# \[e-drug\] Experts' letter to RBM: review the draft strategy for malaria

**URL:** <https://talk.edrugplus.org/t/e-drug-experts-letter-to-rbm-review-the-draft-strategy-for-malaria/18330>\
**Category:** e-drug\
**Created:** [December 3, 2003, 1:47pm UTC](https://talk.edrugplus.org/t/e-drug-experts-letter-to-rbm-review-the-draft-strategy-for-malaria/18330 "2003-12-03T13:47:10Z")\
**Posts on this page:** 1\
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**Author:** ![Julia\_Double](https://avatars.discourse-cdn.com/v4/letter/j/3ec8ea/32.png) [@Julia\_Double](https://talk.edrugplus.org/u/Julia_Double)\
**Post date:** [December 3, 2003, 1:47pm UTC](https://talk.edrugplus.org/t/e-drug-experts-letter-to-rbm-review-the-draft-strategy-for-malaria/18330/1 "2003-12-03T13:47:10Z")

</div>

E-drug: Experts' letter to RBM: review the draft strategy for malaria  
-------------------------------------------------------------------------

Please find below the copy of a letter which was sent last Friday to  
Roll Back Malaria, commenting on the third draft of "RBM Strategic  
Orientations 2004-2008." pdf version available at:  
[http://www.accessmed-msf.org/prod/publications.asp?scntid=2122](http://www.accessmed-msf.org/prod/publications.asp?scntid=2122)  
0031011177&contenttype=PARA (url made need to repair)

"The new RBM strategy sacrifices life-saving treatment to narrow  
cost-effectiveness considerations, and chooses instead to focus  
mainly on prevention of malaria. Emphasizing prevention alone for  
such a common killing disease will certainly not "roll back malaria".

We believe that "Rolling Back Malaria" is possible with effective  
vector control and effective treatment, and that it is not the time to  
abandon this important initiative. We call on the WHO for an urgent  
and complete rethinking of the RBM 2004-08 strategy based on a  
comprehensive review of available evidence and genuine expert  
field experience. If RBM is truly committed to reducing the number  
of deaths from malaria as soon as possible, it should strive to  
provide technical support to assist countries to implement effective  
diagnostic tools and widespread ACT use now, and push for  
increased donor money to support this."

Looking forward how RBM is going to take these comments into  
account in the review of the draft that should be taking place this  
month...

Julia Double  
Medecins sans Frontieres  
Campaign for Access to Essential Medicines  
Tel (direct): +41 22 849 84 03  
Fax: +41 22 849 84 04  
Email: julia.double@geneva.msf.org

----------------------------------------  
THE TIME TO ACT IS NOW

Dr. Fatoumata Nafo-Traore  
Executive Secretary  
Roll Back Malaria Partnership

Roll Back Malaria Secretariat

November 28, 2003

Dear Dr. Nafo-Traore,

As experts and health workers committed to improve health care in  
the developing world, we are extremely concerned and alarmed by  
the newly released draft Roll Back Malaria (RBM) guidelines for  
2004-08, which represent a major backward step in malaria control.

Malaria is killing up to 2 million people every year, most of whom  
are children in Africa. Despite best efforts to date, global control of  
this lethal disease has failed, and infection and death rates are  
rising.

Effective malaria control requires effective prevention and  
treatment programmes. While the international community is  
putting significant efforts to improve prevention measures,  
treatment is becoming increasingly difficult because of loss of  
inexpensive drugs (chloroquine and sulfadoxine-pyrimethamine  
[SP]) to resistance. These drugs simply do not work now in much of  
the malaria affected world.

In 2001 the World Health Organization (WHO) took the lead in  
acknowledging the need to bring effective treatments to those  
affected by epidemics of this devastating disease, advocating the  
use of artemisinin-based combination therapy (ACT). It was also  
recommended that any country changing national antimalarial drug  
policy should change to ACTs. It is well established that ACTs are  
the most rapidly and reliably effective antimalarial drugs. Increased  
use of ACTs has led to a fall in drug prices; today it cost less than  
$US 1 to save the life of a child with malaria using these drugs.

However, chloroquine and SP continue to be provided by donors  
and still recommended in many African countries, leading to  
avoidable death and wasted resources. These ineffective drugs are  
often the only available antimalarials. There is an urgent and  
pressing need to increase the availability of ACTs to replace these  
failing drugs.

