New malaria combination cheaper and easier to take

At least 50 million malaria patient a year could benefit from the first new drug developed by the 2-year-old Drugs for Neglected Disease initiative (DNDi). A patent-free, fixed-dose formulation of combined artesunate–amodiaq antimalarial will be available in early 2006.

Figure. Testing people for malaria at the DNDi/MSF program in Kigova, Burundi. Photo by: Leila Kramis

Unlike existing antimalarials, the new formulation combines 2 drugs in 1 tablet. Adult patients need only 2 tablets per day for 3 days, instead of 8 with current drugs.

“The big advantage is that it is simpler to take,” says DNDi Executive Director Dr. Bernard Pécoul.

The new drug is also cheaper: less than US$1 to treat an adult compared with US$2.5 for current combinations. In addition, current combinations cannot be used by children under 5; the new formulation can be used at 6 months of age.

Malaria is present in more than 100 countries, threatening 40% of the world's population and killing up to 2 million people annually, 90% of them in sub-Saharan Africa.

Sanofi–Aventis, the world's third largest pharmaceutical company, will register, manufacture and sell the drug at cost to NGOs, the public sector and international organizations. “The advantage of Sanofi–Aventis is that they are working in Africa already,” says Pécoul. The company has agreed to donate 3% of private sector sales revenue to DNDi.

The new formulation is generic, “so if it's used widely in Africa, or say, Indonesia, they can produce it themselves,” says Pécoul.

With the increasing parasite resistance to antimalarials, particularly chloroquine, WHO recommends combining 2 antimalarials, 1 being a derivative of artemisinin.

DNDi is supported by Médecins Sans Frontières, 5 public sector institutions and the UNDP/World Bank/WHO's Special Programme for Research and Training in Tropical Diseases. Currently, 18 projects are underway; a second antimalarial, targeted to resistant strains in Latin America and South East Asia, should also be ready in early 2006.