Esther Nakkazi
28 September 2008
Nairobi — Uganda is leading a $3 million initiative that will scale up private sector access to artemisinin combination therapy (ACT) in malaria endemic countries in Africa.
The initiative is expected to contribute to the reduction of malaria morbidity and mortality by delivering effective and affordable antimalarials within 24 hours of fever onset.
The initiative will bring antimalarials as close to homes as possible and enable Uganda to reach the Abuja Revised Roll Back Malaria (RBM) target of 80 per cent.
ACT drugs have been subsidised by over 90 per cent to cost less than a dollar, down from about $12.
ACT is the World Health Organisation recommended first line treatment for malaria in public and private facilities.
Compared with cheap but ineffective drugs, ACTs can be as much as 60 times more expensive to purchase.
The Consortium for ACT Private Sector Subsidy (CAPSS) has been launched in Uganda to assess the effect of providing subsidised ACT through private outlets.
If it is proved to be effective, it will be rolled out in other malaria endemic countries in Africa.
Medicines for Malaria Venture (MMV), the Ministry of Health, International Dispensary Association (IDA) Solutions, Population Science International (PSI) and other health organisations have teamed up to lead the consortium.
In Uganda, it takes 11 days for an average household income to purchase a single course of ACT for a five year old child. This makes it possible for only six per cent of children to access ACTs in 24 hours.
Malaria kills 320 Ugandans every day, mostly pregnant women and children below five.
"The issue here is affordability of drugs. No parent should ever have to choose between food and medicine for their children," said Chris Hentschel, the president of Medicines for Malaria Venture.
CAPSS will save 320 lives a day or 70,000-100,000 lives a year and an estimated annual saving per household of $48-$57 a year.
"ACT is still inaccessible in the private sector, largely because it is not affordable yet approximately 40-60 per cent of Ugandans first visit the private sector when they fall sick," said Emmanuel Otala, Minister of State for Primary Health care.
Mr Otala said the initiative will ensure that at least 50 per cent of the people infected with malaria get the drugs and at least 85 per cent of these buy full doses.
It will also slow the development and spread of drug resistance and displace drugs that are no longer effective, he said.
Those in the private sector will also be packaged differently from those in the public sector, whose package will display a Ministry of Health logo to distinguish the subsidised antimalarials from others sold through the private sector.
"I am confident that with this CAPPS project, we will achieve great milestones in malaria control," said Dr Sam Zaramba, the director general at the Ministry of Health.
ACTs are only available in as few as 1 in 25 private sector drug outlets, even though they can make a patient feel better within hours and get rid of the malaria parasite completely within 3 days.
"I grew up here and I have seen the devastating effects of malaria-affected areas. The disease kills more than 320 people a day. That is the equivalent of 23 full taxis falling off a week bridge and plunging into the river, killing everybody on board-not just today or tomorrow but everyday single day," said Dr. Shaban Mugerwa the district officer of Kaliro one of the most malaria affected areas in Uganda.
"Increasing access to prompt effective treatment for malaria requires innovative strategies such as this one," Edward Ddumba the executive director of the National Referral Hospital Mulago.
MMV is a not for profit organization created to discover, develop and deliver effective and affordable anti-malarials drugs through public-private partnerships.
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