E-drug: Re: NYT: New Drug for Malaria Pits U.S. Against Africa
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Artemesinin derivatives are expensive for the poor. But if someone is
willing to reduce the price, and may be to ensure supplies in a sustainable
manner, it is a great idea.
With what is happening now however, reality will shortly dictate to have one
of the following combinations as first-line treatment:
1. Quinine and SP
2. Quinine and doxycycline (for children above 12 or mothers who are not
pregnant or lactating)
3. Amodiaquine and SP
4. Amodiaquine and doxycycline (for children above 12 or mothers who are not
pregnant).
Using bed nets, indoor DDT spraying and artemisinin, in a study under way in
rural South Africa, malaria deaths dropped 87 percent in a year is a great
revelation limited by many factors. It is very difficult to replicate such
scenes in a sustainable manner in rural Africa!
I also think pilot studies need to more closely reflect the environment or
economic status of groups for which they are intended to benefit: for the
short as well as long terms.
In poor countries like ours, children have only one chance. They struggle
just to visit a health service, and if they get the wrong drug the first
time, they are then found dead. But I am looking at a situation where a
very expensive drug is included in national treatment protocols, prescribed,
and not dispensed free of charge or even at a small cost from a government
facility!
Government can buy cheaper medicines and not very expensive drugs. But if
donors and MSF can pay for or subsidise the expensive antimalarials, and for
a long-time, who will ever refuse such an offer?
George Kibumba, MPS
Teaching Assistant, Clinical Pharmacy
Dept Of Pharmacy, Makerere University
P.O.BOX 7072, KAMPALA, Uganda
Mobile: 256 071 81 54 28
e-mail: kibumba@yahoo.com
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