Chinese Drugs Raises Hopes in Treatment of Malaria
African Church Information Service - Every year, between
300 and 500 million cases of malaria are reported around the
world. Some 90 percent of these cases occur in Africa. Malaria kills between 1.3 and 1.8 million
African children a year.
Malaria presents a major socio-economic challenge to the Africa economies. The disease remains the first cause
of death for children under five in Africa. Experts agree that malaria not only cuts
lives short but has a huge socio-economic impact: patients
are often bed ridden and incapable of carrying out normal
This makes them suffer considerable loss of income and place heavy burden on their
families, the health system and society as a whole. The majority
of national malaria policies particularly within African countries
stress on the disease prevention mechanisms rather than treatment
But prevention is often poor because of lack of adequate facilities
like mosquito treated nets and medicines that are sprayed
to suppress the mosquito breeding places.
Emerging facts indicate that increasing parasite resistance
has rendered antimalarial drugs such as chloroquine, widely used in Africa virtually useless.
This has presented malaria experts with more challenges in
relation to the disease treatment. Medicines San Frontiers
MSF (Doctors Without Borders) says that African countries
have an option of using highly potent Chinese drugs (artemisinin derivatives) as a measure of drug combinations
for effective treatment and to prevent further spread of resistance.
"Knowing more effective drugs are available and not being
able to give them to my patients has been so difficult. Treatment
exists and can avoid people dying unnecessarily," says
Dr Diane Cheynier of MSF Burundi.
MSF recently briefed journalists here on possible options
available for effective treatment of malaria in the region.
MSF subsequently released a report that reveals shortcomings
in the national malaria treatment protocols within the Eastern Africa nations.
"Despite all the evidence in favour
of artemisinin - containing combinations, many governments
are changing their malaria treatment protocol from chloroquine to another drug or other drugs that do not
include artemisinin derivatives,"
notes the MSF report.
Malaria experts are now recommending changing of treatment
protocols to include a combination of drugs. By hitting different
biochemical targets of the parasite, drug combinations are
more effective and allow for shorter treatment courses. It is acknowledged,
drug combinations protect each individual drug from resistance.
Several countries within the East African Network for Monitoring
Antimalarial Treatment have recently switched from chloroquine to Fansidar monotherapy for first-line treatment of malaria.
...Developing countries should not be forced to cope
with the financial burden of improving malaria treatment on
their own. "Malaria is causing worldwide crisis and international
should be forthcoming to help implement practical solutions,"
"Considering the high levels of resistance to Fansidar
on East Africa (60 percent
or more), this short-sighted policy is likely to lead to continued
increases in morbidity and mortality," says MSF.
Artemisinin derivatives, which are
extracted from a Chinese plant and have been used in Asia for more than ten years, have attributes that make them
especially effective against malaria and are therefore viewed
as effective combinations.
Experts say these drugs are fast acting, highly potent and
complementary to other classes of treatment. When used in
combination with a second drug, artemisinin derivatives appear to slow the development of resistance to second drug.
Because of this factor, experts predict that the drug will
continue to be effective in long term. To date, no resistance to arteminisin
drugs has been reported. MSF says that the major factor that
is restricting the Eastern
from implementing effective malaria treatment protocols is
Less effective combinations (amodiaquine
and Fansidar) currently cost US $0.25 per adult treatment while
the more effective combinations (amodiaquine
and artesunate) cost US $1.30 per
adult treatment. However, it is expected that by the year
2004, the cost of the effective combination will drop to US
$0.60 per adult.
MSF says only way to prevent the widespread of use of sub-optimal,
ineffective and further malaria epidemics is to find resources
to fund the use of more effective drugs.
The increase in cost today will be repaid many times in years
to come, says MSF, adding that using effective treatment saves
lives, reduces the number and length of medical consultations
and hospital stays and avoids the expense of ineffective treatment.
"People return home quickly to their families and workplace
thus reducing the enormous socio-economic burden of the disease,"
The United Nations estimates that US $8 billion will be needed
per year to finance the Global Fund for health whose main focus will to fight
the spread of HIV/AIDS. Up to date, only US $1.9 billion has
But malaria experts say more donor cash is needed in the Eastern Africa region to help these nations change their
malaria treatment protocols to the use of more effective drugs.
MSF says anti-malarials produced
in Asia should be made available in Africa as soon as possible.
Indeed, the World Health Organisation
is being called upon to expand the existing AIDS drug pre-qualification
system to malaria and UNICEF (United Nations Children's Fund)
should directly support procurement and distribution.
MSF says that developing countries should not be forced to cope with the financial
burden of improving malaria treatment on their own. "Malaria
is causing worldwide crisis and international aid should be forthcoming
to help implement practical solutions," says MSF.