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Access to Medicines: Antimalarials WHO/UNICEF Technical Briefing Seminar 10 October 2007

Access to Medicines: Antimalarials WHO/UNICEF Technical Briefing Seminar 10 October 2007 Silvia Schwarte Supply Chain Management Global Malaria Programme. Malaria.

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Access to Medicines: Antimalarials WHO/UNICEF Technical Briefing Seminar 10 October 2007

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  1. Access to Medicines: Antimalarials WHO/UNICEF Technical Briefing Seminar 10 October 2007 Silvia SchwarteSupply Chain Management Global Malaria Programme

  2. Malaria • 107 countries: 350-500 million episodes/year (Africa: 57% of all cases) • Over-consumption of antimalarial drugs: 40-60% of all cases treated as malaria are febrile episodes • Treatment availability: predominantly private sector (limited control with limited information on efficacy, safety and quality; use of mono-therapies, patient`s compliance, resistance) • Disease of poverty: low market attraction for companies (many products instead of quality, lack of innovator products, stability, artemisinin-based mono-therapies)

  3. WHO recommendations: ACTs • WHO Guidelines for the Treatment of Malaria: AL, AS+AQ, AS+SP, AS+MQ • National antimalarial medicines policy • Risk of resistance (decreased in vitro sensitivity; in vivo: increased Parasite Clearance Time) • Ban of oral artemisinin-based mono-therapies

  4. (1.) National Medicines Policy and(2.) Procurement and Forecast of ACTs Cumulative number of countries deploying ACTs Cumulative number of countries adopting ACTs as 1st-line treatment Forecast: 124 Million Millions of ACT treatment courses Cumulative No. of countries adopting ACT as 1st-line Rx

  5. ACT - market situation Fig. 1: Estimates of artemisinin dry leaves production (metric tonnes) Fig. 2: Artemisinin prices (USD/kg) over time

  6. New ACTs on the market in 2007-2009 Fixed-dose combinations artemether-lumefantrine AS-Naphthoquine + AS-Piperaquine co-blistered products < 2006 2007 2008 2009 2010 Pyronaridine-AS Pyramax™ Paediatric Coartem™ CD-AS (CDA) AS-AQ DHA-PPQ AS-MQ Resistance

  7. The way forward… • New extraction processes • New sources of artemisinin (e.g. biotechnology yeast cultures, high yield seeds) • Mechanisms to avoid shortages and price fluctuation (safety stocks of artemisinin, predictable funding: AMFm, UNITAID) • Pre-qualification: API and finished products • Reliable forecasting: SCM-database

  8. Thank you!

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