Antimalarial Agents in Africa

Another great audio interview in the NEJM this week.

Arrow KJ, Gelband H, Jamison DT. Making Antimalarial Agents Available in Africa. N Engl J Med. 2005 Jul 6

The Africa Malaria Report 2003 prepared by UNICEF shows that Africa's population carries the largest burden of malaria cases in the world, and the barrier to treating those that have the disease is cost. It's no wonder, with Africa being home to come of the poorest of poor in the world. And now, across Africa, malaria has become resistant to chloroquine - the cheaper antimalarial. The alternative - artemisinins which are widely used in Asia, and very expesive by comparison.

The solution propoes by the Institute of Medicine is to "allow subsidies to enter at a high international level — at the top of the distribution chain. ... The drugs would then flow down to the end users through the same pathways as chloroquine now does, with the requisite profit margins being taken where the private sector now operates. If these drugs start at a very low price when they enter the supply chain and if their supply is adequate, the price to consumers should be about the same as the current price of chloroquine."

Read the story, or listen to the interview, it's heartbreaking.