The World Health Organization has turned to Africa — where a child dies every 30 seconds from malaria — for urgently needed new stocks of a Chinese plant needed to make a key antimalarial drug, a top official said.
Shortages of artemisinin, the drug’s main ingredient, are threatening the success of the WHO’s program to halve the annual global death toll from malaria, currently one million deaths, by 2010. Tanzania and Kenya have planted artemisia annua, from which artemisinin can be extracted, Fatoumata Nafo-Traore, director of WHO’s Roll Back Malaria Department, said in an interview on Friday. The first harvests are expected in mid-year. “We hope it will be possible to secure at least 20 million treatments from the two projects by the end of this year,” Nafo-Traore, a former health minister of Mali, told Reuters. There are 300 to 500 million cases of the mosquito-borne disease each year in more than 100 countries, with the vast majority of deaths in Africa, south of the Sahara. Malaria is the leading cause of death of African children under five. The United Nations agency has been scrambling to find new producers of artemisinin since Swiss drug maker Novartis announced in November that its traditional Chinese suppliers were unable to deliver sufficient quantities this year. Novartis, which sells its malaria drug Coartem to the WHO at product cost, estimated it would only be able to make around 30 million doses in 2005 — half what the WHO requires. Some 42 countries have declared they are ready to use artemisinin-based combination therapies (or ACT drugs), including Coartem, for some patients because mosquitoes have developed resistance to cheaper treatments such as chloroquine. “We are going all out to see how we can reduce the deficit this year … We cannot afford any shortage in raw materials next year, it would be a mess,” Nafo-Traore said. The group Medecins Sans Frontieres (Doctors Without Borders) has expressed alarm about the supply shortage. “This failure of donors and producers means people are dying unnecessarily,” said MSF’s Daniel Berman. MOST DEATHS IN AFRICA The WHO is trying to extend use of insecticide-treated bednets and recommends use of ACTs. In 2000, African leaders meeting in Nigeria set an interim target — ensuring that at least 60 percent of those at risk of malaria or suffering from it have preventive or curative treatment by 2005. But that target is unlikely to be met in most countries, according to a WHO report last month. “Some of them will be able to reach the target — Eritrea already has … In all countries there are good trends, they are changing their drug policy (to ACTs) and have plans to scale-up intervention,” Nafo-Traore said. Although global funding for malaria has climbed six-fold since 1998 to $400 million last year, more funds were needed to help some of the continent’s larger countries increase treatment coverage. She cited Nigeria, which has 45 million cases a year. In all, the WHO estimates that $3 billion is needed annually, including $2 billion for Africa. (Source: Reuters Health, World Health Orgnisation, February 2005)