Arusha — While the country braces to phase out antimalarial drugs currently in use , Sulfadoxine-Pyrimethamine (SP) and Amodiaquine and adopt the new combination therapy treatment, in the effort to fight Africa's biggest killer disease, the Dar-es-salaam-based Shellys pharmaceuticals company launched the first version of this new hybrid antimalarial drug in Arusha over the weekend.

The launching was officiated by the Arusha Regional Medical Officer, Dr. Naftal Ole King'ori and attended by various local physicians, including the In-charge of the Regional Mount Meru Hospital, Dr. Omar Chande, drug store owners, an assortment of other medical practitioners and the medical industry stakeholders.

The new drug which was launched at the Impala Hotel goes by the trade mark of 'Maladar'.This three-day dosage, tablet formatted treatment, is Tanzania's first Artemisinin-based Combination Therapy (ACT), that will soon be replacing the current treatments of Amodiaquine, SP and stand-alone Artemisinin.

However, the medical stakeholders who attended the launch expressed concern that, the government has not yet officially endorsed or gazetted the proposed Combination Therapy alternative, which means despite the introduction of the new drug, they will be compelled to prescribe and sell the already existing anti-malaria remedies.

Dr. Sanjveev Sarkar, the Shelly's production manager explained that he personally spoke to Dr. Alex Mwita, the National Malaria Control Program Manager for mainland Tanzania who gave him the proposed guidelines for new treatment of malaria in the country.

According to Dr.Sarkar, the new ACT treatment was initially supposed to be officially launched at national level and be gazetted this June, however that has been forwarded to next October. However, the Shellys product manager pointed out that already both SP and amodiaquine are being overwhelmed by malarial parasites whose resistance to the two drugs increases at an alarming rate.

The Regional Medical Officer, Dr. King'ori added that to date Malaria remains the number one killer in the country, explaining that 45 percent of all Out and In-patient cases in Arusha are people who suffer from Malaria. "The western countries would like the world to believe that HIV-Aids was the major disease in Africa, but in reality it is Malaria," he said.

Recent estimates of the global malaria burden have shown increasing levels of malaria morbidity and mortality, reflecting the deterioration of the malaria situation in Africa during the 1990s. About 90 percent of all malaria deaths occur in Africa south of the Sahara, and the great majority of them in either expectant mothers or children under the age of five

Key among the factors contributing to the increasing malaria mortality and morbidity is the widespread resistance of Plasmodium falciparum to conventional antimalarial drugs, such as Chloroquine, sulfadoxine-pyrimethamine (SP) and amodiaquine.

According to a medical expert from India, Dr. P.K Iyer, who was also present, Multidrug-resistant P.falciparum malaria is widely prevalent in south-east Asia and South America. Now Africa, the continent with a highest burden of malaria, is also being affected. Resistance to inexpensive mono-therapies such as SP has developed or is developing rapidly, with increased mortality as a result.

The inappropriate use of antimalarial drugs during the past century has also contributed to the current situation: Antimalarial drugs were deployed on a large scale, always as mono-therapies, introduced in sequence, and were generally poorly managed in that their use was continued despite unacceptably high levels of resistance.

In addition, there has been over-reliance on both quinoline compounds ( i.e. quinine, Chloroquine, amodiaquine, mefloquine and primaquine) and antifolate drugs with consequent encouragement of cross-resistance among these compounds.

Over the past decade, a new group of antimalarials - the artemisinin compounds, especially artesunate, artemether and dihydroartemisinin - have been deployed on an increasingly large scale. These compounds produce a very rapid therapeutic response (reduction of the parasite biomass and resolution of symptoms), are active against multidrug-resistant P. falciparum malaria, are well tolerated by the patients and reduce gametocyte carriage (and thus have the potential to reduce transmission of malaria).

To date, no parasite resistance to these compounds has been detected. If used alone, the Artemisinin will cure falciparum malaria in 7 days, but studies in south-east Asia have shown that combinations of Artemisinin compounds with certain synthetic drugs produce high cure rates on just 3 days of treatment. Furthermore, there is some evidence that use of such combinations can greatly retard development of resistance to the partner drug.

As a response to increasing levels of antimalarial resistance, WHO recommends that all countries experiencing resistance to conventional mono-therapies, such as Chloroquine, amodiaquine or sulfadoxine-pyrimethamine, should use combination therapies, preferably those containing Artemisinin derivatives (ACTs - Artemisinin-based combination therapies) for falciparum malaria.

This new development comes just when the Arusha based, Tanzania Pharmaceutical Company had successfully accomplished its own production line of Artemisinin Drug which was not only proving to be effective in combating malaria but was also relatively cheaper when compared to similar drugs with an 'import' tag.