The new RBM strategy sacrifices life-saving treatment to narrow  
cost-effectiveness considerations, and chooses instead to focus  
mainly on prevention of malaria. Emphasizing prevention alone for  
such a common killing disease will certainly not "roll back malaria".  
It is widely accepted in the field of HIV/AIDS that there are medical,  
macro-economic, social, moral, and ethical imperatives to provide  
life-extending treatment to the 6 million people who are in need.  
Why is malaria, which is so much easier to treat, any different?  
RBM's guidelines set to reverse more than 5 years of consultation  
and expert opinion in the field of global control of malaria. We  
believe that "Rolling Back Malaria" is possible with effective vector  
control and effective treatment, and that it is not the time to  
abandon this important initiative. We call on the WHO for an urgent  
and complete rethinking of the RBM 2004-08 strategy based on a  
comprehensive review of available evidence and genuine expert  
field experience. If RBM is truly committed to reducing the number  
of deaths from malaria as soon as possible, it should strive to  
provide technical support to assist countries to implement effective  
diagnostic tools and widespread ACT use now, and push for  
increased donor money to support this.

Sincerely,

Dr Abdullah Ali  
Malaria Programme Manager  
Zanzibar

Dr. Fred Binka  
School of Public Health, University of Ghana  
Ghana

Prof. Philippe Brasseur,  
Institut de Recherche pour le Developpement  
Senegal

Professor Oumar Gaye,  
Coordinator of the RAOTAP1/WAMTN  
West African antimalarial treatment network  
Senegal

Dr. F. K. Kato,  
Senior Medical Officer,  
Malaria Control Programme, Ministry of Health, Kampala  
Uganda.

Dr T.K. Mutabingwa  
Chairman of EANMAT  
Tanzania

Prof. Robert Snow  
Head Malaria Public Health Group  
KEMRI/Wellcome Trust Collaborative Program  
Kenya

Dr. Fran�ois Nosten  
Director  
SMRU Shoklo Malaria Research Unit  
Thailand

Prof. Nick White  
Wellcome Trust Mahidol University Oxford Tropical Medicine  
Research  
Programme  
Faculty of Tropical Medicine - Mahidol University, Bangkok  
Thailand

Prof. Barry R. Bloom, PhD  
Dean, Harvard School of Public Health  
Professor of Immunology and Infectious Diseases  
Harvard University  
USA

Prof. Carol Hopkins Sibley,  
Professor of Genome Sciences  
University of Washington- Seattle  
USA

Allan Rosenfield, MD  
Dean, Mailman School of Public Health  
DeLamar Professor of Public Health  
Columbia University  
USA

Ron Waldman, MD, MPH  
Center for Global Health and Economic Development  
Mailman School of Public Health  
Columbia University  
USA

Prof. Dyann Wirth, Ph.D.  
Professor, Infectious Diseases, Department of Immunology and  
Infectious  
Diseases  
Harvard University School of Publich Health  
Director, Harvard Malaria Initiative  
Harvard University  
USA

Prof. Dr. Marleen Boelaert  
Public Health Department  
Prince Leopold Tropical Medicine Institute - Antwerpen  
Belgium

Docteur Paolo Chiodini  
Responsable des projets  
CUAMM  
Italy

Prof. Umberto D'Alessandro  
Head Epidemiology Unit, Dept Parasitology  
Institute Tropical Medicine - Antwerp,  
Belgium

Pr Martin Danis  
Parasitology, University Hospital Pitie-Salp�triere,  
Pierre et Marie Curie-Paris 6 University  
France

Dr Cristiana De Lorenzi  
Alisei  
Italy

Dr. Pierre Druilhe  
Head of the BioMedical parasitology Unit  
Institut Pasteur  
France

Suzanne Fustukian  
Lecturer, Centre for International Health Studies  
Queen Margaret University College - Edinburgh  
United Kingdom

Prof. Massimo Galli  
Director of the Infectious Diseases Institute  
University of Milan  
Italy

Dr Philippe J Guerin  
Scientific Director  
Epicentre - Paris  
France

Dr. Christa Hook  
Malaria expert,  
Medecins Sans Frontieres  
United Kingdom

Prof. Giuseppe Ippolito  
Scientific Director of the National Institute of Infectious Diseases  
Lazzaro Spallanzani, Rome  
Italy

Dr. Jean-Marie Kindermans  
Malaria Access Campaign  
Medecins Sans Frontieres  
Belgium

Dr. Marina Madeo  
Health Department coordinator  
ONG COOPI  
Italy

Prof. Mauro Moroni  
Coordinator Infectious diseases department  
L. Sacco Hospital, Milan  
Italy

Dr. Bernard Pecoul  
Director Access to medicines campaign  
Medecins Sans Frontieres  
Switzerland

Dr. W. M. Watkins  
Wellcome Trust Fellow,  
Department of Pharmacology & Therapeutics, University of  
Liverpool  
United Kingdom

Prof. Nick Anstey  
Head, International Health Program  
Menzies School of Health Research,  
Darwin, Australia

Dr. Dave Durrheim, MPH&TM, DrPH  
Associate Professor James Cook University  
Head of School of Public Health and Tropical Medicine  
and Director of the Anton Breinl Centre of Public Health and  
Tropical  
Medicine  
Australia

Dr Ric Price  
Senior Researcher - Menzies School of Health Research,  
Darwin,  
Australia

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