E-drug: MSF report: Artesunate instead of quinine could save 200,000 per year
--------------------------------------------------------------------
Colleagues
MSF released a report this week calling for governments, the WHO and donors
to help countries change their severe malaria treatment protocols from
centuries old quinine, to the newer, more effective drug artesunate; the
report can be downloaded from here:
http://www.msf.org/msf/articles/2011/04/malaria-making-the-switch.cfm
Revolutionary Advance in Severe Malaria Treatment:
Using Artesunate Instead Of Quinine Could Save 200,000 Lives Annually
New MSF report calls on African governments, WHO and donors to urgently
make the switch
Geneva, 19 April 2011 – After the revision of World Health Organization
(WHO) guidelines yesterday, international medical humanitarian organisation
Médecins Sans Frontières (MSF) calls for a drug proven to reduce deaths in
children suffering from severe malaria to be immediately rolled out in
African countries. In its new report Making the Switch, MSF calls on
African governments to follow new World Health Organization (WHO)
guidelines, and switch from the far less effective quinine to artesunate,
which could avert nearly 200,000 deaths each year. MSF also calls on WHO
and donors to support governments so this urgent treatment change can
happen quickly.
“When children arrive at the clinic with severe malaria, they often are
having convulsions, vomiting or at risk of going into shock, and you just
want to be able to give them effective treatment quickly,” said Veronique
De Clerck, Medical Coordinator for MSF in Uganda. “For decades, quinine has
been used in severe malaria, but it can be both difficult to use and
dangerous, so it’s time to bid it farewell. With artesunate, we now have a
drug that saves more lives from severe malaria, and is safer, easier and
more effective than quinine.”
Quinine has to be given three times a day in a slow intravenous drip that
takes four hours, a treatment that is burdensome for both patients and
health staff. Artesunate, in contrast, can be given in just four minutes,
by giving a patient an intravenous or intramuscular injection.
A landmark clinical trial in late 2010 concluded that the use of artesunate
to treat children with severe malaria reduces the risk of death by nearly a
quarter. The study, carried out in nine African countries, found that for
every 41 children given artesunate over quinine, one extra life was saved.
Because of the complexities of administering quinine, children in the trial
who were assigned to receive quinine were almost four times more likely to
die before even receiving treatment.
MSF participated in the trial through its research affiliate Epicentre,
with a research site in Uganda. MSF has since changed its own treatment
protocols and now plans to work with national health authorities to roll
out artesunate in its projects over the coming months.
The evidence is overwhelming, but MSF’s report stresses that change will
not happen on its own. While WHO has now issued new guidelines recommending
artesunate for treating severe malaria in children in Africa, it needs to
also develop a plan to help countries make this switch. African
governments must urgently change their treatment protocols and donors must
send a clear signal to countries that they will support the additional cost
where needed. Artesunate is three times more expensive, but the difference
in cost of US$31 million each year for a global switch is very little for
the nearly 200,000 lives that researchers say could be saved.
“We’ve been here before – when WHO changed its treatment recommendations
for simple malaria in 2001 it took years for countries to actually make the
switch, and shockingly, in some countries the far inferior drugs are still
being used ten years on,” said Dr. Martin De Smet, who coordinates MSF’s
malaria work. “With severe malaria, WHO needs to make sure that the change
is much less sluggish, so lives can be saved immediately. There’s simply
no excuse not to make the switch now.”
MSF provided malaria treatment to around one million people in 2010.
Severe malaria kills over 600,000 African children under the age of five
annually. Each year, around eight million simple malaria cases progress to
severe malaria, where patients show clinical signs of organ damage, which
may involve the brain, lungs, kidneys or blood vessels. ‘Making the
Switch’, MSF’s new report calling for a change in protocol for the
treatment of severe malaria in children can be downloaded from
www.msfaccess.org
Joanna Keenan
Press Officer
Campaign for Access to Essential Medicines
Medecins Sans Frontieres
msfaccess.org
twitter.com/MSF_access
facebook.com/MSFaccess