Thalif Deen
UNITED NATIONS, Jan 19 2006 (IPS) – The World Health Organisation (WHO) has strongly criticised 21 pharmaceutical companies for marketing and selling single drug malaria pills that have the potential to develop resistance against one of the most common and serious tropical diseases.
The use of single-drug artemisinin treatment or monotherapy hastens development of resistance by weakening but not killing the parasite, the WHO said Thursday.
The problem has assumed such seriousness that WHO has decided to name names, providing a list of the pharmaceutical companies marketing and selling these malaria pills. These sales should halt immediately, the WHO said.
The 21 pharmaceutical companies identified by name are based in eight developing and industrial countries: China, India, Vietnam, Kenya, Belgium, Switzerland, Ghana and France.
They range from China s Holley Pharmaceuticals Company and India s Cipla, to Dafra of Belgium and Mepha of Switzerland.
We request pharmaceutical companies to immediately stop producing single-drug artemisinin tablets and instead produce artemisinin combination tablets only, Dr Lee Jong-wook, WHO s director-general, told reporters.
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It is critical that artemisinins be used correctly, he said, pointing out that the new treatment guidelines we are releasing today provide countries with clear and evidence-based direction on best treatment options for malaria .
According to the new WHO guidelines, malaria must be treated with artemisinin combination therapies (ACTs), not by artemisinin alone or any other monotherapy.
In a statement released Thursday, Dr. Arata Kochi, the director of WHO s Malaria Department, says: We are concerned about decreased sensitivity to the drug in southeast Asia which is the region that has traditionally been the birthplace of anti-malarial drug resistance.
In Thailand, he said, sulfadoxine-pyrimethanime (SP) was initially considered about 100 percent effective in curing malaria when it was introduced in 1977. But within five years, it was curing only 10 percent of cases due to drug resistance.
The WHO said the once-popular chloroquine has lost is effectiveness in almost every part of the world.
Between 1991 and 2004, 95 percent of African children with malaria were treated with chloroquine, even though the drug eventually was only able to cure half of malaria cases in many countries. Other malaria medicines such as atovaquone developed resistance within one year of introduction, the Geneva-based U.N. agency said.
According to a WHO report on counterfeit drugs, up to 25 percent of drugs consumed in developing countries are substandard. In certain regions of Africa and Asia, this figure exceeds 50 percent.
Our biggest concern right now is to treat patients with safe and effective medication and to avoid the emergence of drug resistance, Kochi said.
If we lose ACTs, we ll no longer have a cure for malaria, and it will be at least 10 years before a new one can be discovered, he warned.
According to the U.S. Centres for Disease Control and Prevention (CDC), malaria is a major international public health concern, causing about 300-500 million infections worldwide and about one million deaths annually, with 90 percent occurring in Africa. Malaria is prevalent in large areas of Central and South America, the Dominican Republic, Haiti, Africa, Asia, Southeast Asia, the Middle East, Eastern Europe and the South Pacific.
The disease is transmitted by an infected female anopheles mosquito primarily between dusk and dawn. The CDC says there is no current vaccine available against malaria but it could be prevented through an appropriate drug regimen and using anti-mosquito measures.
In June 2001, the 191-member General Assembly adopted a resolution creating the Global Fund to Fight AIDS, Tuberculosis and Malaria . The Fund is the largest financier of insecticide-treated bed nets in the world, currently funding some 109 million bed nets to protect families from transmission of malaria.
In the West African country of Niger alone, it has distributed more than two million bed nets. According to the Fund, only two percent of children in Africa sleep under a bed net treated with insecticide.
The Fund is also planning to deliver some 264 million artemisinin-based combination drug treatments for resistant malaria.
To date, the Fund has committed over 4.4 billion dollars in some 128 countries to fight all three diseases.
According to the Fund, malaria has been estimated to cost Africa over 12 billion dollars every year in lost gross domestic product (GDP), even though it could be controlled by a fraction of that sum .
In some areas, malaria parasites have developed resistance to the cheapest and most common drugs used to treat the disease. However, resistance to treatment can be delayed by using therapies that combine different medications, the Fund says.