Following the significant gains in the fight against malaria over the past decade, future efforts must be more targeted if progress is to be maintained, UNITAID warns.
According to the World Health Organization (WHO), between 2001 and 2010, 1.1 million deaths and 274 million cases of malaria were averted thanks to the scale-up of global anti-malaria efforts, including greatly improved access to the most effective treatments available, the artemisinin-based combination therapies (ACTs). Efforts are now focused on ensuring that these treatments are used appropriately by correctly and rapidly diagnosing true cases of malaria amongst other causes of fevers, and by providing prompt and effective treatment of severe malaria to significantly reduce death and disability. UNITAID’s support gives priority to projects that aim to improve access to malaria diagnosis and to improve access to effective malaria treatment.
Access to ACTs globally increased from 11 million treatments in 2005 to 278 million treatments in 2011, through large ACT scale-up initiatives including the Affordable Medicines Facility for malaria (AMFm) largely funded by UNITAID. In spite of these advances in diagnosis and treatment of malaria, severe malaria remains a significant challenge. It affects 8 million people each year, mostly young children in Sub-Saharan Africa. In response, UNITAID is making up to US$ 34 million available to the Medicines for Malaria Venture (MMV) to accelerate the adoption of injectable artesunate (for patient treatment in medical facilities) and rectal artesunate (for in-home and community pre-referral treatment), the best treatments for very sick children. Through this investment, UNITAID expects to improve access to these life-saving treatments for the severest cases of the disease.
“With artesunate treatments we are better able to treat severe malaria,” said Dr Denis Broun, Executive Director of UNITAID. “Currently access to these treatments is very limited and this contributes significantly to the high death rate from severe cases, especially in children.”
It is now understood from some studies that many fever episodes in malaria-endemic areas are not caused by malaria, whereas more than 80% of patients with fever are still treated for malaria without a confirmatory diagnosis. “We must be much more accurate in case management, both to ensure that we treat the true cause of fevers, and to ensure the rational use of malaria medicines,” continued Dr Broun. “Diagnosis and correctly targeted treatment of malaria will help to prevent resistance to antimalarial medicines and also will accelerate diagnosis and improve the treatment of patients with other causes of fever such as pneumonia.”
Simple and rapid malaria diagnostic tests (RDTs) are now available and can be used at the community level, in peripheral health facilities, and in both the public and the private sectors to ensure proper diagnosis and targeted treatment for malaria. In January 2013, UNITAID granted The Foundation for Innovative and New Diagnostics (FIND) US$ 9.4 million to expand access to quality control for RDTs thereby ensuring that the malaria RDTs being used give accurate results. Portable, affordable and easy to use, malaria RDTs can detect the presence of the malaria parasite in a tiny drop of blood and give results in under 25 minutes. This grant complements UNITAID’s 2012 US$ 34.4 million commitment to increase access to RDTs in the private sector in five target countries in Africa.
Beyond 2013, UNITAID will continue to identify high-impact investment opportunities to improve access to better products for the prevention, diagnosis and treatment of malaria.
UNITAID (www.unitaid.eu) is a global health initiative launched in 2006 by the Governments of Brazil, Chile, France, Norway and the United Kingdom to provide sustainable funding for the fight against HIV/AIDS, malaria and tuberculosis. About 70% of UNITAID’s funds come from a small levy on airline tickets. Through implementers, UNITAID finances the purchase of quality-assured drugs and diagnostics for patients in poor countries, using its market power to expand supply, promote development of new and better products, cut delivery lead times and reduce prices.