Written by Henry Neondo
African governments should begin looking inwards to raise funds needed to fight malaria, a disease that still kills an African child every 45 seconds Dr Nathan Mulure, Novartis Pharma, Nairobi told participants at the first African Science Journalist Conference going on in Nakuru, Kenya.
According to Dr Mulure, donor funding has become unreliable adding that the only sustainable way in the fight against the disease that is caused by a parasite (Plasmodium falciparum) and transmitted by mosquitoes is through raising local funds.
Dr Mulure pointed to Tanzania, Zambia and South Africa as countries in Africa who have shown that it is possible for governments to set aside budgets within their own resources to wage war against malaria.
He said that although African governments may be looking to the West for support, yet, malaria is still an African problem and the solution to it lies within the continent.
According to Dr Mulure, although Malaria is preventable and treatable, yet nearly 800,000 lives are lost to the disease every year, mostly children under 5 years old and pregnant women.
He said 80 per cent of the 300-500 million clinical cases per year are reported in Africa and that 90 per cent of the estimated 1 million deaths per year occur in Africa.
He said most of the older treatments (e.g. chloroquine) are no longer effective anymore because of resistance.
Yet global mechanisms such as the Affordable Medicines Facility – an innovative financing mechanism designed to expand access to the most effective treatment for malaria, artemisinin-based combination therapies (ACTs) ends at the end of the year due to lack of funds.
Through the facility, the Global Fund, as host and manager of the AMFm, has negotiated with drug manufacturers to reduce the price of ACTs, and to require that sales prices must be the same for both public and private sector first-line buyers.
As a result, private importers now pay up to 80 percent less than they did in 2008-2009. The Global Fund pays most of this reduced price (a ‘buyer co-payment’) directly to manufacturers to further lower the cost to eligible first-line buyers of ACTs purchased from manufacturers.
This means that first-line buyers only pay the remainder of the sales price for the ACTs. First-line buyers are expected to pass on the highest possible proportion of this price benefit so that patients are able to buy ACTs across the public, private, not-for-profit and for-profit sectors at prices that are less than those of oral artemisinin monotherapies and competitive with the prices of CQ and SP.
AMFm Phase 1 which is set to end this year, is being implemented through nine pilots in eight countries: Cambodia, Ghana, Kenya, Madagascar, Niger, Nigeria, Tanzania (including Zanzibar) and Uganda.esides the challenge of funding.
Dr Mulure added that the issue of poor quality drugs, emergency of resistance to available drugs and long and complicated supply and procurement chain as well as lack of accurate data especially in the private sector are still challenges that those leading the war against Malaria still contend with.
Innovations and partnership
Dr Mulure however cited some few innovative ways countries have adopted to record some noted successes against malaria. "Coupled with global partnership, winning the war against malaria appears achievable," he noted.
Countries such as South Africa, Tanzania, Jamaica, Madagascar, Zanzibar, Rwanda and Kenya have seen malaria incidents drastically reduced by use of indoor residual sprays, distribute insecticide treated bednets, early diagnosis of suspected cases as well as treat identified cases with artemisinin combination therapy.
A participant from Zimbabwe said his country has adopted such mechanism as levying every working person some tax that is spent to fighting diseases such as HIV.
Tanzania's sms for life programme—which brings together mobile phone provider, IBM, Novartis and other partners and uses mobile phones to track weekly stock outs of ACTs and quinine in rural health--is proving a success and many countries are thinking copying the programme in bid to heighten their efforts in eliminating malaria.