First medicines developed by Drugs for Neglected Diseases Initiative (DNDi) will be easier to use and less expensive than current ACTs, but action is needed to make sure the treatments reach patients.

Two new, non-patented malaria treatments will be available in the global fight against the disease by the second half of 2006, the Drugs for Neglected Diseases initiative (DNDi) announced today at 54th annual American Society of Tropical Medicine and Hygiene (ASTMH) Conference. The fixed-dose, artemisinin-based combination therapies (ACTs) – artesunate/amodiaquine (AS/AQ) and artesunate/mefloquine (AS/MQ) – will be easier to use and less expensive than current ACTs, and will also be available in pediatric formulations.

DNDi’s innovative FACT Project (fixed-dose, artemisinin-based combination therapy) has brought together academic, public and private partners from around the world to address the need for more effective tools to battle malaria. These two new ACTs are the first medicines developed by DNDi since its inception in 2003.

“ These two, new fixed-dose combinations have been adapted to patients’ needs – they are more affordable and easier to use,” said Dr. Bernard Pecoul, Executive Director of DNDi. “ The fact that they are not under patent removes a significant barrier to their availability and should serve as a model for future drug development for neglected diseases.”

Because increasing resistance has rendered common anti-malarials like chloroquine ineffective, the World Health Organization (WHO) has recommended the use of ACTs since 2001. To date, 43 sub-Saharan countries have adopted ACTs in their malaria treatment protocols, but only 15 have actually begun to implement the change, and only a handful have done so on a national level.

“In our projects worldwide, MSF has seen that patients urgently need safe, effective, affordable malaria treatments, and a fixed-dose combination leads to better adherence,” said Dr. Unni Karunakara, Medical Director of the Doctors Without Borders/Médecins Sans Frontières’ (MSF’s) Campaign for Access to Essential Medicines. “Today, even though many countries have changed their national protocols to ACT, very few patients are actually receiving the treatment. The problem in tackling malaria now is no longer medical, technical, or scientific – it is political.”

High cost and procurement problems on the local and regional levels have so far prevented wider access to ACTs. The cost of the new fixed-dose treatments from DNDi could be up to 50% less than existing ACTs, with the target price for the new AS/MQ formulation being $2-$2.50 US for adults and $1-$1.50 US for children. For the AS/AQ formulation, which is being produced by sanofi aventis, the target price will be $1US for adults and $0.50 US for children.

“We have to find ways to make the price of these new medicines, and ACTs in general, comparable to the cost of chloroquine,” said Professor Nick White, Professor of Tropical Medicine at Oxford University. “A subsidized fund could be one solution, but i t is clear that the international community has to take immediate steps to fund the fight against malaria with medicines that work.”

The Drugs for Neglected Diseases Initiative (DNDi) is an independent, not-for-profit drug development initiative established in 2003 by MSF and six other founding partners, including public sector research institutions from Brazil, Kenya, Malaysia, and India as well as the Institut Pasteur in France and the World Health Organization’s Tropical Diseases Research (TDR) program. With a current portfolio of 20 projects, DNDi aims to develop new, improved, and field-relevant drugs for neglected diseases – such as leishmaniasis, human African trypanosomiasis, and Chagas disease – that afflict the very poor in developing countries. DNDi also raises awareness about the need for greater R&D for neglected diseases and strengthens existing research capacity in disease-endemic countries. For further information, please consult www.dndi.org

Malaria in figures

WHO has designated Malaria, as well as HIV/AIDS and TB, as one of the major public health challenges undermining development in the poorest countries in the world.

• Malaria kills approximately three million people every year, and affects some 500 million.
• A child dies of malaria every 30 seconds in Africa.
• An estimated 50% of the world population, mostly living in the world poorest countries, are at risk of malaria.
• Malaria is the leading cause of death among the under-five children in sub-Saharan Africa.
• Despite being recommended by WHO since 2001, the deployment of ACT is underway in 15 Sub-Saharan countries out of 43 listed by WHO-AFRO. Fifteen countries have adopted the policy of AS-AQ as first-line.
• It is estimated that dozens of millions of people could benefit from this treatment each year.