A two-year-old pilot program that aims to protect the most effective drug for malaria from resistance, through a novel economic strategy that supports the use of combination therapy, is in danger of being discontinued. The goal has been to boost the availability and affordability of artemesinin-combination therapies (ACTs) for treating the disease to assure that the key drug, artemesinin, remains effective. Barry R. Bloom, Joan and Jack Jacobson Professor of Public Health at Harvard School of Public Health (HSPH), co-authored a November 2, 2012 policy paper in the journal Science urging that the program be kept afloat but modified.
In 2010, the Global Fund to Fight AIDS, Tuberculosis and Malaria launched the program—the Affordable Medicines Facility for malaria (AMFm)—in seven African countries. Through the program, retail prices for ACTs have been significantly lowered and availability has increased in most of the pilot countries. Keeping the price of ACTs competitive is crucial, said Bloom, because people who can’t afford this therapy typically turn to artemisinin monotherapy or, worse, ineffective or substandard drugs. Because increasing resistance to artemesinin is already being seen in Asia from continued use of monotherapy, the World Health Organization recommends that only the combination therapy be used.