Chloroquine malaria treatments to be phased out - health minister

Nigeria is to phase out malaria-resistant drugs such as chloroquine immediately and switch to the more effective but more expensive artemisinin-based drugs, Health Minister Eyitayo Lambo said on Tuesday. With the mosquito-borne disease responsible for 30 percent of all childhood deaths, Nigeria has adopted a World Health Organisation (WHO) recommendation to use artemisinin-based combination therapy. Artemisinin is an anti-malarial agent extracted from the dry leaves of a Chinese herb, Artemsisia annua, also known as qinghaosu or sweet wormwood. A health ministry statement said there was evidence of widespread drug resistance to the most common treatments - chloroquine, used in Africa since the 1950s and sulfadoxine-pyrimethamine (better known as Fansidar), introduced to Africa in the early 1990s. "Evidence has shown that these drugs have lost their efficacy due to the emergence of resistant strains of plasmodium falciparum (the malaria parasite)," Lambo was quoted as saying in the statement. Artemisinin-based drugs on the other hand, had proved "highly efficacious” in treating malaria, which is responsible for more than 60 percent of visits in Nigeria’s outpatient hospital services, and 11 percent of pregnancy-related deaths. Lambo said the problem of drug-resistant malaria was compounded by a wide circulation of fake, adulterated or substandard drugs in Nigeria, often leading to wrong diagnosis of the disease and associated drug failures. Nigeria's food and drug administration agency estimates that more than 60 percent of pharmaceuticals on sale in the country are fake, substandard or adulterated due to the presence of powerful criminal gangs trading in counterfeit drugs. Artemisinin-based drugs currently in use in Nigeria are imported, but the health ministry said it was attempting to get pharmaceutical firms to produce them locally. Lambo on Monday met representatives of pharmaceutical firms and promised help in producing the new drugs in Nigeria. Meanwhile, the National Institute of Pharmaceutical Research and Development in the capital Abuja has launched a project for large-scale growing of the plant, Artemsisia annua, said the institute's director, Uford Inyang. Plant nurseries have been developed and plants can be obtained from the institute by farmers or firms, he added. But representatives of drug companies who met the minister expressed some misgivings about the new policy. Emmanual Ebere, chairman of the Pharmaceutical Manufacturers' Group of the Manufacturers Association, asked that the effective implementation of the policy be postponed to January 2007. Sam Ohuabunwa, head of Neimeth Pharamceuticals, agreed and said efforts should be made to ensure the new drugs were cheaply and widely available before the new policy was implemented. "An essential drug is one that is used for a greater number of people, is available at all times in the right quantity and is affordable to a greater number of people," said Ohuabunwa. "The drug we are talking about is neither available nor affordable." Artemisinin-based drugs typically cost US$ 1.30 to treat a single case of malaria in West Africa, compared to 10 cents for the chloroquine treatment.