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[afro-nets] Malaria drug for the poor "a bad idea"

  • From: "Claudio Schuftan" <claudio@hcmc.netnam.vn>
  • Date: Thu, 12 Apr 2007 06:24:29 +0700

Malaria drug for the poor "a bad idea"


Malaria drug for the poor "a bad idea"

By Andrew Jack in London

Published: April 9 2007 17:04 | Last updated: April 9 2007 17:04

Innovative plans to subsidise malaria drugs to make them more affordable for the poor will be counter-productive and should be abandoned, the outgoing head of the world?s largest multilateral funder of projects to fight infectious disease has warned.

Sir Richard Feachem, who stepped down from the Global Fund to fight Aids, TB and Malaria last month, said a ?high-level? malaria subsidy under development with World Bank support risked failing to reach those for whom it was intended and even worsening the incidence of malaria. He said it would undermine pharmaceutical innovation and distract political commitment.

His comments came at the end of his five-year contract with the Fund, which he has built into an organisation with more than $10bn in donor pledges to support treatment and prevention programmes that tackle the most lethal infectious diseases around the world.

Significant new hope in the fight against malaria â?? which kills more than 1m people a year â?? has come recently via the launch of highly effective combination drugs based on artemisinin, a Chinese medicinal herb, to which the parasite has little resistance.

However, the relatively high cost of the drug compared with existing less effective anti-malarials prompted Kenneth Arrow, the US Nobel prize-winning economist, two years ago to propose a ?high-level subsidy? for malaria, designed to reduce substantially the raw material costs and to persuade the poor to use it.

The Bill and Melinda Gates Foundation gave a $4m grant to study the feasibility of the idea to the World Bank, which has since sub-contracted to specialist consultants an analysis of how the scheme would work.

Earlier this year the Dutch government, strong backers of the proposal, hosted a technical meeting to discuss progress in Amsterdam, and British officials have also been involved in talks that could lead to a $300m annual subsidy being launched by early next year.

However, a recent internal position paper by the Global Fund argued that even with the subsidy, the price would remain unaffordable for many consumers, who may start treatment and then drop it, triggering drug resistance and a further increase in the number of victims of malaria.

It also argued that advocates for the subsidy had attempted to create the impression of consensus in favour, when serious criticisms had not been addressed. ?It?s not just getting the design right ?we should not be doing it,? said Sir Richard.

Defenders of the malaria subsidy argue there is a need for greater involvement of the private sector, given that most people in the developing world buy their drugs commercially whereas the Global Fund?s programme predominantly gives money to government and non-profit groups.

Michel Kazatchkine, a French doctor and Aids specialist, took over from Sir Richard this month. In addition to the malaria issue he has to address relations with Unitaid, a French-led initiative to support drug purchases for infectious diseases.

Claudio Schuftan