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Posts Tagged ‘Antimalarial medication’

Boosting global malaria?

Posted by African Press International on May 14, 2013

Artemisinin is usually extracted from the sweet wormwood tree, mainly grown in Asia (file photo)

NAIROBI,  – The UN World Health Organization has accepted the first semi-synthetic version of artemisinin, the key ingredient for malaria treatment globally, for use in the manufacture of drugs, boosting hopes that more people will have access to life-saving medication.

With an estimated 219 million malaria infections and 660,000 deaths – mainly children under five – annually, the disease is one of the world’s biggest killers.

Until now, artemisinin, the key ingredient in the WHO-recommended first-line malaria treatment artemisinin-combination therapy (ACT), has only been available by extraction from the sweet wormwood tree, native to Asia. However, climatic factors have meant it has suffered from uneven supply over the years.

“Normally, artemisinin is sourced from a plant, which is affected by seasonal factors – now, we have a man-made source, which ensures a constant supply of the drug,” Anthony Fake, active pharmaceutical ingredients focal point for WHO’s prequalification of medicines programme, told IRIN.

Funded by the Bill & Melinda Gates Foundation, scientists at the University of Berkeley, California, were able to genetically engineer a strain of baker’s yeast to mass-produce the semi-synthetic artemisinin.

French pharmaceutical firm, Sanofi, which manufactures the semi-synthetic artemisinin, recently announced that it planned to “produce 35 tonnes of artemisinin in 2013 and, on average, 50 to 60 tonnes per year by 2014, which corresponds to between 80 and 150 million ACT treatments”.

Agencies involved in fighting malaria say they have big expectations for the new product.

“The production of semi-synthetic artemisinin will help secure part of the world’s supply and maintain the cost of this raw material at acceptable levels for public health authorities around the world and ultimately benefit patients… Having multiple sources of high-quality artemisinin will strengthen the artemisinin supply chain, contribute to a more stable price, and ultimately ensure greater availability of treatment to people suffering from malaria,” Scott Filler, senior technical adviser for malaria at the Global Fund to fight AIDS, Malaria and Tuberculosis, told IRIN via email.

According to Martin de Smet, who heads up Médecins Sans Frontières’ working group on malaria, the uncertainty of natural artemisinin’s availability has led to bulk buying and speculation in the market, leading to the price of the raw product varying widely – from US$400 per kg to $1,000 per kg – over the years.

He noted that the new development would have gains wider than ACTs: “It also opens doors to other forms of artemisinin use other than ACT, for example, artemisinin injections for severe malaria.”

Not a replacement

De Smet said it would be important for the supply of the natural version of artemisinin to continue alongside the semi-synthetic production.

“We hope that the message will not be that it will replace the natural product, because this would act as a disincentive to the farmers, who could stop producing their crops. It should be complementary, with a growing share of the market,” he added. “Hopefully, we will see the price of ss artemisnin matching the lowest price available for the natural product.”

Both WHO’s Fake and MSF’s de Smet say there is no need for concern over differences in efficacy or safety, as drugs manufactured with both versions of artemisinin contained the same active chemical ingredient.

“There is still a lot to do – pharm companies need to formulate the end products that they will produce based on the semi-synthetic artemisinin, and these then need to be prequalified by WHO – a bureaucratic process but one which ensures that the drugs are safe and effective,” he said.

“We don’t expect to see change overnight, but rather a gradual increase in the market share by companies manufacturing drugs using the semi-synthetic artemisinin – even if we see them getting 10 percent and eventually 20 percent, this will help ease speculation about the product’s availability and stabilize prices.”

kr/cb  source



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Posted by African Press International on April 30, 2013

