured to prevent theft (1= secure)

[A1] = Sum of A =

% adequate storage conditions = ([A1]/8) x 100

Please provide a description of the environment where question 31 does not adequately describe the situation. 32 [OBSERVATION]

[Optional]

Was the patient pack of Coartem available) – i.e. the 6,12, YES NO 33 18,24 packs with special patient instructions (should also be [OBSERVATION] marked as available in part 3) 6

34 Does the outlet sell/provide TB medicines? YES NO If yes to #34 - the outlet sells/provides TB medicines, ask questions 35-40 – otherwise END of part 1: How do you the Medicines recommended by Ministry of Health manager/owner/in-charge decide which type of TB Customer demand medicines to stock? Most profitable The items listed to the right Recommended by local health professional should not be read out, they are for the data collector to Special purchase terms offered use to code the response; although prompts can be Lowest priced 35 made to assist the person being interviewed Drug company/rep influence

Influence of the pricing of same therapeutic group Tick as applicable Location of pharmacy and type (wealth) of customer

Country of origin of product

Season disease patterns

Other (state)

Approximately how many people bought TB medicine yesterday 36 - e.g. 1, 5, 10, 20, 50, >50

Out of patients/customers you served yesterday, how many would you say did not buy a 37 full course of TB treatment e.g. 1,2,3,5,6,10

Approximately how many people bought TB medicine in the last week 38 - e.g. 1, 5, 10, 20, 50, >50

What are your sources of Own knowledge information about TB medicines? Box/leaflet with medicine

Drug company information The items listed to the right should not be read out, they Ministry of Health guideline are for the data collector to 39 use to code the response; Medical reference book although prompts can be made to assist the person Workshops, seminars, CME being interviewed Media (print, radio, TV) Tick as applicable Other (state)

How do customers/patients ask for TB medicines? Tick one by something for 40 TB/persistent cough by specific medicine name 7

Part 2

Generic name, Medicine Brand or Manufacturer Total Available Pack size Pack Price of Unit Total Any Comments dosage form, Type product number of 1/0 recomme size pack price (4 number expired strength name(s) generic nded found found digits) packs (1/0) version on found shelf Highest 10 Amitriptyline price 25mg cap/tab Lowest Price 10

Highest 15 Amoxicillin price 500mg cap/tab Lowest Price 15

Highest 28 Atenolol 50mg price cap/tab Lowest Price 28

Highest 10 Captopril 25mg price cap/tab Lowest Price 10

Highest 1 Ceftriaxone price 1g/vial injection Lowest Price 1

Highest 10 price 500mg cap/tab Lowest Price 10

Highest 100ml Co-trimoxazole price 8+40mg/ml suspension Lowest Price 100ml

Highest 10 Diazepam 5mg price cap/tab Lowest Price 10

Highest 1 Diclofenac price 50mg cap/tab Lowest Price 1 8

Medicine Brand or Manufacturer Total Available Pack size Pack Price of Unit Total Any Comments Generic name, Type product number of 1/0 recomme size pack price (4 number expired dosage form, name(s) generic Nded found found digits) packs (1/0) strength version on found shelf Highest 30 Glibenclamide price 5mg cap/tab Lowest Price 30

Highest 20 Omeprazole price 20mg cap/tab Lowest Price 20

Highest 100ml Paracetamol price 24mg/ml suspension Lowest Price 100ml

Salbutamol Highest 1 Cannister Unit price = 1 dose inhaler price (200 doses) 0.1mg/dose Lowest Price 1 Cannister Unit price = 1 dose inhaler (200 doses) Highest 30 Simvastatin price 20mg cap/tab Lowest Price 30 9

If the outlet stocks TB medicines

Generic name, dosage Medicine Brand or Manufacturer Total Available Pack size Pack Price of Unit Total Any Comments form, strength Type product number of 1/0 recomme size pack price (4 number expired name(s) generic Nded found found digits) packs (1/0) version on found shelf Isoniazid (INH) 100 Highest mg tab/cap price Lowest Price

