Estimating the needs for artesunate-based combination therapy for malaria case-management in Africa.
Because of inadequacies in national health information systems, the volumes of drugs required to support an effective policy transition toward artesunate-based combination therapy (ACT) are unknown for most African countries. A series of national surveys and population projections have been used to estimate the age-structured fever burden among 41 malaria endemic countries in Africa. Under present fever-management guidelines, commodity costs and internationally agreed coverage targets, the financial resources to meet the needs of ACT in most African countries are huge. Between US$1.6 billion and US$3.4 billion per annum must be found to give Africa the chance to consider a drug policy based on ACT. Substantial reductions in these costs would be achieved through more effective targeting of resources--only 20% of drugs would be required to manage fevers among the most at-risk pediatric patient populations. Better diagnostics would also be an important consideration for a new ACT policy in Africa.
Snow
Robert W
RW
KEMRI/Wellcome Trust Collaborative Program, PO Box 43640, Nairobi, Kenya. rsnow@wtnairobi.mimcom.net
Eckert
Erin
E
Teklehaimanot
Awash
A
D000293:Adolescent; D000328:Adult; D000349:Africa; D000367:Age Factors; D000962:Antimalarials / Q000191:economics / Q000627:therapeutic use*; D037621:Artemisinins / Q000191:economics / Q000627:therapeutic use*; D000077332:Artesunate; D002648:Child; D002675:Child, Preschool; D016527:Drug Costs; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D008288:Malaria / Q000188:drug therapy* / Q000191:economics; D012307:Risk Factors; D012717:Sesquiterpenes / Q000191:economics / Q000627:therapeutic use*
D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D000077332:Artesunate