[Ip-health] Financial Times: Malaria drug for the poor ' a bad idea'

[Thiru Balasubramaniam]

<SNIP>

Michel Kazatchkine, a French doctor and Aids specialist, took over from
Sir Richard this month. In addition to the malaria issue he has to
address relations with Unitaid, a French-led initiative to support drug
purchases for infectious diseases.


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Malaria drug for the poor =91a bad idea=92

By Andrew Jack in London

Published: April 9 2007 17:04 | Last updated: April 9 2007 17:04

Innovative plans to subsidise malaria drugs to make them more
affordable for the poor will be counter-productive and should be
abandoned, the outgoing head of the world=92s largest multilateral funder
of projects to fight infectious disease has warned.

Sir Richard Feachem, who stepped down from the Global Fund to fight
Aids, TB and Malaria last month, said a =93high-level=94 malaria subsidy
under development with World Bank support risked failing to reach those
for whom it was intended and even worsening the incidence of malaria.
He said it would undermine pharmaceutical innovation and distract
political commitment.

His comments came at the end of his five-year contract with the Fund,
which he has built into an organisation with more than $10bn in donor
pledges to support treatment and prevention programmes that tackle the
most lethal infectious diseases around the world.

Significant new hope in the fight against malaria =96 which kills more
than 1m people a year =96 has come recently via the launch of highly
effective combination drugs based on artemisinin, a Chinese medicinal
herb, to which the parasite has little resistance.

However, the relatively high cost of the drug compared with existing
less effective anti-malarials prompted Kenneth Arrow, the US Nobel
prize-winning economist, two years ago to propose a =93high-level
subsidy=94 for malaria, designed to reduce substantially the raw material
costs and to persuade the poor to use it.

The Bill and Melinda Gates Foundation gave a $4m grant to study the
feasibility of the idea to the World Bank, which has since
sub-contracted to specialist consultants an analysis of how the scheme
would work.

Earlier this year the Dutch government, strong backers of the proposal,
hosted a technical meeting to discuss progress in Amsterdam, and
British officials have also been involved in talks that could lead to a
$300m annual subsidy being launched by early next year.

However, a recent internal position paper by the Global Fund argued
that even with the subsidy, the price would remain unaffordable for
many consumers, who may start treatment and then drop it, triggering
drug resistance and a further increase in the number of victims of
malaria.

It also argued that advocates for the subsidy had attempted to create
the impression of consensus in favour, when serious criticisms had not
been addressed. =93It=92s not just getting the design right =96 we should n=
ot
be doing it,=94 said Sir Richard.

Defenders of the malaria subsidy argue there is a need for greater
involvement of the private sector, given that most people in the
developing world buy their drugs commercially whereas the Global Fund=92s
programme predominantly gives money to government and non-profit
groups.

Michel Kazatchkine, a French doctor and Aids specialist, took over from
Sir Richard this month. In addition to the malaria issue he has to
address relations with Unitaid, a French-led initiative to support drug
purchases for infectious diseases.



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Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International (KEI)
voice +41.22.791.6727
fax +41.22.723.2988
mobile +41 76 508 0997
thiru@keionline.org