Global switch needed on severe malaria drug: MSF

LONDON Tue Apr 19, 2011 5:06am EDT

Kenyan nurses weigh a child before she is given an injection as part of a malaria vaccine trial at a clinic in the Kenya coastal town of Kilifi, November 23, 2010. REUTERS/Joseph Okanga

Kenyan nurses weigh a child before she is given an injection as part of a malaria vaccine trial at a clinic in the Kenya coastal town of Kilifi, November 23, 2010.

Credit: Reuters/Joseph Okanga

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LONDON (Reuters) - Up to 200,000 deaths from severe malaria could be averted each year if malarial countries were to switch to a more expensive but more effective drug, the medical charity Medecins Sans Frontieres (MSF) said Tuesday.

In a report on the mosquito-borne disease, MSF said data from recent trials in Africa had shown that the drug, called artesunate, was more effective and easier to use than quinine, a cheaper malaria medicine often used in poorer countries.

There are around 240 million malaria cases across the world every year and the disease kills more than 850,000 people annually, many of them children, the World Health Organization (WHO) says. Most malaria cases are in Africa, where it kills a child every 45 seconds.

MSF said around eight million simple malaria cases progress every year to severe malaria, where patients show clinical signs of organ damage which may involve the brain, lungs, kidneys or blood vessels.

"When children arrive at the clinic with severe malaria, they are often having convulsions, vomiting or at risk of going into shock, and you just want to be able to give them effective treatment quickly," Veronique De Clerck, an MSF medical coordinator in Uganda, said in a statement with the report.

"For decades, quinine has been used in severe malaria, but it can be both difficult to use and dangerous, so it's time to bid it farewell. With artesunate, we now have a drug that saves more lives from severe malaria, and is safer, easier and more effective than quinine."

APPEAL

MSF called on African governments, the WHO and international aid donors to back an immediate global switch to artesunate for severe malaria -- a move it said could avert up to 200,000 deaths a year.

While artesunate is three times more expensive than quinine, MSF said the difference in cost of $31 million each year for a global switch would be "very little for the nearly 200,000 lives that... could be saved."

Quinine has to be given three times a day via intravenous drip that takes several hours, while artesunate can be given in a few minutes with an intravenous or intramuscular injection.

MSF cited data from a clinical trial in late 2010 which found that the use of artesunate to treat children with severe malaria reduces the risk of death by nearly a quarter.

The study, carried out in nine African countries, found that for every 41 children given artesunate over quinine, one extra life was saved.

Owing to the difficulties of administering quinine, children in the trial assigned to receive that medicine were almost four times more likely to die before even receiving treatment.

The WHO has said it will issue new guidelines soon recommending artesunate for treating severe malaria in children in Africa, but MSF said the United Nations health body also needed to develop a plan to help countries make this switch.

"African governments must urgently change their treatment protocols and donors must send a clear signal to countries that they will support the additional cost where needed," it said.

(Editing by Gareth Jones)

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