Funding and distribution of inappropriate drugs add to rising global childhood mala...( 'Institutional inadequacies' of the Wor...),Health

'Institutional inadequacies' of the World Health Organization (WHO) and the Global Fund for Aids, tuberculosis, and Malaria (GFATM) have created a crisis which is leading to increased malarial deaths in children and will contribute to the failure of WHO's 1998 'Roll Back Malaria' campaign to halve deaths from malaria by 2010, conclude authors of an article in this week's issue of THE LANCET.

At least a million deaths are caused by malaria every year, principally among children, all of which could be saved by effective treatment. The ability to do this is undermined by drug resistance in Plasmodium falciparum (the deadly species of the disease) to conventional treatments such as chloroquine, sulfadoxine-pyrimethamine, or the combination of these drugs. The rise of drug resistance is the leading cause of the global increase in childhood malarial deaths. Recent evidence suggests that a new, highly effective treatment known as artemisinin-class combination therapy (ACT) offers more hope for treating malaria in countries where drug resistance to conventional drugs has become widespread. For that reason, ACT is now officially the global policy for treating drug resistant malaria according to WHO.

However, international health scholar Amir Attaran from the Royal Institute of International Affairs and colleagues from Africa, Asia, and Europe, document numerous cases where WHO is violating its own policy. The article states: 'Most African countries reluctantly cling to chloroquine, sulfadoxine-pyrimethamine, or the insignificantly better combination of chloroquine and sulfadoxine-pyrimethamine, because ACT is ten times more expensive and, therefore, unaffordable to them. When those same countries seek financial aid from GFATM to purchase ACT, they are forcefully pressured out of it by governments such as the USA, whose aid officials say that ACT is too expensive and "not ready for prime time". WHO acquiesces to this pressure to cut costs, and despite a polic
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
15-Jan-2004

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