Combined therapy urged for malaria

The World Health Organisation has recommended a combination therapy malaria drug as a way around the parasite's growing resistance to conventional medicines.

In a message coinciding with Africa Malaria Day, the United Nations agency urged countries to switch to combination therapy where there was strong evidence that existing drugs were not working.

Medecins Sans Frontieres welcomed the move, saying clear guidance had been lacking from the WHO despite evidence that current treatment strategies were not curing patients.

Drug-resistant malaria kills many African children. The disease, caused by a parasite transmitted by the bite of an infected female mosquito, kills a child every 30 seconds.

The WHO said artemisinin-based combination (ACTs) therapies, derived partly from a Chinese herb, killed the parasite fast and caused few side-effects.

"Because ACTs combine two medicines which work in different ways, it is unlikely that the malaria parasite - which has rapidly developed resistance to other, single treatments - would evolve to resist these medicine combinations," the WHO said.

It said it had added one of the combination medicines, artemether/lumefantrine, by Swiss drug company Novartis, to its list of recommended "essential medicines".

"This medicine, known by the brand name Coartem, is the only medicine which combines an artemesinin and non-artemisinin compound in a single tablet," the WHO said.

Dr Kamini Mendes, an Indian expert at the WHO, said: "We are urging countries to move to the new treatment when there is evidence that the current drugs are failing.

"They should start changing policy when failure rates reach 15 per cent and implement it before resistance reaches 25 per cent."

She added: "There is a caveat, though. The new treatments are significantly more expensive than the medicines currently used.

"The challenge will be how to finance new treatment."

However, the Global Fund to Fight Aids, Tuberculosis and Malaria, which has held a three-day board meeting in New York, is expected to announce that it will pay for proposals to help "roll back" malaria in Zambia and Zanzibar.

The WHO said: "These proposals include purchasing and phasing in the use of new ACTs."

For decades, the best-known treatment for malaria was chloroquine, a medicine costing about US6c (14c) a time, which has saved millions of lives, it said.

But resistance had grown to it and to a second drug, sulphadoxine-pyrimethamine.

More than 90 per cent of the estimated 300 million to 350 million cases of malaria each year are in sub-Saharan Africa.

About one million people die each year.

- REUTERS

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