Isoniazid (INH) 300 Highest mg tab/cap price Lowest Price

Rifampicin 150 mg Highest tab/cap price Lowest Price

Rifampicin 300 mg Highest tab/cap price Lowest Price

Ethambutol (EMB) Highest 400 mg tab/cap price Lowest Price

Pyrazinamide (PZA) Highest 400 mg tab/cap price Lowest Price

Isoniazid/ Ethambutol Highest 150mg/ 400mg price tab/cap Lowest Price

Rifampicin/ Highest Isoniazid tab/cap price 150 mg/75 mg Lowest Price

Rifampicin/ Isoniazid Highest tab/cap: price 300 mg/150 mg Lowest Price

Rifampicin/ Isoniazid/ Highest Pyrazinamide/ price Ethambutol tab/cap: Lowest Price 150mg/ 75mg/ 400mg/ 275 mg 10

Part 3

Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Loquin Medriech Sterilab 60ml 50mg./5ml oral suspension 001 Amobine Regal 60ml 002 Camoren Rene Industries 60ml 003 Amodiaquine Uniquin Pharmaceutical 8 200mg tablet 004 Manufacturing Co.(K) Maratab Lincoln Pharmaceuticals, 8 005 Amoquine Agog Pharma 8 (thane) 006 Loquin Medriech Sterilab 8 007 Betaquine Beta Healthcare 8 008 International Amodiaquine Uganda Pharmaceuticals 8 009 Camoren Rene Industries 8 010 Amobin Regal Pharmaceuticals 8 011 Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Larither Ipca Laboratories 12 40mg capsule 012 Artemether Artesiane Rotexmedica 1 100mg/ml injection 013 Rtitas Intas 1 014 Artenam Ebewe Pharma 1 015 Artemether Artesiane Rotexmedica Gmbh 1 20mg/ml injection 016 Artena Ebewe Pharma 1 paediatric 017 11

Artemether Artemedine Kunming Pharmaceutical 1 80mg/ml injection 018 Romether Zhejiang Tianfeng 1 019 Phamaceutical Artemedine Kunming Pharmaceutical 1 020 Larither Ipca Laboratories Ltd 1 021 Artesiane Rotexmedica Gmbh 1 022 Artemether Ametherde Mpf Bv 60ml 3mg/ml powder for oral suspension 023 Artesiane Mpf Bv Oudehaske 60ml 024 Artemether Artesiane Erfa Rue 6 40mg suppository 025 Artemether Artemedine Kunming Pharmaceutical 12 50mg tablet 026 Rtitas Intas 12 027 Artenam Qualiphar Nv/Sa 12 028 Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Artemether + Coartem Novartis 6 20mg + 120mg tablet 029 - 032 12

18

24

Lumiter Macleods Pharmaceuticals 24 033 Artefan 20/120 Ajanta Pharmaceuticals 24 034 Lumartem Cipla 24 035 + napthoquine Arco Kunming Pharmaceutical 1 phosphate 125mg + 50mg tablet 036 12

Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Plasmotrim R P Scherer Gmbh & Co. 6 200mg suppository 037 Artesunate Plasmotrim R P Scherer Gmbh & Co. 6 50mg suppository 038 Artesunate Arinate Erfa 6 100mg tablet 039 Allnat Ajanta Pharma 6 040 Falcinil Cipla 6 041 Azunate Macleods Pharmaceuticals 6 042 Artesunate Plasmotrim Mepha 6 200mg tablet 043 Artesunate Allnat Ajanta Pharma 12 50mg tablet 044 Falcinil Cipla 12 045 Azunate Macleods Pharmaceuticals 12 046 Artesunate Zhejiang Holley Nanhu 12 047 Plasmotrim Mepha 12 048 Arinate Erfa 12 049 Artesunate + sulfamethoxypyrazine Ariplus Erfa 3+3 / 050 100mg + 500mg/ 25mg tablet Artesunate + sulfamethoxypyrazine Co-arinate Erfa 3+3 /pyrimethamine junior 100mg + 250mg/12.5mg tablet 051 Artesunate + sulfamethoxypyrazine Combisunate Ajanta Pharma 3+3 /pyrimethamine forte 100mg + 250mg/12.5mg tablet 052 Artesunate + sulfamethoxypyrazine Co-arinate Erfa 3+3 /pyrimethamine 053 200mg + 500mg/25mg tablet Artesunate + amodiaquine Amonate Erfa 3+6 100mg + 200mg tablet Junior 054 Artesunate + amodiaquine Amonate adult Erfa 3+12 200mg + 153.1mg tablet 055 13

