Thanks to WHO effective combo malaria therapy will be de-rigueur

May 15 2006

Following pressure from the World Health Organization (WHO), 13 pharmaceutical companies have agreed to comply with their recommendation that single-drug artemisinin medicines for the oral treatment of malaria need to be phased out.

The group of 13 includes the main producers of high quality artemisinin monotherapies.

The companies have agreed to now focus their marketing efforts for malaria primarily on artemisinin combination therapies (ACTs), in line with WHO advice.

It has been found that the use of single-drug artemisinin treatment, or monotherapy when used on a wide scale especially, only serves to accelerate the development of resistance to artemisinin in malaria parasites, which is self-defeating.

However when used correctly in combination with other anti-malarial drugs in ACTs, artemisinin is as close as 95% effective in curing uncomplicated malaria and the parasite is highly unlikely to become drug resistant.

At the start of the year the WHO appealed to all companies to refrain from marketing oral artemisinin monotherapies and to re-direct their production efforts towards ACTs.

After the January appeal, an additional 23 companies were identified and informed of the WHO's recommendation and 13 companies said they would comply with the WHO guidance.

Other companies have also said they are willing to collaborate in this particular initiative.

Dr. Lee Jong-wook, WHO director-general says the organisation has seen significant progress in curbing the supply of inappropriate and clinically unsound malaria treatments in the last three months, which is due to determination.

He says the WHO now wants to see a complete transition to the provision of WHO-recommended combination therapies, in order to preserve the efficacy of such life-saving treatments.

The WHO has promised to closely monitor those companies that have not yet declared their intention.

The organization is prepared to provide guidance to companies manufacturing ACTs that are seeking prequalification of their products, a process that involves meeting internationally agreed standards of efficacy, safety and quality.

The WHO has also called on national drug regulatory authorities in malaria-endemic countries to prohibit marketing of oral artemisinin monotherapies.