Subsidized, Cheaper And Effective Antimalarial Drugs In Nigeria

Malaria is a deadly endemic in Africa. The disease causing pathogen is transmitted by the bite of an infected female anopheles mosquito. The disease cause signs and symptoms that occur twice in a day when they burst out of red blood cells. Fortunately, there have been different curative drugs for it. The first was chloroquine which is now restricted due to development of resistance to it. It was cheap, effective and safe. Presently, there are newer, alternatives to chloroquine. Unfortunately, these ones are more expensive.
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Artemisinin based combination therapy (ACT) was introduced in 2000. They were adopted by World Health Organisation (WHO) in 2001. They are safe and effective with no resistance. This push WHO to change their treatment guideline to ACT as first line treatment of malaria. However, not every person's could afford the high cost of this drug. In other to provide this drug at all level at a price affordable for all, the Global Fund to Fight AIDS, Tuberculosis and Malaria in Geneva, Switzerland in association with other organisations like Roll Back Malaria (RBM) campaigne designed a programme to help subsidize these ACTs. This lead to the Launch of Affordable Medicines Facilities for Malaria (AMFs) in 2010. This programme began in most African countries including Nigeria in 2011.
The programme is designed to increase availability of ACTs in public and private sector, reduce cost, increase market share of ACTs among antimalarials and lastly increasing the use of ACTs among the poor people, children and people living in rural areas.
They partnered with some major drug manufacturers with reduced price for ACTs. They also make it possible for first line buyer to have access to ACTs from manufacturers. This help to cut cost of middle man. They also partnered with private sectors. This is because majority of poor people don't visit public health care facilities as much as they do in private sectors. The private health facilities are usually close by, cheap and saves time. They encourage them to use a lower markup price to help reduce the overall total price.
To differentiate between products in the market with lower cost and that have met the sponsors standard, manufacturers are mandated to brand all AMFs ACTs with a green leaf with the words 'ACTm.'
The Logo that is use to brand all AMF ACTs
AMF ACTs branded logo

AMF ACTs campaign in an Africa country
AMF ACTs campaign
So many years down the lane, there is yet to be a study by the government to investigate the positive effect of this good programme. Just some few private individuals have come up with some good analysis.
From some research already, it is unfortunate that many Nigeria's are not even aware that there is a programme of such. The problem it is causing is that they now seek herbal solution as they believe their money will not be enough to afford them the drug. This would have change if there is a public enlightenment campaign.
According to one survey carried out in one of the northern state of Nigeria (malaria research and treatment, by Ikeoluwapo O., Vol 13, June 2013) using 478 respondents, 97% knows about chloroquine. This is in sharp contrast to those who know about ACT (42%). 36% knew ACT is the first line therapy in the management of malaria.
Coming now to AMF ACTs, the result is quiet disturbing. Only 9% knew about AMF ACTs. Also, 43% have seen the package of one of the AMF ACTs with its symbol. For those who knew, majority got to know about it from radio stations jingles. The symbols was to some an indication that it is an ACT. The others felt it meant nothing while the last group knew what it was for.
What this mean is that health facilities are not doing enough to enlighten the general public as to the use of subsidized ACTs. This have been left for the government to do who have paid less attention to it.
The cost of AMF ACTs is less than the costs of the other unsubsidized ACTs. But it is higher than the recommended price. But that is better. If we push hard for a availability of these cheaper products, more lives will be save. The benefits far outweighs the cons.
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Some countries are yet to adopt ACTs as first line therapy. Some are still using artemisinin products alone or in combination with older drugs. This is because ACTs are more expensive than the the older cheaper drugs. They also fear entering AMF ACTs programme will backfire when the donor agents stop sponsoring the programme leaving the country at the mercy of malaria. This argument is valid. But each country should also push for preventive measures rather than the fight for cure.
So when next you visit your community pharmacy, you can as well ask for any ACT with the logo or subsidized brand. They are cheaper, equally active and equally safe.
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