Artesunate + amodiaquine Amonate Erfa 3+12 200mg + 200mg tablet 056 Artesunate + amodiaquine Amqunate Cosmos 6+6 50mg + 150mg tablet 057 Artesunate + amodiaquine Larimal Ipca Laboratories 12+12 50mg + 153.1mg tablet 058 Artesunate + amodiaquine Falcimon kit Cipla 12+12 50mg + 200mg tablet (adults) 059 Arsucam Marphar 12+12 tablets 060 Falcimon kit Cipla 3+3 (children) 061 Falcimon kit Cipla 6+6 062 Macsunate Macleods Pharmaceuticals 12+12 plus 063 Macsunate Macleods Pharmaceuticals 3+3 plus jr. 064 Macsunate Macleods Pharmaceuticals 6+6 plus kid 065 Artesunate + Cipla 12+12 amodiaquine 066 Artesunate + Artequin Mepha 3+6 200mg + 250mg tablet 600/1500 067 Artequine Mepha 3+3 600/750 lactab 068 Artesunate + mefloquine Artequin Mepha 3+6 300mg + 375mg tablet 300/375 069 Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 + 62.5mg/25.0 Malanil Glaxosmithkline Inc., 12 mg tablet paediatric 070 14

Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 phosphate Chloroquine Shijiahuang 1 40mg/ml injection 071 Chloroquine Claris Lifesciences 1 phosphate 072 Chlorointa Intas Pharmaceuticals 1 073 Chloroquine Shanghai Sine Jinzhu 1 phosphate 074 Chloroquine Ningbo Dahongying 1 075 Pharmaceuticals Chloroqiune phosphate Medquine Medipharm Industries 60ml 120mg/5ml syrup 076 Intaclor Regal Pharmaceuticals 60ml 077 Chloroqiune phosphate Ago-cq Agog Pharma 60ml 75mg/5ml syrup (thane) 078 Chloroqiune phosphate Kam quin Kampala Pharmaceutical 60ml 80mg/5ml syrup 079 Chloroqiune phosphate Chloroquine Lincoln Pharmaceuticals 10 250mg tablet phosphate 080 Chloroquine Ningbo Dahongying 10 phosphate 081 Chloroquine Wuhan Grand 10 phosphate Pharmaceutical 082 083

Ago-cq Agog Pharma 10 084 Afrim Panacea Biotec 10 085 Kam quin Kampala Pharmaceutical 10 086 Fraquine Fredun Pharmaceuticals 10 087 Flaci-chlor Flamingo Pharmaceuticals 10 088 Uniquin Unibios Laboratories 10 089 15

