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Improving access to good quality drugs is a crucial element of malaria control. Ensuring high standards for medicines as well as medical treatment will be essential in preserving the efficacy of the current first line treatment, Artemisinin-based combination therapy (ACT). Although public funding for malaria control has increased markedly in recent years to approximately $1.3 billion in 2007[1], the majority of Africans in high malaria burden countries access treatment through the private sector. With some exceptions, publicly financed treatment programs have had limited penetration into rural areas of sub-Saharan Africa, where the malaria burden is greatest. General shops, pharmacies and hawkers are ubiquitous resources. Because these outlets are poorly regulated, the quality, price and administration of anti-malarials vary significantly. Drug resistance to artemisinin has already been established in South East Asia and could spread to Africa. The use and misuse of substandard drugs could accelerate parasite resistance to artemisinin, which would be devastating for malaria control.

Much media and advocacy attention has been directed toward new discoveries of antimalarial treatment, and relatively little toward the mechanisms for delivering treatments to those in need. A major exception is the proposed Affordable Medicines Facility--malaria, which has the potential to increase access to medicines and should be commended for targeting the private sector. However, for mechanisms such as this to effectively deliver medicines to those most in need, more targeted research is needed on the market for antimalarials and the business models of general stores and traders in remote rural areas. . . .

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Roger Bate is a resident fellow at AEI.

Notes

1. 14th RBM Partnership Board Meeting Presentations. Executive Director’s Report. Roll Back Malaria Partnership. Available: http://www.rbm.who.int/partnership/board/meetings/ppt/14pbm/14pbm_ed.pdf