Alarmingly few African patients
with malaria are getting existing effective treatment that could
cure them in a
few days, says Médecins Sans Frontières.
Alarmingly few African patients with malaria are getting
existing effective treatment that could cure them in a few days, says
Médecins Sans Frontières.
Four years after the World Health Organization issued a global recommendation
for countries to switch from old malaria treatments to artemisinin-based
combination therapies, or ACTs, and two years after the Global Fund
decided to fund ACTs, MSF teams witness government-run health facilities
still giving patients old malaria medicines instead of a treatment
that works.
" Here in Dabola, we manage to provide ACTs and see our patients
cured after three days, but just 40 km down the road the situation
is dramatically different: people aren't getting the best treatment
although officially, the government changed the protocol a year ago
already,"
said Dr Barbara Maccagno, medical coordinator
for MSF in Guinea Conakry. MSF estimates that less than 1% of all
malaria patients
in the country are getting ACTs today. Malaria is the leading cause
of death in Guinea, accounting for over 15% of all deaths recorded
in the country's health facilities.
Guinea is by no means an isolated case. In Zambia, MSF estimates that
a mere 11% of all patients presenting with malaria are receiving ACTs.
MSF teams in several African countries report similar experiences:
for example in Sudan, Kenya, Malawi, Côte d'Ivoire and Sierra
Leone, the ministries of health are still using chloroquine or sulfadoxine-pyrimethamine,
even though these drugs are known to be largely ineffective and are
no longer recommended as first-line treatment.
Nearly 40 African countries or territories have adopted ACTs as their
national treatment protocol for malaria to date. But out of these,
over 70% are either not deploying the policy at all, or are implementing
it very slowly. This is due to a combination of obstacles such as lack
of political will and financial and human resources; lack of training
for health workers and the resulting poor recognition of the benefits
of ACTs among the communities; shortages of ACTs of assured quality;
the fact that health workers do not have access to rapid diagnostic
tests; and poor access to health care in general. So malaria, a curable
disease, continues to kill a child every 30 seconds.
" The lack of coordinated support to countries by WHO's malaria
programme, the Roll Back Malaria partnership and donors such as the
US President's Malaria Initiative has hampered the procurement and
distribution of ACTs at country level to date,"
said Dr
Prudence Hamade, head of the MSF malaria working group.
" In addition, the Global Fund is a pure funding agency and
has not been able to help countries with the actual ACT implementation
process."
Out of the $208 million allocated by the Global Fund for ACTs since
2002, only about 30% has actually been used for procurement of this
recommended treatment.
" Without rapid steps to ensure that effective drugs actually
reach the people who need them, governments' decisions remain virtual
and end up having no meaning for those who were supposed to benefit
from them," said Dr Karim Laouabdia, Director of MSF's Campaign
for Access to Essential Medicines.
" Giving patients chloroquine against malaria is about as
effective as giving them a bag of sugar - medically and ethically,
it is just
wrong. We know implementing ACTs is no easy task, but no-one should
be allowed to drag their feet in making sure these life-saving drugs
get to all those who need them."
After some supply problems, companies are now producing ACTs. New
fixed-dose combination treatments will be available by the end of 2006,
with clear benefits to patients, such as a smaller pill count. There
is no excuse not to act now.
In 2005, MSF treated approximately 1.8 million malaria patients in
40 countries in Africa, Asia and Latin America. MSF has been advocating
for ACTs since 2001 and uses them consistently in its programmes worldwide.
Malaria is a parasitic disease that is spread by mosquitoes and kills
over one million people a year, mostly in Africa.
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those of IvyRose Ltd.. Material in this news item was released
by Médecins Sans Frontières (MSF) on 21 April 2006.
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