[Effects on Health] Malaria treatment still elusive to most

from Reuters Alert Net

By Laura MacInnis

GENEVA, April 24 (Reuters) - Most of the world's millions of malaria sufferers are not getting life-saving drugs nearly five years after the World Health Organisation urged their widespread use, despite a huge boost in aid, health experts said on Monday.

The U.N. health agency has since 2001 recommended countries switch to artemisinin-based combination drugs -- known as ACTs -- to treat malaria because the deadly mosquito-borne infection had become resistant to conventional medicines like chloroquine.

While 34 African countries have committed to using ACT therapies, the Roll Back Malaria Partnership group said only 17 use the medicines in their health systems.

Of these, just 4 are distributing the drugs on a national scale, it said, while most of those who catch the disease are still treated with cheaper, less effective drugs.

Malaria kills more than one million people each year, mainly in Africa where a child dies from the disease every 30 seconds.

Fragile health systems, including poor training for doctors and nurses, slow drug procurement and delivery kinks from weak infrastructure are partly to blame for slow adoption rates, Maryse Dugue of Roll Back Malaria told a Geneva conference.

Dugue said while the Global Fund to Fight AIDS, Tuberculosis and Malaria had provided large sums to help countries shoulder the cost of the more expensive ACT treatments, the short-term nature of those grants was worrying for some.

"Some countries have some reticence about changing their drug programmes," she said. "There is a need to find stable, long-term sources of financing (for ACT drugs)."

The Global Fund, launched in 2002, makes up about two thirds of worldwide financing to prevent and treat malaria, and is the main financier of developing countries' scale-up of ACT drugs.

Its executive board meets this week in Geneva to decide on whether to launch a sixth round of grants in what observers say is a key juncture for the young development financier as it decides its future size and ambition.

Bernard Nahlen, a senior advisor at the Global Fund, said there was a wide sense the board would launch a fresh round of programmes despite lacking the donations to cover the approximate $1 billion which would be needed for the grants by year's end.

"It will be surprising if there is not a Round 6," he said.

The non-profit medical organisation Medicins Sans Frontieres last week estimated that only 30 percent of Global Fund money allocated for ACT treatment since 2002 has been used for procurement of the drugs.

While not commenting on specific figures, Nahlen described countries' slow adoption of new malaria drugs as a frustration for the institution.

"The Global Fund is only going to be as successful as the political leadership, the civil society and other partners at the country level are in delivering these goods," Nahlen said.

"Frankly, in some countries there are ACTs sitting in warehouses, and there are other countries who have the financing and have not even put their orders in yet," he said.

Other health experts said it was normal for countries to take time to shift from one drug treatment program to another.

Peter Olumese of the WHO's Global Malaria Programme said ACT drug adoption was an ongoing, if slow, process.

"Countries are not moving as fast as we would expect them to, but they are moving," he said.