Plea for free malaria drugs to curb counterfeits, resistance

The most effective treatment for malaria should be provided free of charge to ensure courses are completed and "remove the vulnerable from the clutches of counterfeit drugs," according to two prominent experts in the anti-infectives field.

Patricia Schlagenhauf-Lawlor of Zurich University in Switzerland and Eskild Petersen of Aarhus University Hospital in Denmark make the plea in the latest edition of the journal Expert Reviews in Anti-Infective Therapy.

They note that resistant malaria parasites pose a major public health threat, citing recent research indicating that resistance to the most effective drug regimen for the disease - artemisinin-based combination therapy (ACT) is emerging in southeast Asia.

"Although new antimalaria compounds are in the pipeline, no new drug is likely to be able to replace artemisinins in the near future," write Schlagenhauf-Lawlor and Petersen.

Counterfeiting is a major contributor to the problem, but other factors include the use of artemisinin drugs, such as artesunate, as a monotherapy rather than in combination with other drugs.

The solution could be to make ACT available to patients free of charge, to destroy the market for counterfeits and avoid patients failing to complete a course of treatment because they cannot afford the medicine.

Malaria affects 250 million people a year around the world and kills one million. Spread of resistance to the most severely-affected areas, particularly Africa where one in five children dies from the disease, could have devastating consequences.

"Free artemisinin combination treatments may be a cheap price to pay for preserving an effective antimalarial treatment," they conclude.

References:

Expert Rev. Ant Infect. Ther. 7(9), 1039-1042 (2009)