  • By Dickens Wasonga, 
As the World marks Malaria Day, the Roll Back Malaria Partnership(RBM) is set to launch a three-year campaign under the theme “Invest in the Future: Defeat Malaria.”
The campaign is to help strengthen political will and generate the funding needed to continue averting deaths in malaria-endemic countries.
According to sources mapping progress against key milestones on the road to 2015 shows how the collective efforts of the global malaria community contribute to creating a healthier and more prosperous world.
The source adds that the RBM campaign will help mobilize the resources and support the malaria fight through 2015 and beyond.
The African Media and Malaria Research Network (AMMREN), a Network with membership in 10 African countries engaged in malaria control advocacy, believes the global malaria community is doing the right thing by taking stock of the promises and realities of ending malaria deaths at the targeted date of 2015.
According to Mrs Charity Binka of Ghana who is also the AMMREN CEO, many African countries missed the 2010 Abuja targets to reduce malaria morbidity and mortality by half.
Binka pointed out that with less than two years to meeting the 2015 targets of further reduction of 75% in morbidity and 50% reduction in mortality, countries are now scaling up efforts to at least sustain the modest gains made over the last decade.
The CEO said her AMMREN is of the view that the gains made in malaria control are fragile and could easily be reversed unless malaria continues to be a priority for decision-makers, donors and the communities.
According to her ,this is because the efforts and resources that will be invested in control efforts over the next years will have an impact on whether or not the malaria map will keep shrinking or expanded by the malaria parasites.
While commending, governments, donors, health officials and other key players for efforts made in past decade to bring down malaria morbidity and mortality figures, she said AMMREN is of the view that the widespread negative practice of the treating malaria without diagnosis is likely to hinder the acceleration of the control efforts.
Over 80% of cases of malaria is still being treated without diagnostic testing in many malaria –endemic countries in Africa according to WHO.
The world health body reveals that the universal diagnostic testing will ensure that patients with fever receive the most appropriate treatment, and that antimalarial medicines are used rationally and correctly.
AMMREN is now calling for the scaling up of diagnosis before treatment and a massive deployment of artemisinin-based combination therapies (ACTs) to ensure that appropriately diagnosed cases are treated promptly and correctly.
Some African countries have made significant gains in this regard. The WHO indicates that 60 African governments were providing ACTs free of charge to all age groups as at 2010.
The network is of the view that there must be a scaling up of these laudable efforts so that millions of African who still lack ready access to appropriate treatment will be covered to ensure that every confirmed malaria case gets treated.
It is also asking for a focused attention on preventive activities through the use of treated bed nets. This is because in the fight against malaria, prevention is the best of all options. The higher the number of people using bed nets, the bigger the rate of reduction in malaria cases.
It shares in the optimism of African scientists, the donor community and stakeholders, that malaria can be pushed out of Africa this century.
However, this optimism must be measured against promises made about 13 years ago, when 40 African Heads of State made a declaration in Abuja, Nigeria to reduce the malaria burden on the continent by setting targets.
Many countries have missed the 2005 and 2010 targets and also likely to miss the 2015 targets unless conscious efforts are made increase access to essential malaria interventions such as diagnosis, treatment and prevention.
The continued existence of taxes and tariffs on commodities for malaria control in some countries shows lack of commitment towards dealing with malaria.
Taxes and tariffs and non-tariff measures make these life-saving products unaffordable to the poor and vulnerable.
Despite challenges, in the last decade, there have been some investments in new tools such as long lasting insecticidal nets, rapid diagnostic tests, indoor residual spraying and ACTs. The scaling up of these activities has resulted in modest progress as some countries are now moving from control activities to malaria elimination.
Angola, Mozambique, Zambia and Zimbabwe in 2009, according to a Roll Back Malaria report, have joined other countries in their region to form a sub-regional malaria elimination initiative known as Elimination 8.
The Gambia, Rwanda, Sao Tome & Principe and Madagascar have also secured global funds to prepare for elimination. And since 2007, countries in the Southern African Development Community (SADC) has shown the intent to eliminate malaria.
“As of 2010, the total number of reported cases of malaria in Botswana, South Africa and Swaziland were relatively low raising hope of elimination,” the report added.
With talks of malaria elimination slowly making its way to the front burner, the question of malaria vaccines, as an additional tool must be given urgency and supported by all stakeholders to ensure that it is quickly incorporated into the National Immunization Day schedule once a vaccine receives licensure.
So far the RTS,S, appears to be most promising malaria candidate vaccine. If all goes well the vaccine could be available for targeted use in the next couple of years for young children.
Indeed there is hope on the horizon and AMMREN will continue to lead in providing accurate and timely information on malaria as part of its effort to wipe out the disease from the face of the globe. AMMREN also urges other African journalists to join in the malaria elimination crusade.
Kicking out malaria from Africa is a responsibility of governments, identifiable organizations, communities and individuals. April 25 should be seen as a day of renewal of commitment to work towards a malaria free society.


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