WHO in new drive to assure on effective Anti-malaria drug

By Henry Neondo in Arusha

A three-day conference aimed at ensuring a reliable supply of artemisinin-based combination therapies (ACTs), the most effective antimalarial medicines currently available, opens in Arusha today.

A dependable supply of ACTs is crucial for preventing hundreds of thousands of deaths each year from falciparum malaria, the deadliest form of the disease.

The meeting, convened by the World Health Organization (WHO), brings together growers of Artemisia annua – the plant containing artemisinin, the raw material needed to manufacture ACTs – with representatives of international and non-governmental organizations, government agencies and companies engaged in making these medicines available to malaria patients and officials from the ministries of health and agriculture of Tanzania, Kenya and Uganda and the ministry of trade of Tanzania.

This is the first time actors involved in every step of the ACT production chain – from seed planting to the processing of artemisinin to manufacturing of finished pharmaceuticals – will meet together.

Since 2001, 51 countries, 34 of them in Africa, have followed WHO’s recommendation that they adopt ACTs as the first-line treatment for malaria. Eighteen countries adopted them in 2004 alone.

The resulting surge in demand – from 2 million treatment courses in 2003 to 30 million courses in 2004 and a projected 70 million treatment courses for 2005 – led to a shortfall of artemisinin and ACTs, which WHO announced in November 2004.

Participants at the meeting will seek to develop strategies to avert any future shortage.

One key strategy is stepping up cultivation of Artemisia annua; and sights have turned towards East Africa, where it grows well.

“Scaling up production of the plant presents an excellent opportunity for economic development in Africa. We are already seeing the first encouraging results here in Tanzania, which started large-scale cultivation of Artemisia annua in 2004.

African farmers and their partners in research and development and industry will play a critical role in ensuring sufficient ACT supply and ultimately contribute to reductions in malaria burden,” said Dr Jack Chow, WHO Assistant Director-General of WHO for HIV/AIDS, TB and Malaria.

Participants in the meeting will review the status of ACT supply and anticipated demand in the light of experiences over the past two years; pinpoint technical questions that need to be addressed by research and identify sources of financial, marketing and technical support for the production of Artemisia annua, artemisinin and WHO-approved ACTs.

They will also examine strategies to create a sustainable market so as to reduce the price of these vital medicines.

Falciparum malaria causes as many as 400 million infections a year and at least a million deaths, some 80 per cent of them in sub-Saharan Africa.

ACTs are at least 10 times more costly than chloroquine and other commonly used malaria drugs, which are no longer effective in many regions because the malaria parasite has become resistant to them.

Twenty-five African countries have received funding for ACT procurement from the Global Fund to Fight TB, AIDS and Malaria, which makes it economically feasible at present for them to purchase these medicines for use in public health facilities.

“This meeting comes at a crucial moment. So far, just 25 countries worldwide, 12 of them in Africa, have begun procuring these medicines.

We want to encourage the others to start placing their orders, and placing them promptly, secure in the knowledge that a sufficient supply will be available,” said Dr Fatoumata Nafo-Traoré, Director of the WHO Roll Back Malaria Department.

Countries are expected to place orders for at least 130 million treatment courses of ACTs in 2006. It is anticipated supply will be sufficient to meet that demand.

“An important task at the meeting is to plan for 2007 and beyond,” Dr. Nafo-Traoré said.