Local Production of Antimalarial Drugs

11 Mar 2009
Africa Fighting Malaria
The idea that local production of goods increases access to those goods has captured the imagination of many policy makers, politicians and individuals for countless decades. Yet the evidence to back this up is absent. Instead, there are centuries of evidence that more open trade, which allows countries to benefit from their comparative advantage in the production of goods and services, allows all parties to prosper and gives people access to a wider range of goods, often at a lower cost.

News that local production of antimalarial commodities is being favored by activists and local politicians is worrying for 2 reasons. First, there is no guarantee that locally produced goods will be cheaper or more available to those most in need. Second, there is no guarantee that locally produced goods will be manufactured to the high standards required if the scale-up in malaria control is to be successful.

Of course, AFM welcomes competition; in general, competition can increase choice and lower prices, which should benefit consumers - in this case people suffering from malaria. So news that Uganda-based Quality Chemicals has been granted a contract to provide the Ugandan Government with a generic version of the first-line malaria treatment Coartem (artemether-lumefantrine) should be good news. But, this is only good news if the contract was subject to competitive bidding on the basis of producing comparable high-quality drugs. Yet another article published in New Vision explains that donor agencies would not procure the locally manufactured drugs because their quality has not yet been established by the WHO or a stringent regulatory authority.

Quality of drugs must be the first criterion upon which any selection is made; this is especially true for malaria where a child can die so quickly if effective treatment is not provided. Furthermore, the prospect of drug resistance developing to artemisinin-based combination therapies is very real; for this reason, all governments should re-double their efforts to ensure that only the highest quality drugs are procured.

Uganda's Primary Healthcare Minister, Emmanuel Otaala, expressed fears that the imported Coartem could affect local production; AFM believes that the Government of Uganda should stringently guard against any protectionist measures to favor local producers. There is no reason for local producers not to compete along with all other producers on the basis of quality and price.

Local industry analysts in Nigeria erroneously suggest that certain medicines are not available because they are not produced locally. They also blame the Government for their inability to compete for tenders.

The consumer - in this case vulnerable children at risk from malaria - must be the first and only consideration for the procurement of antimalarial commodities. Any attempt to favor local producers or special interest groups simply puts industrial policy ahead of public health, which is dangerous and unacceptable.