July 7, 2014

After what appeared to be a floundering start, the international community’s efforts to reduce malaria infections and deaths in Africa are finally gaining track.

In 1998 the World Health Organization, UNICEF and a consortium of donors including NGOs and financial institutions launched a program called Roll Back Malaria, a campaign that aims to cut malaria infections and deaths in half by 2010 and effectively eliminate malaria deaths by 2015. However, inadequate funding, ineffective anti-malaria drugs in Africa and bad planning and leadership led to what the program’s critics dubbed “medical malpractice.”
Since then, the campaign has gotten its act together.

The three main pillars of the campaign—access to insecticide-treated mosquito nets, indoor insecticide spraying in heavily affected areas and treatment with artemisinin-based drugs known as ACTs—show improvements in all three.

Funding for global anti-malarial efforts is also up and seems likely to remain the same.

The Global Fund to Fight AIDS Tuberculosis and Malaria has disbursed nearly $1.7 billion for malaria programs. The United States has committed over $1.2 billion for anti-malaria programs in several African countries. The World Bank too has stepped up by offering billions in loans and grants.

The growth in spending on anti-malaria efforts reflects increased funding for public health in Africa by governments and donors.

Pharmaceutical companies like Novartis are developing and offering affordable and effective antimalarial drugs to patients in Africa.

Novartis said it plans to offer a new antimalarial drug called Coartem that will treat uncomplicated malaria disease in adults and children over the age of 12 years in Kenya.

According to data, malaria costs Africa an average of $12 billion in lost GDP every year, accounting for about 40 percent of public health expenditures and 40 percent of hospital admissions. In some African countries the disease is blamed for reducing growth rates by as much as 1.3 percent.

About 90 percent of the estimated 300 million cases of malaria annually occur in Africa, accounting for nearly 900,000 deaths each year–mostly among children.

The new drug cuts in half treatment time for the malaria disease and has already been made available to patients in Uganda, Ghana, Nigeria and Angola. It offers fewer tablets, a convenient solution for patients with busy lives. The full course of treatment for malaria has been reduced from 24 tablets to six tablets translating into a 75 percent reduction in pill burden. Patients are able to recover in less time. Kenya is the latest country in Africa to receive the drug.

Novartis worked with WHO to develop a child-friendly medication, the Coartem Dispersible. Dispersible tablets easily break up in water, are sweet and easy to take.

Kenya is thus one of the largest recipients of Coartem.

Coartem is the only FDA-approved ACT in the United States and the first one to be approved by the European Medical Evaluating Agency (EMEA).

According to the World Bank, and recent data indicates a sharp decline in malaria cases.
According to the Kaiser Family Foundation in Washington D.C., development aid earmarked for health nearly tripled between 2001 and 2006, from $7.2 billion to $20.1 billion globally. About a third of that money was directed to Africa.

African governments have also begun to invest more in health, using savings from debt relief and increased budgetary allocations, although only a handful of countries invest more than 5 percent of their annual budgets to health care.

Most analysts say growth in Africa’s health sector is likely to be strong over the next few years in response to the increased spending and as pressure builds on both donors and recipient governments to meet the 2015 deadline for the ambitious health targets set by the internationally agreed Millennium Development Goals.

The boost in health spending is also creating some significant synergies.

Farmers in Uganda, Tanzania and Kenya have began commercial production of the plant from which artemisinin is produced. Although the plant is native only to China and Vietnam it has flourished in Africa–with 4,000 smallholder farmers producing enough for 22 million doses last year. With 3.3 billion people in 109 countries at risk of malaria globally and demand for artemisinin skyrocketing, Africa is poised to emerge as a major supplier as well as the largest consumer of the drug.