Cosmoquin Cosmos 10 090 Chloroquine Shanghai Sine Jiufu 10 091 Pharmaceuticals Co. Lariago Ipca 10 092 Renequin Rene Industries Ltd 10 093 Chloroquine Uganda Pharmaceuticals 10 phosphate 094 Simquine Simrone Pharmaceuical 10 095 Oroquin Elys Chemical 10 096 Sugaquin Kampala Pharmaceutical 10 097 Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Clindacin-150 Flamingo Pharmaceuticals 16 150mg capsule 098 Ltd Dalacin C Pharmacia & Upjohn 16 099 Clindamycin hydrochloride Dalacin C Pharmacia & Upjohn 16 300mg capsule 100 Clindamycin palmitate Dalacin C Pharmacia & Upjohn 80ml 75mg/5ml granule for oral use 101 Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Dihydroartemisin/ Duo-cotecxin Zhejiang Holley Nanhu 8 phosphate 40mg + 320mg tablet 102 160mg/80ml oral Cotecxin Zhejiang Holley Nanhu 80ml powder for suspension 103 Dihydroartemisinin Cotecxin Zhejiang Holley Nanhu 8 60mg tablet 104 Abaxin Lincoln Pharmaceuticals 8 105 Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Microdox Micro Labs 10 100mg capsule 106 Doxyren Rene Industries 10 107 Doxefil Fourts (India) Laboratories 10 108 16

Revidox Macleods Pharmaceuticals 10 109 Restacycline Medibios Laboratories 10 110 Doxycycline Elys Chemical Industries 10 111 112

Doxycycline Micro Labs 10 113 Doxycyline Labotatoire Baily-Creat 10 114 Chemin De Nuisement Unidox 100 Unibios Laboratories 10 115 Fradox Fredun Pharmaceuticals 10 116 Doxina Centaur Pharmaceuticals 10 117 Doxycycline Flamingo Pharmaceuticals 10 118 Azudox Kampala Pharmaceutical 10 119 Agodox Agog Pharma 10 120 Brodox Plethico Pharmaceuticals 10 121 Doxycycline Simrone Pharmaceuical 10 122 Doxycycline Cosmos 10 123 Doxitab Cipla 10 124 Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 hydrochloride Halfan Glaxowellcome 30ml 100mg/5ml oral suspension 125 Halofantrine hydrochloride Halfan Glaxowellcome 6 250mg tablet 126 Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Mefloquine Mephaquin Mepha 4 250mg tablet 127 phosphate Primaquine Cyano Pharma 14 15mg tablet 128 17

Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 bisulphate Quinine Regal Pharmaceuticals 42 300mg tablet bisulphate 129 Quinine dihydrochloride Rogoquin Zhenjiang Tianfeng 1 300mg/ml injection 130 Quinine Ningbo Dahongying 1 131 Quinine dhcl Zhejiang Pharmaceutical 1 132 Linquine F Lincoln Pharmaceuticals 1 133 Quinine dhcl Indus Pharma Pvt 1 134 Quinine Pharmedic (Pvt) 1 135 Kwinil Intas Pharmaceuticals 1 136 Quinine dhcl Rotexmedica Gmbh 1 137 Quinine dihydrochloride Quinisha Intermed 4, G.K 100ml 100mg/5ml syrup 138 Quinimix Medipharm Industries 100ml 139 140

Requin Rene Industriesd 100ml 141 Upquin Uganda Pharmaceuticals 100ml 142 Kamquin Kampala Pharmaceutical 100ml 143 Agog-quine Agog Pharma 100ml 144 Quinine sulphate Flaci-quin 300 Flamingo Pharmaceuticals 42 300mg tablet 145 Quinine Lincoln Pharmaceuticals, 42 sulphate 146 Quinil 300 Ajanta Pharma 42 147 18

Quininga Inga Labs 42 148 Quinine Macleods Pharmaceuticals 42 sulphate 149 Quinisha Intermed, 4 G.K. 42 150 Quinine Micro Labs 42 sulphate 151 Ago quinine Agog Pharma 42 152 Qinarsol Cipla 42 153 Rez-q-300 Plethico Pharmaceuticals 42 154 Requin Rene Industries Ltd 42 155 Quinfer Fredun Pharmaceuticals Ltd, 42 156 Quinine Kampala Pharmaceutical 42 sulphate 157 Quinine Elys Chemical Industries Ltd 42 tablets 158 Quinine Uganda Pharmaceuticals ( 42 sulphate 159 19

Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Sulfadoxine/pyrimethamine Meldar Centaur Pharmaceuticals 15ml 250mg/5ml + 12.5mg/5ml 160 suspension Falcidin Cosmos 10ml 161 Sulfadoxine/pyrimethamine Malarest Pharmedic (Pvt) 15ml 500mg+25mg suspension powder 162 Sulfadoxine/pyrimethamine Malarest Pharmedic (Pvt) 3 500mg+25mg tablet 163 L-kelfin Lincoln Pharmaceuticals 3 164 Malaren Rene Industries 3 165 Fansidar Roche Products Pty 3 166 Malamox Milan Laboratorie 3 167 Sulfadoxine + Micro Labs 3 pyrimethamine 168 Malwin Medibios Laboratories 3 169 Beta sp Beta Healcare 3 170 Neosidar Kampala Pharmaceutical 3 171 Amalar Micro Labs Ltd 3 172 Mal-ps Simrone Pharmaceuical 3 173 Malargard Intermed, 3 174 Agosidar Agog Pharma 3 175 Falcistat Remedica 3 176 Kamsidar Kampala Pharmaceutical 3 177 Sudorin Fredun 3 178 Sulfadoxine/ Fourts (India) Laboratories 3 pyrimethamine 179 20

Malareich Medreich Sterilab 3 180 Sulphadoxine/ Panacea Biotec 3 pyrimethamine 181 Falcidin Cosmos 3 182 Meldar Centaur Pharmaceuticals 3 183 Nopyrin Flamingo Pharmaceuticals 3 184 Intadoxine Regal Pharmaceuticals 3 185 Orodar Elys Chemical Industries 3 186 Rimodar Anglofrench Drugs & 3 187 Industries Malagon Uganda Pharmaceuticals 3 188 Laridox Ipca Laboratories 3 189 Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Sulfadoxine+pyrimethamine+ Falcidin+cq Cosmos 1+3 chloroquine tablet 250/12.5mg+75mg tablet paediatric 190 Sulfadoxine+pyrimethamine+ Homapak 1+3 chloroquine (halfstrength) 250/12.5mg +1 25mg tablet GREEN 191 Sulfadoxine+pyrimethamine+ Falcidin+cq Cosmos 1+3 chloroquine tablet junior 500/25mg+150mg tablet 192 Sulfadoxine+pyrimethamine+ Homapak 3+10 chloroquine (adult/ full 500 /25mg + 250mg tablet strength RED 193 Homapak Kampala Pharmaceutical 1+3 (fullstrength) Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Sulphamethoxypyrazine/ Kelfalin Cosmos 2 pyrimethamine 195 500mg + 25mg tablet Dafrafin 500 Erfa 2 196 Metakelfin Pfizer -Pharmacia 2 197 21

Generic name, dosage form, Brand name Manufacturer Available Pack size Pack Price of Unit Total # Any Comments strength 1/0 recomm- size pack price (4 packs expired Ended found found digits) found 1/0 Tetracycline hydrochloride Tetracycline Ningbo Dahongying 28 250mg capsule 198 Pharmaceuticals Tetracycline Shijiazhuang 28 199 Pharmaceutical Aramycin Intermed 28 200 Tetracycline Simrone Pharmaceuical 28 201 Tetraren Rene Industries 28 202 Teracin Uganda Pharmaceuticals 28 203 Tetracycline Astra Life Care 28 204 Agotetra Agog Pharma 28 (thane) 205 Kam tetra Kampala Pharmaceuticals 28 206 207

28 22

Part 4 For anti-malarial medicines not listed above – please complete in full

Generic name, dosage form, Brand name Manufacturer Available Pack Price of Unit Total # Any Comments AREA SUPERVISOR: strength 1/0 size pack price (4 packs expired found found digits) found 1/0 medicine code for medicines not in part 3 (where exists)