A controversial program that uses the private market to provide affordable malaria treatments to people in Africa has dramatically increased access to care and should be continued, according to a policy article by scholars including Ramanan Laxminarayan of Princeton University in the Nov. 2 issue of the journal Science.
The researchers stated that the two-year old pilot program, which is up for renewal this November and enables reduced-price malaria drugs to be sold in shops and market stalls, successfully broadened the availability of effective malaria therapies and reduced the use of less effective treatments that promote drug-resistance.
The private-market approach — sometimes called the Coca-Cola model in reference to the soda's apparent ability to reach remote areas of the world — aims to deliver drugs in regions where the majority of people obtain medicines from shops rather than from district hospitals or clinics.
"This experiment demonstrates that we can use private distribution mechanisms to make treatments available in rural areas," said Laxminarayan, a research scholar in the Princeton Environmental Institute, lecturer in economics at Princeton University and director of the Center for Disease Dynamics, Economics and Policy in Washington, D.C.
Laxminarayan co-authored the Science article with Kenneth Arrow, professor of economics at Stanford University and a 1972 Nobel laureate in economics; Dean Jamison, professor of global health at the University of Washington in Seattle; and Barry Bloom, Harvard University Distinguished Service Professor at the Harvard School of Public Health.
The researchers found that the program, known as the Affordable Medicines Facility - malaria (AMFm), enhanced access to the most effective malaria medicine, known as artemisinin combination therapy (ACT), while reducing purchases of less-effective drugs, such as artemisinin alone, which has been shown to promote artemisinin-resistance.
ACT prices were lowered by a range of US $1 to US $5 per dose in the five countries that substantially implemented the program, according to results published in the Oct. 31, 2012 issue of The Lancet. The price-reductions were achieved via negotiations with manufacturers and subsidies from donors. The program operated in seven African countries (Ghana, Kenya, Madagascar, Niger, Nigeria, Tanzania and Uganda) and was organized by the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
Controversial when first proposed (see "Malaria Drugs, the Coca-Cola Way" in Science, Nov. 21, 2008), the private-market approach is a departure from government-run programs that rely on healthcare workers or clinics to distribute free or subsidized malaria drugs. Critics worried that the approach was unproven and that distributors might pocket the subsidies, according to the 2008 article.
The success of Coca-Cola and other goods at making it to rural markets stems from the fact that someone makes money at every step in the distribution chain, Laxminarayan said. Making malaria drugs available at low prices to distributors and retailers enables these distribution chains to carry ACTs to distant marketplaces, he said.
Princeton University: http://www.princeton.edu
This press release was posted to serve as a topic for discussion. Please comment below. We try our best to only post press releases that are associated with peer reviewed scientific literature. Critical discussions of the research are appreciated. If you need help finding a link to the original article, please contact us on twitter or via e-mail.
Bone marrow grafts have helped both patients stay all but virus-free for three years. But the disease has come back before in others, and a simpler treatment is needed
Low levels of alcohol can improve your ability to discriminate between different odours, but be warned, the effect is reversed if you drink too much
Modified mozzies will be raised and released on a commercial scale for the first time, but critics warn that this biotech has not been sufficiently tested
Locally acquired cases of chikungunya virus have been identified in the US for the first time, while cases soar in Europe and Central America
A significant percentage of obese kids think their weight is just fine. But do they need to know the truth to get healthier?
Cancer-fighting drug romidepsin has been shown to expose hibernating HIV, making it susceptible to attack
Oversleep causes a feeling similar to feeling hung over and it's caused by the same biological function that gives you jet lag.
Early results of a drug combination called PaMZ offer the best hope in decades of bringing the pernicious, drug-resistant form of tuberculosis under control
The U.S. Centers for Disease Control and Prevention "may never know" how a fairly harmless form of bird flu was cross-contaminated with a dangerous bird flu strain before it was sent to a laboratory outside of the CDC, an agency spokesman said on Monday.
A group of seven leading drugmakers has agreed to share an array of neglected experimental medicines with British academic researchers in the latest example of the deepening ties between industry and external scientists.