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.
Treating patients with the deadly Ebola virus takes doctors, drugs, and a whole lot of chlorine.
For decades, smokers in eastern Europe have used cytisine from laburnum trees to help them quit. Good results in a new trial could make cytisine much more popular
The National Institutes of Health has approved requests for waivers from a moratorium on experiments that aim to make the virus that causes Middle East respiratory syndrome more infectious in mice.
It's all fun and games until someone dislocates a knee, wets himself or has a stroke
Use of synthetic drugs, like bath salts, by young people continues to decline across the nation, according to a study by the University of Michigan.
Researchers are struggling with how to balance the benefits and risks of genetic experiments that can give viruses new talents for causing infections.
For all the medicine they provide at this center, physicians and staff from Doctors Without Borders spend as much time encouraging the patients to eat, drink, and keep fighting. Every patient gets a standard regimen of antibiotics, paracetemol and other pain medications, vitamins, oral rehydration therapy or intravenous fluids. Drugs can control nausea for those who need them; everyone gets antimalarials.
Dengue sickens millions of people each year, and there's no cure. Now scientists have found powerful antibodies that stop the virus. Their discovery offers a road map to develop a simple vaccine.
British doctors make the case for playing music during an operation
Doughnuts? No thank you. An edible powder made from stuff our gut bacteria excrete can stop people gaining weight when taken daily