Lagos — Every step to check the malaria scourge has over the decades enjoyed unqualified support from the Nigerian people. This is natural. 57 out of 150 million Nigerians are annually afflicted by malaria. The illness accounts for 30% of child-related mortality in Nigeria and 11% of maternal mortality. It is, therefore, not surprising that Nigeria is responsible for 40% of malaria cases in Africa, the region where malaria is most pronounced.

However, the planned launch next month by The Global Fund of the second phase of its anti-malaria programme has met with stiff resistance. The opposition is somewhat ironical. When last July The Global Fund launched the first phase which saw the Federal Government partner with it and the Society for Family Health as well as the Yakubu Gowon Centre for National Unity and International Cooperation for the success of the National Programme on Malaria Control, the action enjoyed raving praise. Called the public sector phase of the anti malaria campaign, the public has since the launch enjoyed drugs and treated mosquito nets at little or no cost.

The ongoing furore over the anti-malaria campaign has to do with the nature of the second phase: involvement of the private sector and compelling it to sell specific drugs at a highly subsidized rate. The Global Fund wants to flood the Nigerian market, among other nations where malaria is endemic, with Artimisinin Combination Therapies (ACTs) from September. ACTs are the first line drugs in malaria treatment, but their prices are very high.

They sell for between 250 and 300 naira per dose, unlike traditional therapies like chloroquine and sulphur doxine pyrememythine which sell for only between 60 and 70 naira per dose. Many malaria sufferers in our country, where 70 % of the people live on one dollar per day or even less, are thus stuck with the cheaper therapies. According to the World Health Organization, between 250 000 and 300 000 Nigerians die annually, most children under age 5, on account of poor malaria treatment.

To make the efficacious ACTs more accessible to the people, The Global Fund is launching Affordable Medicines Facilities- malaria (AMFm) under which Artimisinin Combination Therapies will be sold to end users at between 60 and 70 naira per dose.

It has signed an agreement with six manufacturing companies to purchase their ACTs and send them to needy countries with as much as 95% of their costs subsidized. As part of the measure to ensure that none of the ACTs is sold at more than N70 at any retail shop, The Global Fund will bear both the transportation and insurance costs up to the point of entry in each beneficiary nation.

Both local and foreign firms are being signed on in Nigeria, as in other participating African countries, to act more or less as sales agents of the pharmaceutical companies whose ACTs are patronized by The Global Fund, a worldwide financing institution set up in 2002 to fight tuberculosis, HIV and malaria.

The participating firms must be registered with the Corporate Affairs Commission, the National Agency for Food and Drug Administration and Control (NAFDAC), the Pharmaceutical Council of Nigeria, the Pharmaceutical Group of the Manufacturing Association of Nigeria or the Association of Representatives of Overseas Pharmaceutical Manufacturers (NIROPHARM). They must ensure strict compliance.

The bad news is that all six pharmaceutical companies whose ACTs are to be used are either European or Asian; none is in Africa. The firms are Novartis of France, Sanofi-aventis of Switzerland and Guilin of China; others are Ajanta, Ipca and Cipla-all of India. These are famed international pharmaceutical manufacturing companies.

They enjoy WHO pre-qualified status. They have made massive investments over the years. They are lucky to operate in countries where they enjoy stable public policy, first class infrastructure like electricity, water and roads.

They also have access to cheap credit, enjoy tax reliefs and export incentives, among other forms of official assistance. All this makes it difficult for Nigerian manufacturers, who currently have practically no access to bank credit and are stuck with providing their own infrastructural requirements, to compete with their foreign counterparts.

Still, many Nigerian pharmaceutical products, including ACTs, have proved to be exceedingly effective. They need to be patronized by The Global Fund even without attaining the WHO pre-qualified status. If they fail to enjoy patronage on a grand scale, none of the manufacturers will ever stand a fighting chance of achieving WHO pre-qualified status.

The situation facing the local pharmaceutical companies is, in fact, worse. Many of them are very likely to die within months of the takeoff of the AMFm project. There is no way they can compete with big foreign firms whose products are subsidized by as much as 95%.

To exacerbate the impending crisis, it is not just local manufacturers that will be affected. Other stakeholders like pharmaceutical importers who make first class anti-malarials available in Nigeria will be ruined. Think of the catastrophic effects on the employment market, which is already in a deep mess.

There is another bad news: The AMFm programme is not to run in perpetuity but for only about two years. This is more than enough time to wipe out the indigenous pharmaceutical industry. What will happen to the local industry thereafter? Who will revive the businesses and restore hundreds of thousands to work?

The nobility of the idea behind AMFm project is not in doubt. However, in reality the project is bound to create far more problems than it seeks to solve.

The Nigerian government has a compelling duty to ask The Global Fund to concentrate on fighting the malaria scourge through the public sector, as it has been doing admirably since the middle of last year. The AMFm idea is not well thought out.