Artemisinin and Malaria

[Guest guest]

Hi All,

 

se this, crossposted from Daniel Luthi of the TCM Lis.

Phil

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

Global fund changes tack on malaria therapy

 

DECLAN BUTLER, Nature 429, 588 (10 June 2004);

doi:10.1038/429588a [PARIS]

 

An outcry from researchers has helped prompt a move to switch

malaria treatment in Africa to a more effective therapy. The drug,

artemisinin, comes from a Chinese herb, and cures 90% of

patients in three days. But aid donors have shrunk from promoting

artemisinin, largely because it costs at least ten times more than

established malaria treatments, to which the parasite that causes

the disease has grown resistant.

 

At a closed meeting last month, the Geneva-based Global Fund to

Fight AIDS, Tuberculosis and Malaria agreed to instruct African

countries to retrospectively modify all malaria grants awarded to

specify only the newer drug. The move will cost the fund more than

a billion dollars over the next five years, says Vinand Nantulya, one

of its senior officials. All future funding will stipulate the use of

artemisinin.

 

The policy change is expected to force most countries to change

their national drug policies. " Money talks, " says Allan Schapira,

coordinator of malaria policy and strategy at the Roll Back Malaria

team of the World Health Organization (WHO). Nantulya admits

that the move was given " further impetus " by the discussion that

followed publication of an article in The Lancet in January in which

prominent scientists accused the fund and the WHO of

" malpractice " for bowing to pressure from aid-giving countries. They

also cautioned against the use of out-dated drugs (Lancet 363,

237–240; 2004).

 

Donors such as the United States and Britain had discouraged

African countries from adopting artemisinin on the grounds that it

cost too much, that data on its effect in children were insufficient,

and that it was not needed in regions where other anti-malaria

drugs still worked, says Amir Attaran of the Royal Institute of

International Affairs in London, and the article's lead author. In

2002, the WHO recommended artemisinin as the treatment of

choice, but in Africa only Zambia and Zanzibar have adopted it.

 

The growing resistance of the malaria parasite Plasmodium

falciparum to chloroquine and sulfadoxine–pyrimethamine, the

mainstay of treatments in Africa — where 90% of global malaria

deaths occur — has also damaged the lofty ambitions of the Roll

Back Malaria initiative. This was launched in 1998, with the goal of

halving malaria deaths by 2010. But deaths are up, not down, and

mortality rates of treated patients are doubling in many parts of

Africa. John Lidén, a spokesman for the Global Fund, says that it

revisited resistance data from the WHO and other sources, and

that this " composite set " convinced it to act. " We are results-

based, " he says, " and if we find we are paying for medicines that

don't work, we want to pay for those that do. "

 

The higher cost of artemisinin means that African countries will

spend their revised grants more rapidly than they had intended. The

drug costs about US$2 for each adult treatment, compared with ten

cents for existing drugs. Its price is expected to fall to about $1

with improvements in production. Countries might be allowed to

apply for further grants in advance to make up the loss, Lidén says,

and donors may be asked to release an additional $1 billion to pay

for the drug. " I appeal to the donor community to recognize that

moving countries to using the right drugs will require much more

money, " says Nantulya, " They must take this seriously. "

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Best regards,

 

Email: <

 

WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland

Mobile: 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

Tel : 353-; [in the Republic: 0]

WWW : http://homepage.eircom.net/~progers/searchap.htm

 

Chinese Proverb: " Man who says it can't be done, should not interrupt man doing

it "