[Ip-health] MSF paper says new global subsidy for malaria medicines must ensure quality of care

[Leyla.POPE@geneva.msf.org]

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AMFm - New global subsidy for malaria medicines must ensure quality of care=
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Geneva - 21 July 2009 - A new drug subsidy designed to increase access to=
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life-saving malaria treatment must remain focused on quality patient care=
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if it is to succeed, according to a paper published by M=C3=A9decins Sans=
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Fronti=C3=A8res (MSF) authors in this week=E2=80=99s open access journal PL=
oS Medicine.=0D
The subsidy, called the Affordable Medicines Facility - malaria (AMFm),=0D
will be rolled out in 2009 and plans to address concerns of poor access to=
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artemisinin-based combination therapies (ACTs) for malaria, currently the=
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most effective treatment that exists. The authors cite a recent household=
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survey across 18 African countries that found only about three percent of=
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children under five years with fever had received an ACT.=0D
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In order to enhance quality of care, the paper argues that the AMFm should=
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adopt policies to exclusively fund fixed-dose combinations, withhold=0D
support for ineffective combinations, and support wider adoption of rapid=
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diagnostic tests (RDTs). The authors also demonstrate how generic=0D
competition has already significantly reduced the price of antimalarials=0D
over time.=0D
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=E2=80=9CThe AMFm is an innovative but untested global initiative with the=
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potential for both positive and unintended consequences for health,=E2=80=
=9D says=0D
one of the authors, Dr von Schoen-Angerer, Director of MSF=E2=80=99s Campai=
gn for=0D
Access to Essential Medicines. =E2=80=9CKeeping the focus on quality care -=
 through=0D
patient-centred policies on fixed-dose combinations, increased access to=0D
rapid diagnostics, delivery, and monitoring of real impact for people -=0D
will help the AMFm to meet the long unfulfilled promise of artemisinin for=
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those who continue to suffer from malaria today.=E2=80=9D=0D
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The AMFm aims to address inadequate access to ACTs for treating P.=0D
falciparum malaria by subsidising producer prices. First proposed in 2004,=
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the facility aims to lower end-user prices to the level of older=0D
antimalarials, making ACTs more affordable and delaying resistance to=0D
artemisinin derivatives by driving artemisinin monotherapy and substandard=
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antimalarials out of the market.=0D
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The AMFm is hosted by the Global Fund to Fight AIDS, Tuberculosis, and=0D
Malaria and 11 countries have been invited to participate in the initial=0D
phase: Benin, Cambodia, Ghana, Kenya, Madagascar, Niger, Nigeria, Rwanda,=
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Senegal, Tanzania, and Uganda.=0D
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MSF treats malaria in its programmes around the world and treated close to=
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1.2 million malaria cases in 2008. MSF was an early proponent of ACTs, and=
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started using them in its projects in Africa in 2001.=0D
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The article, =E2=80=9CFocusing on Quality Patient Care in the New Global Su=
bsidy=0D
for Malaria Medicines=E2=80=9D, is freely available from the open access jo=
urnal=0D
PLoS Medicine at:=0D
medicine.plosjournals.org/perlserv/=0D
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For more information, please contact:=0D
Guillaume Bonnet, Press Officer, +41 79 203 13 02=0D
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Artemisinin-based combination therapy =E2=80=94 ACT=0D
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The best current treatment is a combination of drugs that includes=0D
artemisinin derivatives, extracts of a Chinese plant, Artemisia annua.=0D
Artemisinin derivatives should not be used alone, but always with a=0D
companion drug such as amodiaquine. A combination of drugs with independent=
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modes of action and different biochemical targets is not only more=0D
effective, but also successful in preventing or slowing the development of=
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resistance, because the probability of parasites being simultaneously=0D
resistant to two drugs is greatly reduced. Combining artemisinins with a=0D
companion drug shortens the treatment course to three days.=0D
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How FDCs can protect artemisinins=0D
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When provided in co-blisters, where two different drugs are packaged=0D
together but not combined in the same pill, there is the risk that patients=
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take only one of the drugs, which greatly increases the risk of resistance=
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developing. Fixed-dose combinations (FDCs), where the drugs that need to be=
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taken together are combined into a single pill, lead to better patient=0D
adherence and reduce the risk of drug resistance.=0D
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Leyla Pope=0D
Communications Officer=0D
M=C3=A9decins Sans Fronti=C3=A8res=0D
Campaign for Access to Essential Medicines=0D
Tel. + 41(0) 22 849 89 88