E-DRUG: Drug companies agree to stop single artemisinine? (2)
--------------------------------------------
Dear E-Drugger,
Perusing Dr Kochi's profile and idiosnycracies as an
avowed result-driven public health specialist makes an
interesting reading. I am so happy that he is in
charge of the malaria desk in WHO. Perhaps, the
million of vulnerable underserved population in
developing world, who bear the heaviest of the
financial and human costs of malaria will now have a
better deal. To win the war against malaria and other
public health challenge such as HIv/Aids, TB etc
certainly require an unpretentious, unrepentant and
decisive result-driven approach, diplomatic niceties
or not. Dr Kochi is indeed a "breath of fresh air" and
I dare say, "fresh antimalaria air".
As for disappearance of single-product artemisinine in
the antimalaria market, that is not the situation in
Nigeria, the most populous black nation on earth. The
country recently enacted a new antimalaria treatment
policy discarding the use of choloroquine and
sulphadoxine/pyrimethamine as first line for ACT
combinations. This change was met with serious
opposition from a cross-section of stakeholders on
health care in Nigeria. A number of reasons were
adduced for this opposition, some genuine, others
economic and selfish. As thing stand now in Nigeria,
many generic brands of single artemisinine and its
derivatives are being sold and used with or without
prescription. They are cheaper than the ACT
combinations, most of which are branded innovator
compounds, hence more expensive and out of reach of
majority of the populace. A course of generic single
product arteminine derivatives cost between 250 and
400 Nigerian Naira, while the branded ACT combinations
cost about 1000 naira. Although both drugs are out of
reach of most Nigerians, those who buy the artemsinine
derivatives may be buying the single product
artemisinine for economic reason. Furthermore
self-medication with the now discarded choloroquine
and other drugs as patients' first reponse to
presumptive features of malaria is still pervasive.
These discarded drugs are still being actively
promoted , distributed, sold and use for treatment of
malaria,in Nigeria; of course with negative influence
on morbidity and mortality data. This problems are
certainly not peculiar to Nigeria. I am sure it is now
clear why the malaria desk at WHO need somebody in the
mould of Dr Kochi.
Kazeem Babatunde Yusuff
Dept. of Clinical Pharmacy & Pharmacy Administration
Faculty of Pharmacy
University of Ibadan
Ibadan, Nigeria.
Tel:234-80-37220220
e-mail: yusuffkby@yahoo.co.uk