Friday, April 24, 2009

More on Malaria...

In continued celebration of World Malaria Day--

http://www.nytimes.com/2009/04/18/world/18malaria.html?_r=1&scp=2&sq=malaria&st=cse

On April 17, nytimes.com covered a new campaign--Affordable Medicines Facility for Malaria-- that aims to substantially cut Malaria drug costs for the developing world. 

The campaign plans to pressure (and help subsidize) drug companies currently manufacturing Artemisinin combination drugs (see http://en.wikipedia.org/wiki/Artemisinin) until the drugs are affordable to developing-world consumers over less-effective, but cheaper, alternatives like Choloroquine, to which many malaria strains have become resistant. Currently, Artemisinin combination drugs cost 10 to 40 times more than Chloroquine.

The Global Fund, the Roll Back Malaria Partnership, and Unitaid; along with Norway, Britain, and the Netherlands, are spearheading the effort. 

The US has not yet given its support, arguing that "the advocacy [has gotten] out ahead of the evidence." The deputy coordinator of the President's Malaria Initiative, Dr. Bernard Nahlen, called for more studies showing that this type of effort would work before the US would join the campaign.

I understand why the US is reluctant to put money into something relatively new and unknown. As the article points out, better and more widespread Malaria diagnostics may be a key issue to deal with before turning to treatment: there's evidence that, in many parts of the world, fearful patients overdiagnose malaria and end up using drugs when they may not actually need them. (If this were to happen with new multi-drug therapies, could it contribute to increased resistance?). 

On the other hand, If Obama truly means to meet his ambitious 2015 goal, I'm not sure he has time to wait around. He may need to accept this bolder effort (and many more like it) as a real-world laboratory for the "further research" he seeks; and let go of plans for more cautious study.

-Anne



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