Achieving sustainability, quality and access: lessons from the world's largest revolving drug fund in Khartoum

East Mediterr Health J. 2007 Nov-Dec;13(6):1476-85. doi: 10.26719/2007.13.6.1476.


Ensuring a reliable and affordable supply of essential drugs to health facilities is one of the main challenges facing developing countries. This paper describes the revolving drug fund in Khartoum, which was set up in 1989 to improve access to high quality drugs across the State. An evaluation in 2004 showed that the fund has successfully managed a number of threats to its financial sustainability and has expanded its network of facilities, its range of products and its financial assets. It now supplies essential drugs to 3 million out of the 5 million population of Khartoum each year, at prices between 40% and 100% less than alternative sources. However, results illustrated the tension between achieving an efficient cost-recovery system and access for the poorest.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Commerce
  • Developing Countries
  • Drug Costs / statistics & numerical data
  • Drugs, Essential* / economics
  • Drugs, Essential* / supply & distribution
  • Efficiency, Organizational
  • Financing, Government / organization & administration*
  • Health Care Surveys
  • Health Services Accessibility / organization & administration*
  • Health Services Needs and Demand
  • Humans
  • Marketing of Health Services
  • Models, Organizational
  • Organizational Objectives
  • Poverty Areas
  • Program Evaluation
  • Quality Assurance, Health Care / organization & administration*
  • Rural Health
  • Sudan
  • Surveys and Questionnaires
  • Total Quality Management / organization & administration


  • Drugs, Essential