Roll Back Malaria campaign still has a long way to go

Médecins Sans Frontières estimates that the cost of providing artemesinin based treatments to all African countries that need it would be between $100m and $200m a year at today's prices.

The report came out the day before the World Health Organization and Unicef launched their joint report on malaria in Africa - an update on progress towards the goals for tackling malaria set by African leaders at a summit in Abuja in 2000. These goals were to ensure that, by 2005, 60% of people with malaria had access to affordable treatment within 24 hours, 60% of children and pregnant women at risk of getting malaria had mosquito nets treated with insecticide, and 60% of all pregnant women had access to prophylactic treatments.

The report from Médecins Sans Frontières claims that traditional antimalaria drugs such as chloroquine and sulfadoxine-pyrimethamine are almost useless because of the high degree of resistance to them. WHO guidelines on malaria treatment recommend their replacement with the effective artemesinin based combination treatments.

Although their effectiveness has been proved, artemesinin based treatments are difficult to implement in Africa because of their cost. The report says that a dose for an adult costs $1.50 (£0.94; a1.36), compared with $0.10 for chloroquine.

"It is not only the cost of the new drugs, but also the cost of change," explained Dr Christa Hook, a medical adviser to the UK branch of Médecins Sans Frontières.

"There is an initial need for a big injection of funds, but after that the needs may be reduced and the costs are expected to drop," she added.

Médecins Sans Frontières estimates that the cost of providing artemesinin based treatments to all African countries that need it would be between $100m and $200m a year at today's prices but claims that international donors have enough funds to support such a move. Although no large scale, prospective economic evaluation has been done, the charity says that the treatment is cost effective and feasible.

Cutting the prices of other combination treatments and scaling up their production is also needed, the report says. It urges Unicef, WHO, and the Global Fund to fight AIDS, tuberculosis, and malaria to "pool needs and make large orders to prime the drug production pump and bring down prices."  

The Médecins Sans Frontières report, Act Now to Get Malaria Treatment that Works to Africa, is available at www.accessmed-msf.org and Africa Malaria Report 2003 is at http://mosquito.who.int