Donors ready to subsidise new malaria drug


Published: December 26 2005 22:22 | Last updated: December 26 2005 22:22

International organisations are backing a pioneering subsidy programme that
could make a new generation of malaria medicines affordable around the world
from the start of 2007. The World Bank is developing proposals with Roll
Back Malaria, a partnership that includes Unicef, the World Health
Organisation and western and developing nations, for a mechanism to
underwrite widespread use of artemisinin combination therapy (ACT).

Through a “high level global subsidy” of at least $100m a year from aid
donors, officials believe they can make significant progress in stimulating
competition among producers of ACTs and reduce the price to that of far
inferior medicines such as chloroquine.

Olusoji Adeyi, who is leading the project for the World Bank, said: “The
concept is so clear, the real bottleneck is money.”

The move would mark an important boost to flagging efforts to tackle
malaria, one of the world’s leading killer diseases which claims more than a
million lives a year and is on the rise at a time of growing drug
resistance.

The World Bank has prepared a proposal seeking $2.5m over nine months from
the Bill & Melinda Gates Foundation to finalise how the subsidy would work.
The aim is to work within an existing organisation, providing funding to a
procurer such as Unicef, creating a market for drugs companies interested in
manufacturing ACTs.

The initiative builds on recommendations made in 2004 by the US Institute of
Medicine in a group chaired by the Nobel laureate Kenneth Arrow to work
alongside existing competitive drug distribution systems to establish a
“high level subsidy” as the only way to make ACTs widely affordable,
particularly in Africa.

Novartis, the Swiss drug group, has developed the first ACT recommended by
the World Health Organisation, known as Coartem, and has attempted to offer
it at cost to developing nations. Yet at $2.50 per adult treatment, it is
still 10-20 times more expensive than other malaria drugs.
The company has long complained that orders for Coartem – currently placed
country by country – are well below estimates of demand, making it reluctant
to invest too much in scaling up production and building new factories.

Sanofi aventis of France is close to launching a different ACT, but
activists have called for competition from generic manufacturers to bring
down prices further. Prof Arrow conceded that the subsidy mechanism would
have to ensure that its benefits were passed on from manufacturers to
patients, and that it would need to be maintained over many years. “The
programme will encourage producers but the problem is consumers. Africa’s
going to have to become a lot richer before the subsidy is no longer
required.”

A World Bank study last summer estimated that even a relatively small
subsidy injected rapidly would save many lives and slow the development of
drug-resistant malaria.



By Andrew Jack in London

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