E-DRUG: MSF paper says new global subsidy for malaria medicines must ensure quality of care
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AMFm - New global subsidy for malaria medicines must ensure quality of care
Geneva - 21 July 2009 - A new drug subsidy designed to increase access to
life-saving malaria treatment must remain focused on quality patient care
if it is to succeed, according to a paper published by Medecins Sans
Frontieres (MSF) authors in this week's open access journal PLoS Medicine.
The subsidy, called the Affordable Medicines Facility - malaria (AMFm),
will be rolled out in 2009 and plans to address concerns of poor access to
artemisinin-based combination therapies (ACTs) for malaria, currently the
most effective treatment that exists. The authors cite a recent household
survey across 18 African countries that found only about three percent of
children under five years with fever had received an ACT.
In order to enhance quality of care, the paper argues that the AMFm should
adopt policies to exclusively fund fixed-dose combinations, withhold
support for ineffective combinations, and support wider adoption of rapid
diagnostic tests (RDTs). The authors also demonstrate how generic
competition has already significantly reduced the price of antimalarials
over time.
'The AMFm is an innovative but untested global initiative with the
potential for both positive and unintended consequences for health,' says
one of the authors, Dr von Schoen-Angerer, Director of MSF's Campaign for
Access to Essential Medicines. 'Keeping the focus on quality care - through
patient-centred policies on fixed-dose combinations, increased access to
rapid diagnostics, delivery, and monitoring of real impact for people -
will help the AMFm to meet the long unfulfilled promise of artemisinin for
those who continue to suffer from malaria today.'
The AMFm aims to address inadequate access to ACTs for treating P.
falciparum malaria by subsidising producer prices. First proposed in 2004,
the facility aims to lower end-user prices to the level of older
antimalarials, making ACTs more affordable and delaying resistance to
artemisinin derivatives by driving artemisinin monotherapy and substandard
antimalarials out of the market.
The AMFm is hosted by the Global Fund to Fight AIDS, Tuberculosis, and
Malaria and 11 countries have been invited to participate in the initial
phase: Benin, Cambodia, Ghana, Kenya, Madagascar, Niger, Nigeria, Rwanda,
Senegal, Tanzania, and Uganda.
MSF treats malaria in its programmes around the world and treated close to
1.2 million malaria cases in 2008. MSF was an early proponent of ACTs, and
started using them in its projects in Africa in 2001.
The article, “Focusing on Quality Patient Care in the New Global Subsidy
for Malaria Medicines”, is freely available from the open access journal
PLoS Medicine at:
medicine.plosjournals.org/perlserv/
For more information, please contact:
Guillaume Bonnet, Press Officer, +41 79 203 13 02
Artemisinin-based combination therapy — ACT
The best current treatment is a combination of drugs that includes
artemisinin derivatives, extracts of a Chinese plant, Artemisia annua.
Artemisinin derivatives should not be used alone, but always with a
companion drug such as amodiaquine. A combination of drugs with independent
modes of action and different biochemical targets is not only more
effective, but also successful in preventing or slowing the development of
resistance, because the probability of parasites being simultaneously
resistant to two drugs is greatly reduced. Combining artemisinins with a
companion drug shortens the treatment course to three days.
How FDCs can protect artemisinins
When provided in co-blisters, where two different drugs are packaged
together but not combined in the same pill, there is the risk that patients
take only one of the drugs, which greatly increases the risk of resistance
developing. Fixed-dose combinations (FDCs), where the drugs that need to be
taken together are combined into a single pill, lead to better patient
adherence and reduce the risk of drug resistance.
Leyla Pope
Communications Officer
Medecins Sans Frontieres
Campaign for Access to Essential Medicines
Tel. + 41(0) 22 849 89 88
Leyla.POPE@geneva.msf.org