Who is producing ACT now? *

European producers Novartis, a company based in Switzerland, sells a fixed-dose ACT combination (artemether/lumefantrine), under the name Coartem&##8482;. A WHO programme "controls" the supply of a discounted version of this drug, at $2.40 per adult dose. Coartem is sold at about US$12 in private pharmacies in developing countries. Coartem&##8482; challenge: 1) simplify the WHO process for obtaining access to discounted Coartem&##8482;. 2) reduce the "public" and private prices Sanofi-Synthélabo, based in France, sells artesunate produced by the Chinese company Guilin under the trade name Arsumax® on the African market. They have also had a blister of Arsumax® and amodiaquine under development for more than a year, but have so far failed to produce any supply. In July 2002, Sanofi told MSF that they could fulfil large orders for this combination blister by December 2002, but they are now saying that large quantities will not be available until September 2003. The company has also failed to file necessary paperwork to the WHO pre-qualification unit. Sanofi ACT challenge: 1) stop aggressively marketing the stand-alone artesunate product and 2) begin marketing the combination blister in needed quantities at an affordable price Mepha, based in Switzerland, has developed a combination blister of artesunate and mephloquine (for the Asian market) and is currently developing a combination blister of artesunate and amodiaquine for the African market. Asian Producers Indian producers Several Indian companies are in the process of developing ACT blisters. They include Ipca, Medicamen (in collaboration with Danikapharma/Mission Pharma) and Cipla. Indian producer challenges: 1) meet WHO, UNICEF and MSF quality requirements and 2) scale up production of artesunate in combination blister packs Vietnamese and Chinese producers Along with the Chinese, the Vietnamese are currently the leading extractors and synthesizers of artemisinin derivative raw materials. In Vietnam, several of these raw material producers are investing in meeting international standards for the manufacturing of tablets and will likely offer cheaper finished products by 2004. In China, the Guilin factory is the only one producing artesunate tablets. These tablets can only be purchased by non-profit institutions and governments for Africa (the private market is by contract covered by Sanofi). African producers African producers will also be part of the solution. For example, the Kenyan pharmaceutical company Cosmos has already started production of artemisinin derivative, and the Artemesia plant is now being grown in Tanzania. Other African companies are likely to follow suit in the near future. *This is a non-exhaustive list of current producers of ACT