Africa News
4 March 2002

PanAfrica, 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 daily activities.

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 options.

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 aid should be forthcoming to help implement practical solutions," says MSF.

"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 Africa countries from implementing effective malaria treatment protocols is the cost.

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," says MSF.

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 been pledged.

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.