By ARTHUR MAX
The Associated Press
Friday, January 19, 2007; 11:08 AM
AMSTERDAM, Netherlands -- A global fund is being created to subsidize the purchase of a new generation of anti-malaria drugs for Africa, where the mosquito-borne disease kills 1 million people a year, mostly children under 5, a World Bank-sponsored forum announced Friday.
The two-day conference of 80 health experts, African government ministers and nongovernment organizations was called to build on a 2004 report by Nobel economics laureate Kenneth Arrow on how to make the new drugs affordable to the world's poorest and most vulnerable people.
The drugs, Artemisinin-based Combination Therapies, or ACTs, are meant to replace chloroquine and other old generation drugs sold in Africa and Southeast Asia for about 10 US cents (8 eurocents) per treatment but which have become ineffective.
"Old medicines have become useless because of the emergence of resistance," Arrow told reporters at the end of the conference.
Until recently, ACTs were produced for about US$2.50 (euro1.93) per three-day treatment, but the retail price was two or three times that much. Production costs are now dropping to about $1.00 (euro.77), World Bank experts said.
People earning $1 to $2 a day cannot afford ACTs even at the reduced price. "With the likely markup, they are well above the purchasing power of the average African," Arrow said.
ACTs are based on Chinese herbal medicine but use a combination of ingredients, which makes it harder for the malaria parasite to develop resistance than the single-action drugs which no longer work.
The conference began the task of building a network of donor countries, led by the Netherlands, and of setting up the architecture for administering the fund. Drugs would be distributed by government health programs and by local stores, where most people now buy their medicines.
Initial estimates say the fund will need about $80-100 million (euro62-77 million) in the first year, building up to about $250 million (euro193 million) per year in subsequent years, said Andreas Seiter, the World Bank official heading up the project.
Buyers would place orders directly with pharmaceutical companies, but would be billed for only a fraction of the cost. The manufacturers would invoice the global fund for the remaining amount, Seiter said, bringing down the cost to the consumers to roughly what they pay now for chloroquine.
Seiter said he expected the structure of the fund to be completed this year, with the first subsidized drugs finding their way to village stores in the first half of 2008.
Olusoji Adeyi, the World Bank's coordinator of public health programs, said it took 18 months of discussions to reach a broad agreement on the need for the subsidy. The plan will work in tandem with the bank's malaria-prevention programs to provide mosquito nets and insecticide to affected areas.
Malaria victims suffer fever, chills, and flu-like symptoms that leave them debilitated and could lead to death if untreated. The Center for Disease and Control Prevention says 350-500 million cases of malaria occur each year worldwide, making it one of the deadliest diseases in underdeveloped parts of the world.
Nigerian Health Minister Eyitayo Lambo welcomed the plan. "We are very happy about it," he said. "The global fund initiative, or whatever it will be called, should have started yesterday, not today."
The World Bank says malaria affects about 110 million Nigerians a year from a population of more than 130 million. The bank said almost 29 percent of Nigerian children's deaths and 11 percent of deaths among pregnant women are caused by malaria.
