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Prices of antimalaria drugs to drop by 80% …under new $343m public-private initiative

By Sola Ogundipe

NIGERIANS and their counterparts within sub-Sahara Africa and Asia are just a step away from having full access to cheaper  and more effective antimalaria drugs.

The development is being made possible courtesy of a collaboration between the Global Fund and six manufacturers of quality-assured malaria drugs who have have finalised agreements to place affordable life-saving malaria drugs within reach of millions of people in need the world over, especially children.

UNITAID, Government of the United Kingdom and the Bill & Melinda Gates Foundation are  financiers of a US$216 million co-payment fund to be used for the global subsidy. In addition, the Global Fund will spend about US$127 million on country-level activities to support the agreement.

The public- private collaboration, is a part of the Affordable Medicines Facility-malaria (AMFm) Phase 1,  and is earmarked in nine pilots in  Cambodia , Ghana , Kenya , Madagascar, Niger, Senegal, Tanzania,  Uganda  and Nigeria. After two years, providing it is successful, a decision will be taken on whether to expand it globally.

Bill Gates during one of his visits to Nigeria. The Bill & Melinda Gates Foundation is collaborating with UNITAID, Government of the United Kingdom and others to fund the project.

Good Health Weekly gathered that under the agreements, private importers will now pay up to 80 per cent less than they did in 2008-2009 for the most effective malaria drugs (artemisinin-based combination therapies – ACTs), bringing the factory gate prices down to the same level as for public sector buyers.

The AMFm will then subsidise purchases made by first-line buyers, all of whom have signed an undertaking to pass the benefit of low prices down the supply chain, thereby enabling the roughly 60 percent of malaria patients who obtain treatment in private shops to obtain the most effective treatments at affordable prices.

Currently ACTs make up only 5 percent, but orders of treatments provided through the private sector. Orders of ACTs at these more affordable prices have already begun.

According to reports, the six manufacturers that have signed Master Supply Agreements with the Global Fund under the AMFm are: Ajanta Pharma, Cipla, Guilin , Ipca, Novartis and Sanofi-aventis – all pharmaceutical companies meet the Global Fund’s quality criteria for supplying ACTs to first-line buyers under the AMFm. While other manufacturers may participate in the AMFm, provided that they meet the quality criteria.

The Clinton Health Access Initiative (CHAI) negosupply chain; and supporting activities to promote appropriate use of ACTs.

By working through the public, NGO and private sectors, AMFm will help to expand services beyond the reach of current financing mechanisms that work mostly through the public and NGO sectors.

During the last few years new, effective malaria medicines have been made available for free in many public health clinics. When combined with national campaigns to provide mosquito bed-nets for every family living in areas with malaria this has led to a dramatic fall in malaria deaths in several countries in Africa . The combination of bed nets to prevent malaria transmission and drugs that cure malaria quickly has reduced malaria deaths by  50 -90 percent  in areas where both are widely available.

However, because most people do not have immediate access to public health facilities they buy their drugs at local market stalls and private pharmacies. Artemisinin-based combination therapies or ACTs, are about 10 – 40 times more expensive when sold over the counter than the old drugs which have lost their effectiveness because the malaria parasite has developed resistance to them. As a result of the high cost, many still buy these cheaper less effective drugs and currently, only one in every five patients treated for malaria has access to ACTs.

The AMFm was developed through the Roll-Back Malaria programme– a broad partnership of public and private institutions, including the World Bank, UNICEF, the Global Fund, WHO, and the Bill and Melinda Gates Foundation.


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