The perils of delivering anti-malarial drugs through private sector examined
This is a privately owned drug store in Madagascar. This type of facility is often used by to distribute anti-malaria drugs in sub-Saharan countries, making the drugs accessible but sometimes given to people who don’t need it. Andrew Tatem, an associate professor of geography at UF’s Emerging Pathogens Institute, helped to track this pattern. Credit: Capsule Survey Firm
(Medical Xpress)—Getting high-quality anti-malarial drugs to people in places like Zanzibar and Mozambique is a tricky business.
A 2009 program, called the Affordable Medicines Facility-malaria, or AMFm, tried to do it by giving subsidies directly to drug manufacturers, but critics are now saying that the program has promoted dangerous misuse of these expensive medications. A new study co-authored by a University of Florida researcher, however, suggests that misuse is a bigger problem in some areas than others, and that an AMFm-like approach could still have value in some regions.
The study is published in the Nov. 2 edition of the journal Science.
"It's a bit silly to talk about the private sector market for anti-malarials in Africa in general terms because there is so much variation in malaria prevalence, availability of health services, finances and culture within the region," said Justin Cohen, senior technical adviser for the Clinton Health Access Initiative and lead author of the study.
A "one-size-fits-all" approach to working with the private sector in Africa will inevitably be an ill fit for some places, he said.
In many African countries, more people have access to privately run health facilities or drug stores than to public health institutions, so using them as a means to get better quality medicines to people in outlying areas is an attractive strategy. However, the decentralized nature of the private sector has also made it difficult to assess how many drugs are being purchased and how the drugs are being used.
"Part of the problem has been that we've never had good information for how big the private sector market is for anti-malarials in sub-Saharan Africa," Cohen said.
Andrew Tatem, associate professor of geography at UF's Emerging Pathogens Institute, was able to help in that regard.
Tatem combined population data from a project he runs called AfriPop with sub-Saharan household survey information to estimate the number of people buying anti-malarials from private sector markets. The team then combined the results with data from the Malaria Atlas Project to see how demand for medication stacked up against known rates of malaria infection.
"We found that in some regions, as few as 5 percent of the people taking anti-malarials likely had malaria." Tatem said.
Malaria is often assumed to be the culprit when children run a fever in sub-Saharan Africa. When that happens, parents will often treat it with anti-malarials the way that Americans might treat flu symptoms with a cold medicine.
Taking the drugs when they are not needed wastes money, and it could possibly cause drug-resistant strains of malaria to develop. Cohen said that AMFm critics aren't wrong when they say that programs should be providing more diagnostic tests along with these medications. The study notes that while 655 million people purchased anti-malarial medications, only about 50 million rapid diagnostic tests were delivered globally in 2010.
However, Cohen said that increasing access to affordable drugs even in the absence of diagnosis may be a good short-term strategy in places like Nigeria where infection rates are high.
"Ultimately, everyone should receive effective diagnosis and the appropriate treatment for the true cause of their illness," Cohen said. "But in the short term, if most people in an area have malaria, we can do a lot of good by increasing accessibility to higher quality malaria drugs."
Testing everyone who needs it will be expensive and resources are currently limited. According to the study, donations for malaria control declined in 2012 for the first time in a decade.
"It's great to talk in the abstract about how things should be ideally," Cohen said. "But in the end, you have to get going and do your best with what you have."
Journal reference: Science
Provided by University of Florida
- Fake malaria drugs threaten crisis in Africa Jan 17, 2012 | not rated yet | 0
- Program to up access to combo malaria therapy successful Nov 01, 2012 | not rated yet | 0
- Malaria prevention saves children's lives Mar 28, 2012 | not rated yet | 0
- Community health workers can effectively manage children with malaria and pneumonia Sep 21, 2010 | not rated yet | 0
- Simple rapid diagnostic tests for malaria work well Jul 06, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
How can there be a term called "intestinal metaplasia" of stomach
14 hours ago Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
- More from Physics Forums - Medical Sciences
More news stories
An experimental sleeping pill from US drug company Merck is effective at helping people fall and stay asleep, according to reviewers at the US Food and Drug Administration, which could soon approve the new drug.
Medications 3 hours ago | 5 / 5 (1) | 0
Transparent information on the evidence supporting global recommendations on paediatric medicines should be easily accessible in order to help policy makers decides on what drugs to include in their national drug lists, according ...
Medications 4 hours ago | not rated yet | 0
Regardless of pain, social class or age, a woman is more likely to be prescribed pain-relieving drugs. A study published in Gaceta Sanitaria (Spanish health scientific journal) affirms that this phenomenon is inf ...
Medications 12 hours ago | not rated yet | 0
A new report suggests that improved health care and significant reductions in drug costs might be attained by breaking up the age-old relationship between physicians and drug company representatives who promote the newest, ...
Medications May 20, 2013 | 5 / 5 (1) | 0
(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...
10 hours ago | 4 / 5 (4) | 0 |
(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...
8 hours ago | 4.8 / 5 (6) | 0 |
Activating an enzyme known to play a role in the anti-aging benefits of calorie restriction delays the loss of brain cells and preserves cognitive function in mice, according to a study published in the May ...
4 hours ago | 5 / 5 (3) | 0 |
A drug commonly used to treat depression and anxiety may improve a stress-related heart condition in people with stable coronary heart disease, according to researchers at Duke Medicine.
5 hours ago | not rated yet | 0 |
Australian scientists have charted the path of insulin action in cells in precise detail like never before. This provides a comprehensive blueprint for understanding what goes wrong in diabetes.
10 hours ago | 4.8 / 5 (4) | 0 |
Researchers at USC have found that a class of pharmaceuticals can both prevent and treat Alzheimer's Disease in mice.
7 hours ago | 5 / 5 (3) | 0 |