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.
Few doctors — and few patients — realize just how profoundly early abuse, neglect and other childhood traumas can damage an adult's physical health.
From Dr Strangelove and water fluoridisation to climate change, scientific method and facts are not always enough to win over the sceptics
On a blog post at PLOS, the tropical disease expert Peter Hotez and postdoctoral fellow Jennifer Herricks take a run through the data on the biggest killers of children around the world in 2013, part of a new dataset from Global Burden of Disease study published in the January Lancet.
Tory MP David Tredinnick seems to believe that astrology could inform and improve UK healthcare. This view is misguided and potentially dangerous
Resistance to vital antimalarial drugs called artemisinins has spread across Burma to the Indian border. If not contained, it could ultimately hit Africa hard
Clostridium difficile sickens nearly half a million Americans annually, killing about 29,000, say federal health officials. They warn hospitals and nursing homes to tighten hygiene protocols.
Study looking at transmission among men who have sex with men recruited 545 participants at high risk of contracting HIV A daily pill can effectively protect gay men against infection with HIV
An experimental therapeutic vaccine from Danish drugmaker Bavarian Nordic helped significantly extend survival in patients with advanced prostate cancer, according to results of a small early-stage trial conducted by the U.S. National Cancer Institute.
Scientists interviewed more than 1,000 men, women and children who were forced into sex work and hard labor. The result is the largest study to detail the health of human trafficking survivors.
Gerbils from Asia rather than black rats were responsible for repeated outbreaks of the bubonic plague in Europe, a study suggests.