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This article is from the In-Depth Report A Guide to Malaria

Money for cheaper herb-based malaria meds

malaria, Affordable Medicines Facility for Malaria, AMFm, Global Fund to Fight AIDS, Tuberculosis and Malaria, artemisinin, Coartem A subsidy program intended to drive down the cost of lifesaving malaria drugs called artemisinin-based combination therapies—now considered the most effective treatment against the parasitic disease—was unveiled today in Norway.

The program, a partnership between nonprofits, the Global Fund to Fight AIDS, Tuberculosis and Malaria and 30 governments, could lower the cost of the treatment, whose main ingredient is a Chinese herb, to between 20 and 50 cents.

Right now, the therapy costs $6 to $10 at the roadside shops where remote villagers purchase the meds, according to the new project, the Affordable Medicines Facility for Malaria (AMFm). The first 11 countries where the discounted meds will be available are Benin, Cambodia, Ghana, Kenya, Madagascar, Niger, Nigeria, Rwanda, Senegal, Tanzania and Uganda.

“The age when the world had effective drugs against infectious diseases but let millions die each year because they couldn’t afford them is over,” Norwegian Foreign Minister Jonas Gahr Støre said in a statement launching the effort today.

The subsidy program was recommended five years ago by the Institute of Medicine (IOM), a U.S. advisory panel, as the best way to make artemisinin-based combination therapies available in poor countries where drug resistance to the Chinese herb is a threat. (One of those drugs, Coartem, was approved by the Food and Drug Administration last week for sale in the U.S; the World Health Organization has approved Coartem and several other artemisinin-combo treatments for purchase by U.N. agencies.)

Combination treatments are considered more effective than artemisinin alone, which stays in the body for only a few days. The additional med sticks around longer, destroying any remaining malaria parasites and lowering the chance that they'll develop resistance to artemisinin itself. But patients sometimes buy stand-alone forms of artemisinin because it's cheaper—a worry for public health officials concerned about resistance to the treatment.

AMFm says the subsidy ($225 million to $233 million in the first two years) also is necessary because the new artemisinin-combo drugs cost 10 to 40 times more than older ones, such as chloroquine, to which malaria has become resistant.

The U.S. isn't kicking any money into the program because of concerns that the subsidized meds are sometimes misused in patients who are feverish but don't have malaria, making such projects a waste of money, according to the New York Times. "I sometimes joke that this is the biggest faith-based initiative in the world of malaria," Bernard Nahlen, deputy coordinator of the President’s Malaria Initiative (an interagency project to expand U.S. funding of overseas malaria projects), told the newspaper. "I’m perfectly willing to be convinced, but sometimes the advocacy gets out ahead of the evidence."

An estimated 350 million to 500 million cases of malaria occur each year, killing nearly a million children annually, mostly in sub-Saharan Africa and Asia.

Read more about how the herb beats malaria in our Ask the Experts piece on artemisinin.

Image of boy waiting for malaria test results in Tanzania by DVIDSHUB via Flickr

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