Number One Killer of Children in Africa Too Expensive to Treat Effectively?
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Report released by MSF shows this myth is unfounded
13 February 2002, Nairobi - As East African countries are about to
change national malaria treatment protocols, M�decins Sans Fronti�res
(MSF) today releases a report in the hope of averting a fatal choice.
In recent years, increasing parasite resistance has rendered antima-
larial drugs such as chloroquine and Fansidar� virtually useless in
many parts of East Africa. Malaria experts agree that in order to of-
fer patients effective treatment and prevent further spread of resis-
tance, protocols should include drug combinations with the highly po-
tent Chinese drugs known as artemisinin derivatives.
However, because of a lack of resources and donor preference for
cheap solutions, many health ministries are considering changing pro-
tocols to transition strategies, using combinations of drugs that
will be equivalent to giving some patients placebos. This decision is
a matter of life and death in a disease that kills between 1.3 and
1.8 million African children a year.
�Knowing more effective drugs are available and not being able to
give them to my patients has been so difficult,� said Dr. Diane
Cheynier, MSF Burundi. �Treatment exists that can avoid people dying
unnecessarily. With the help of donors, African governments can avoid
the fatal error of going to stop-gap, band-aid solutions.�
In MSF�s report, increased costs of more effective drugs are pin-
pointed as one of the chief barriers to widespread implementation in
the public sector. Current drug combinations cost just US$ 0.25 per
adult dose while more effective combinations with artemisinin deriva-
tives cost approximately US$ 1.30. However, the report shows that for
Burundi, Kenya, Rwanda, Tanzania and Uganda combined, the additional
costs to implement the more effective combinations would only amount
to US$19 million a year.
When African governments make the political decision to implement ef-
fective long term strategies, they will need the support of donors.
�We believe that the report released today destroys one of the key
myths blocking the introduction of treatment that has been highly
recommended by leading malaria experts,� said Dr. Jean-Marie Kinder-
mans of MSF, author of the report. �The cost of switching to effec-
tive combinations rather than combinations which are often no better
than placebos is affordable if international donors are willing to
help.�
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 essential elements of effective combinations. They 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 the sec-
ond drug. For this reason, experts predict that artemisinin-
containing combinations would continue to be effective in the long
term. To date, no resistance to artemisinin drugs has been reported.
The full report �Changing national malaria treatment protocols in Af-
rica: What is the cost and who will pay?� can be found at
http://www.accessmed-msf.org
You can download it in Adobe PDF format (188 kB) at:
http://www.accessmed-msf.org/upload/ReportsandPublications/12220021722584/JMKmalariadoc.pdf
For further information, please contact
Daniel Berman
Tel: +254-733-631-531
Malini Morzaria
Tel: +254-72-513-981
Lucy Kange�the
Tel: +254-2-444-474 or +254-2-440-536
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