Disease with a cure
>Published: October 3 2005 03:00 | Last updated: October 3 2005 03:00
Malaria is one of the world's most devastating diseases, accounting for up to 500m infections each year, 1m deaths and billions of pounds of economic damage to the countries most affected, notably in Africa. But unlike Aids and other illnesses still vexing scientists, drugs exist that not only alleviate but cure malaria. More needs to be done to bring these artemisinin-based combination therapies (ACTs) to patients.
For the governments of the developed world, that should begin with fresh financial support. Meeting in London last month, donor nations pledged less than half the target set by the United Nations-backed Global Fund to Fight Aids, Tuberculosis and Malaria to support programmes planned up till 2007. Without greater subsidies, most people in need will not be able to afford the ACTs that have proved so effective.
In the longer term, more research is needed to keep ahead of the evolution of the highly complex malaria parasite. An effective model exists: public-private partnerships that combine non-profit, corporate and academic research to develop drugs for which commercial incentives are limited.
Yet the Medicines for Malaria Venture and the Malaria Vaccine Initiative are struggling to raise funding. The former claims it will be broke by next spring without additional support for existing programmes. Governments are put to shame by the generous support of a handful of philanthropists, led by the Bill & Melinda Gates Foundation.
More money to fight malaria needs to be backed by political support from the international community. The World Health Organisation's system of "pre-qualification" to approve drugs, and the Roll Back Malaria partnership operating alongside it to fight the disease, are woefully under-staffed. The latter has just three staff to co-ordinate procurement, projections of demand and technical assistance to countries seeking to acquire malaria drugs.
The pharmaceutical sector, led by Novartis, GlaxoSmithKline and Sanofi-Aventis, is already helping in the work to find new drugs and experimental vaccines. But it would be in the industry's own interests to second experienced staff to the WHO to create a better co-ordinated and staffed system that would provide the greater support and predictability the companies need to produce malaria treatments speedily and at cost. A new centralised mechanism for planning, purchasing and distribution may be necessary.
That leaves a final challenge for the developing world. Much money already ear-marked for ACTs by the Global Fund has not been used. That partly reflects suspicion about long-term international support and funding for ACTs. But it is also the result of bureaucracy, corruption and misplaced priorities. Recipient nations need to invest more in building up their own healthcare systems and improving distribution to ensure the best drugs are brought to their own people. | 
