Lives being lost unnecessarily in the fight against malaria

A joint report released by the World Health Organization and Unicef last month to mark Africa Malaria Day found that death tolls from malaria are still “outrageously high.” The report found that malaria causes more than 3000 child deaths in Africa every day and that effective antimalarial drugs and bed nets treated with insecticide are not widely available to those who need them.

Jane Crawley, an adviser to WHO's malaria department, also recently noted that the use of bed nets treated with insecticide could greatly reduce malaria transmission, yet coverage with nets, particularly insecticide treated ones, remains poor.

The report detailed the huge problems caused by resistance to antimalarial drugs; resistance to chloroquine and sulfadoxine-pyrimethamine is now so high in parts of Africa that both drugs are virtually useless. The report argues that effective malaria treatment such as combination treatment based on artemisinin should become widely available. Donor agencies should support implementation of this treatment rather than “wasting their money on funding drugs that don't work.”

Young boy waits to be tested for malaria in Mozambique

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Many African countries have already changed their treatment protocols, or are in the process of doing so, to include more effective treatments. In particular, this includes changing to combination treatments including artemisinin. But lack of money and lack of international help have forced some countries to switch to a different single treatment, or to less expensive combinations which do not contain artemisinin. Currently, chloroquine and sulfadoxine-pyrimethamine cost about $0.15 (£0.09; €0.13) for each adult dose, whereas treatment based on artemisinin costs $1-2, although this is expected to decrease to $0.50-0.80 by 2004-5 as orders for the drug increase.

Bernard Pecoul, director of Médecins Sans Frontiéres's campaign for access to essential medicines said: “Since 2001, WHO experts have recommended replacing failing malaria medicines with more effective treatments, but donors have failed to encourage this change, choosing to save money rather than lives. The G8 and African leaders' goal of halving malaria deaths by 2010 will remain a fantasy unless donors are willing to help pay for treatment that works.”