A paediatric malaria treatment, developed in partnership with Brazil’s Instituto de Tecnologia em Fármacos (Farmanguinhos/Fiocruz) and the non-profit medical research organization Drugs for Neglected Diseases initiative (DNDi), will be distributed free of charge through the Brazilian Universal Health System (SUS) to Indigenous children in the Amazon.
This artesunate and mefloquine drug combination, also known as ASMQ, was developed in Brazil as a non-exclusive, not-for-profit public good by a coalition of partners, including Farmanguinhos/Fiocruz and DNDi, to address the problem of the malaria-causing parasite Plasmodium falciparum’s growing resistance to available treatments. The endemic strain is the leading cause of severe malaria in Brazil. ASMQ is a fixed-dose drug combination that is safe, effective, affordable, adapted to tropical conditions, and convenient for patients. It can be given to very young children, from six months of age.
More than 130,000 malaria cases and 62 deaths were reported in Brazil in 2022, with 99% of cases occurring in the Amazon region. Among the more than 1.5 million cases identified in the Brazilian Amazon region from 2013 to 2022, 29% were in children 12 years old and younger.
In January 2023, the Brazilian Ministry of Health declared a public health emergency in the region to address healthcare access issues for people living in the Yanomami territory. One of the main motivations behind this decision is malaria, which reached a record 25,900 cases in 2023 and continues to be one of the leading causes of hospitalization and death in the region in 2024.
‘The treatment offers a lot of advantages. It has few side effects, and it was designed to address the specific needs of children, who are the primary victims of malaria worldwide. The tablets are small and can be crushed, which facilitates administration. Patients feel better on the first day of treatment. In my opinion, the ease of use and speed of recovery make ASMQ the biggest advance in the treatment of malaria in the last 15 years,’ said Jorge Mendonça, director of Farmanguinhos.
ASMQ combines two molecules, artesunate and mefloquine hydrochloride, in a single, simplified treatment. It was developed through a unique, open science, straight-to-generic, not-for-profit model of pharmaceutical development. Studies to prove its safety and efficacy were conducted in Thailand and Brazil. It was registered in Brazil in 2008 and incorporated into the Brazilian National Malaria Prevention and Control Program in 2010.
South-South technology transfers also allowed the medicine to be manufactured in India to address patient needs for ASMQ in Asia.
‘This successful model of not-for-profit collaborative pharmaceutical development, led by an endemic country to address the specific needs of its population, can teach us many valuable lessons about developing new treatments for other diseases requiring urgent attention – including to tackle the fast-spreading dengue epidemic,’ said Dr Sergio Sosa-Estani, director of DNDi Latin America.
‘We are encouraged to see that ASMQ is used as a first-line treatment for Indigenous children in the Amazon region. We recognize Brazil’s Ministry of Health for its work to secure access to malaria treatments for children.’
The Amazon region where ASMQ will be distributed comprises the states of Acre, Amazonas, Amapá, Pará, Rondônia, Roraima, Tocantins, Mato Grosso, and Maranhão.
About Farmanguinhos
Founded in 1976, the Institute of Technology in Pharmaceuticals (Farmanguinhos/Fiocruz) is a technical-scientific unit of the Oswaldo Cruz Foundation (Fiocruz). It operates in a multidisciplinary manner in the areas of education, research, innovation, technological development, and the production of medicines.
Farmanguinhos is an official pharmaceutical laboratory affiliated with Brazil’s Ministry of Health. In addition to researching, developing, and producing essential medicines for the Brazilian population, the Institute also stands out in the fight to reduce the cost of medicines, thereby increasing access to public health programmes for more people.
About DNDi
The Drugs for Neglected Diseases initiative (DNDi) is a not-for-profit medical research organization that discovers, develops, and delivers safe, effective, and affordable treatments for neglected people. DNDi is developing medicines for sleeping sickness, leishmaniasis, Chagas disease, river blindness, mycetoma, dengue, paediatric HIV, advanced HIV disease, cryptococcal meningitis, and hepatitis C. Its research priorities include children’s health, gender equity and gender-responsive R&D, and diseases impacted by climate change. Since its creation in 2003, DNDi has joined with public and private partners across the globe to deliver 13 new treatments, saving millions of lives.
Financial and technical support for the development of ASMQ was provided by Farmanguinhos from Fiocruz; WHO-TDR, Special Programme for Research and Training in Tropical Diseases; the European Union (through the Framework Partnership 5); the French Development Agency (AFD); the Dutch Ministry of Foreign Affairs (DGIS); Médecins Sans Frontières International; the Spanish Agency for International Development Cooperation (AECID) and UK International Development.
DNDi transferred the implementation of its malaria-related projects to the Medicines for Malaria Venture (MMV) in 2015.
Media contacts
Farmanguinhos
Arielle Curti
Phone: +55 (21) 3348-5166
E-mail: comunicação.far@fiocruz.br
DNDi
Frédéric Ojardias (in Geneva)
Mobile: +41 79 431 62 16
E-mail: fojardias@dndi.org
