1. Home
  2. Africa
  3. East Africa

MSF pushes for effective anti-malaria drugs

Medecins Sans Frontieres (MSF) on Wednesday urged international donors to support efforts by East African countries to develop more effective national treatment measures for malaria in order to tackle tens of thousands of child deaths each year as a result of increasing parasite resistance to the anti-malarials currently in use in many parts of the region. Jean-Marie Kindermans, MSF campaigner for essential medicines, told a news conference in the Kenyan capital, Nairobi, that authorities in the region were "aware that they need more effective treatment, but the main obstacle is financial". Kindermans is the author of a "white paper" by MSF, a prominent international health nongovernmental organisation, also released on Wednesday. According to him, the best treatment solution currently available must include derivatives of artemisinin, a drug extracted from a Chinese plant, which has been effectively used in many parts of Asia in the past decade, but which countries in the Eastern African region are unable to afford. "Our ultimate goal is for countries in the region to [be able to] access effective treatment, which includes Chinese drugs. The present protocol used is not effective in East Africa," Kindermans said.
Country Map - Malaria in Tanzania
The average cost per adult of the present treatment protocol in the region is US $0.23, while a more effective protocol, which includes artemisinin derivatives, would cost about $1.30, according to the MSF paper. The $1.05 differential could be greatly reduced if the drug manufacturers agreed to increase their production, according to Kindermans. "We believe that the report released today destroys one key myth blocking the introduction of treatment that has been highly recommended by leading malaria experts," he said. "The cost of switching to effective combinations - rather than combinations which are often no better than placebos - is affordable if international donors are willing to help," he added. Malaria kills between 1.5 and 2 million people annually, 90 percent of whom are African children, according to the MSF paper, entitled "Changing national malaria treatment protocols in Africa: What is the cost and who will pay?" Globally, an estimated 300 to 500 million cases of malaria are reported each year, with 90 percent of those in Africa, where it remains the first cause of deaths of children under five, MSF stated on Wednesday. The traditional anti-malarial, chloroquine, which was discovered in 1934, and saved the lives of millions of malaria patients in Africa for many decades, had now lost its efficacy, because the malaria parasite had become resistant to it, the organisation said. In Africa, national treatment protocols have traditionally mandated the use of a single anti-malarial - either chloroquine or Fansidar - as first-line treatment (drugs for patients with uncomplicated malaria) , but, in recent years, resistance to these drugs has increased dramatically, prompting experts to strongly recommend changing malaria protocols to include a combination of drugs, according to the MSF paper. MSF Campaign Coordinator Daniel Berman told the news conference in Nairobi on Wednesday that many African countries were changing their first-line treatment protocols from the traditional therapies of Fansidar or chloroquine, but for other ineffective combinations which excluded the essential artemisinin derivatives. "It is widely agreed that the best current treatment solution is to use artemisinin-containing combinations. The United States and Europe know the best medicines, but donors are advising African governments to take up the wrong treatment protocols. It is unacceptable to see more people dying when there are effective treatments," Berman said. In Uganda, for example, the national protocol permits a combination of Fansidar and chloroquine for uncomplicated malaria cases and quinine for severe cases, according to MSF. In Kenya, which has an estimated 8.6 million malaria cases each year, the treatment protocol recommends Fansidar as first-line treatment and quinine for second-line treatment, it added. However, Dr Dominic Mutie, World Health Organisation (WHO) Disease Control Officer for Kenya, told IRIN on Wednesday that governments must "exercise caution" in developing their malaria treatment protocols because of the limited range of anti-malarials currently available, in order to avoid running out of alternatives. "They [the Chinese derivatives] work, but if we hurry up to use all the available drugs, then we shall have no more left," he said. "We need to move with more caution. If people are not careful, soon we will get large-scale resistance, and then we will be in trouble." The WHO's Roll Back Malaria campaign, initiated in 1998, has been supporting the Kenyan government's malaria-control programmes. It helped in the completion of a malaria-control strategy towards the end of last year, which replaced chloroquine with a combination of pyrimethamine, according to Mutie. [With some 3,000 people dying from malaria each day because they lack access to health care, life-saving drugs and treated bed-nets, the global Roll Back Malaria Campaign is an initiative which aims to halve the world’s malaria burden by 2010 by enabling communities to take effective, sustainable action against the disease. For more details, and country profiles, go to: http://mosquito.who.int] In Tanzania - where malaria is the leading cause of mortality and morbidity, with 16 million cases each year - the Ministry of Health last year had begun to implement a change in national malaria treatment protocol, from chloroquine to the SP (sulfadoxine-pyrimethamine) first-line treatment, MSF stated on Wednesday. "Artemisinin derivatives are known to be more effective, but they are still considered too expensive to introduce as standard treatment nationwide," it added. Only 13 new drugs have been developed since 1975 for tropical diseases, compared with 1,300 drugs for those which affect developed countries, according to Berman. "We really need new drugs now, because these drugs are failing more and more," MSF warned. According to Mutie, WHO has recommended use of the new treatment protocol proposed by MSF on individual basis and not over a large population, which could "increase pressure on the drug" for parasite resistance. "In Eastern Africa, there are lots of consultations going on, and the Roll Back Malaria strategy is moving on to a more systematic approach of promoting partnership to fight malaria," he added.

This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

Share this article

Get the day’s top headlines in your inbox every morning

Starting at just $5 a month, you can become a member of The New Humanitarian and receive our premium newsletter, DAWNS Digest.

DAWNS Digest has been the trusted essential morning read for global aid and foreign policy professionals for more than 10 years.

Government, media, global governance organisations, NGOs, academics, and more subscribe to DAWNS to receive the day’s top global headlines of news and analysis in their inboxes every weekday morning.

It’s the perfect way to start your day.

Become a member of The New Humanitarian today and you’ll automatically be subscribed to DAWNS Digest – free of charge.

Become a member of The New Humanitarian

Support our journalism and become more involved in our community. Help us deliver informative, accessible, independent journalism that you can trust and provides accountability to the millions of people affected by crises worldwide.

Join