Artemisinin-based Combination Therapies, or ACTs, are now considered to be the best treatment for uncomplicated P. falciparum malaria. The World Health Organization (WHO) currently recommends the following ACTs:Artemether-lumefantrine (e.g. Coartem®, available through Novartis AG)
Artesunate plus amodiaquine (e.g. Arsuamoon®, available through Guilin Pharmaceutical Co. Ltd.)
Artesunate plus sulfadoxine-pyrimethamine (e.g. Sulfamon plus 500, available through Cipla Ltd.)
Artesunate plus mefloquine (e.g. ArtequinTM, available through Mepha Ltd.)
Parasitic resistance to chloroquine and sulfadoxine-pyrimethamine monotherapies was a driver of malariaâ€™s recent resurgence throughout sub-Saharan Africa. In order to preserve ACTs as an effective treatment for malaria, the WHO recommends that drug companies not produce, and governments, donors and private organizations not purchase or administer Artemisinin monotherapies. The WHO recommends changing national treatment policy when treatment failure rates reach 10%, preferably to one of the ACTs listed above. For more detailed information, please refer to the WHO's "Guidelines for the Treatment of Malaria".
The production and distribution of substandard and counterfeit drugs, including ACTs, is a vast, increasing and largely underreported, problem. Adulterated medicines contain little or none of the active ingredients found in their branded equivalent, and often have adverse health effects. AFM has made policy recommendations based on the global threat of fake and substandard drugs and the qualitative risks associated with counterfeit medicines.
AFM published a study in PLoS ONE in May 2008 indicating 35% of antimalarial drugs sold in six major African cities are substandard. The AFM team educated millions of people and policymakers around the world on this issue by generating over 50 earned media hits in leading print, broadcast and electronic media in 17 countries on five continents, including feature stories in The New York Times, Reuters, Economist, and National Public Radio.
AFM's work on this issue has spurred immediate action. Just three weeks after this study was published, the Kenyan and Rwandan governments publicly initiated investigations into drug counterfeiters and nationwide pharmacies, citing AFM's research.
AFM held two briefings on Capital Hill on the subject of Improving Antimalarial Drug Quality in Africa. The first was a Congressional Briefing in June 2008 in collaboration with the Congressional Malaria Caucus. The second was a Senate Briefing in September 2008 hosted by the US Senate Committee on Foreign Relations.
AFM's Board Member, Dr. Roger Bate, recently published a book on counterfeit medicines entitled Making a Killing: The Deadly Implications of the Counterfeit Drug Trade.
AFM is also helping to ensure that every African in need of a malaria treatment has access to a safe and effective one through the March of Washingtons - a broad-based campaign to buy and distribute high quality malaria drugs to people in Africa, and test for fake and substandard malaria drugs on sale in African markets. Funds from the March of Washingtons have been used to collect and test antimalarial drugs on sale in private pharmacies in Zambia. In March 2009, AFM published a report of its findings. Funds have also been used to collect and test essential drugs from pharmacies in Lagos, Nigeria as well as conduct informal surveys of doctors, pharmacists, and healthcare workers in Lagos, Ondo, and Ogun. AFM published a working paper with its findings in August 2009.
To learn how you can become involved in the March of Washingtons visit www.marchofwashingtons.org.
January 14, 2013Substandard Medicines: WHO's inadequate response
January 03, 2013Deadly Fake Medicines
November 20, 2012President's Malaria Initiative's 'mystery' solved
September 27, 2012AFM update on recent drug quality studies
August 16, 2012more
January 18, 2016Success against malaria threatened by new strain
December 25, 2015Tanzania: New Six-Pill Malaria Dose Approved By TFDA
November 22, 2015Antibiotic resistance: World on cusp of 'post-antibiotic era'
November 19, 2015Swaziland likely to be first to eliminate malaria in southern Africa
November 18, 2015more
July 10, 2015The Global Pandemic of Falsified Medicines: Laboratory and Field Innovations and Policy Perspectives: Foreword
April 20, 2015The Global Pandemic of Falsified Medicines: Laboratory and Field Innovations and Policy Perspectives: Summary
April 20, 2015Rapid diagnostic tests for molecular surveillance of Plasmodium falciparum malaria -assessment of DNA extraction methods and field applicability
March 19, 2013The role of pre-shipment batch testing in ensuring good medicine quality
December 05, 2012more
April 23, 2012The Global Fund Proposes Joint Action To Prevent Theft Of Medicines
December 10, 2010The March of Washingtons Distributes $5,000 for Pneumonia Drugs in Uganda
November 11, 2010March of Washingtons donates funds for life-saving antimalarial drugs in Uganda
August 31, 2010WHO releases new malaria guidelines for treatment and procurement of medicines
March 09, 2010more
September 29, 2008Congressional Briefing: Improving Antimalarial Drug Quality in Africa
June 10, 2008more