Estimating antimalarial drugs consumption in Africa before the switch to artemisinin-based combination therapies (ACTs)
AffiliationAEDES Foundation, Brussels, Belgium; Médecins Sans Frontières, Brussels, Belgium; UNICEF/UNDP/WB/WHO Special Programme for Research & Training in Tropical Diseases (TDR), Geneva, Switzerland
MetadataShow full item record
AbstractBACKGROUND: Having reliable forecasts is critical now for producers, malaria-endemic countries and agencies in order to adapt production and procurement of the artemisinin-based combination treatments (ACTs), the new first-line treatments of malaria. There is no ideal method to quantify drug requirements for malaria. Morbidity data give uncertain estimations. This study uses drug consumption to provide elements to help estimate quantities and financial requirements of ACTs. METHODS: The consumption of chloroquine, sulphadoxine/pyrimethamine and quinine both through the private and public sector was assessed in five sub-Saharan Africa countries with different epidemiological patterns (Senegal, Rwanda, Tanzania, Malawi, Zimbabwe). From these data the number of adult treatments per capita was calculated and the volumes and financial implications derived for the whole of Africa. RESULTS: Identifying and obtaining data from the private sector was difficult. The quality of information on drug supply and distribution in countries must be improved. The number of adult treatments per capita and per year in the five countries ranged from 0.18 to 0.50. Current adult treatment prices for ACTs range US$ 1-1.8. Taking the upper range for both volumes and costs, the highest number of adult treatments consumed for Africa was estimated at 314.5 million, corresponding to an overall maximum annual need for financing ACT procurement of US$ 566.1 million. In reality, both the number of cases treated and the cost of treatment are likely to be lower (projections for the lowest consumption estimate with the least expensive ACT would require US $ 113 million per annum). There were substantial variations in the market share between public and private sources among these countries (the public sector share ranging from 98% in Rwanda to 33% in Tanzania). CONCLUSION: Additional studies are required to build a more robust methodology, and to assess current consumptions more accurately in order to better quantify volumes and finances for production and procurement of ACTs.
- Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries.
- Authors: O'Connell KA, Gatakaa H, Poyer S, Njogu J, Evance I, Munroe E, Solomon T, Goodman C, Hanson K, Zinsou C, Akulayi L, Raharinjatovo J, Arogundade E, Buyungo P, Mpasela F, Adjibabi CB, Agbango JA, Ramarosandratana BF, Coker B, Rubahika D, Hamainza B, Chapman S, Shewchuk T, Chavasse D
- Issue date: 2011 Oct 31
- Health workers perceptions on chloroquine and sulfadoxine/sulfalene pyrimethamine monotherapies: implications for the change to combination therapy of artemether/lumefantrine in Tanzania.
- Authors: Tarimo DS, Malekela DA
- Issue date: 2007 Apr
- Conquering the intolerable burden of malaria: what's new, what's needed: a summary.
- Authors: Breman JG, Alilio MS, Mills A
- Issue date: 2004 Aug
- Artemisinin-based combination therapies (ACTs): best hope for malaria treatment but inaccessible to the needy!
- Authors: Mutabingwa TK
- Issue date: 2005 Sep
- Comparative efficacy and safety of chloroquine and alternative antimalarial drugs: a meta-analysis from six African countries.
- Authors: Mengesha T, Makonnen E
- Issue date: 1999 Jun