The “grand experiment” of the Affordable Medicines Facility-malaria (AMFm) — a pilot program that aims to get artemisinin-based combination therapies (ACTs) into rural areas of several African nations — “seems likely to end, its successes underrated and potential improvements not yet explored,” a Nature editorial says. In October, “an independent evaluation found that it had performed remarkably well on the main benchmarks of success, increasing the number of outlets stocking ACTs and lowering prices,” but last week “the Global Fund to Fight AIDS, Tuberculosis and Malaria decided to end the AMFm as a stand-alone program, by integrating it into the fund’s core system for awarding malaria-control grants to countries,” the editorial notes, adding, “This integration probably spells the end for AMFm, because there will be no new money for the program after the end of next year.”
IRIN examines the controversy surrounding the Affordable Medicines Facility-malaria (AMFm), writing, “The argument over the way it operates has reignited ahead of a board meeting of the [Global Fund to Fight AIDS, Tuberculosis and Malaria] on 14-15 November, which is due to assess the success of the project and its reliance on private sector providers.” The news service reports on an evaluation of AMFm published recently in the Lancet and another paper by Oxfam criticizing the facility. The Global Fund Board, which administers AMFm, “is meeting in nine days to decide whether AMF has worked as was intended, and whether it should be continued, scaled up, or abandoned altogether,” IRIN writes (11/5).
The BMJ examines the history of fraud allegations against the Global Fund to Fight AIDS, Tuberculosis and Malaria and the organization’s ongoing reform efforts. “Most observers agree that after a honeymoon first decade, the Global Fund had grown so big, and the economic climate and attitudes to diseases such as AIDS have changed so dramatically, that more rigor and efficiency was needed, fraud or no fraud,” BMJ writes. The Fund is expected to appoint a new director “and a new funding model, to be announced on November 15, [which] are supposed to get things back on track” (Arie, 11/12).
BBC News examines “a worrying drop in the effectiveness of the artemisinin-based drugs” against malaria along the Cambodian-Thai border, and how clinics are attempting to combat the trend by offering monetary incentives to patients to complete treatment regimens. “Thanks to the efforts of health workers … , and the widespread availability of treatment, malaria still only kills a handful of people in Thailand each year,” according to the BBC. “The focus now is on trying to monitor and contain artemisinin drug resistance into a few hotspots, prolonging the drug’s effective lifespan globally until alternative treatments are available,” the news service writes, adding, “Africa’s hopes of maintaining its progress rests firmly on South East Asia’s efforts.” Fatoumata Nafo-Traore, executive director of Roll Back Malaria and the former health minister of Mali, said if drug-resistant malaria reached Africa, it would be a “massive crisis” because there is not an alternative drug to the usually highly effective artemisinin-based drugs, according to BBC (Fisher, 11/22).
“Many of Africa’s anti-malaria drugs are fake or of poor quality, weakening a crucial battle against the world’s deadliest disease, a new investigation has found,” GlobalPost reports, adding, “Many of the drugs — even those approved by the World Health Organization — are Chinese fakes or low-quality variants that failed quality tests, according to two new studies released today” (Conway-Smith, 7/10). “Two studies published in Research and Reports in Tropical Medicine suggested manufacturing problems, rather than counterfeiting, may be to blame for these substandard drugs in low- and middle-income countries around the world,” Agence France-Presse writes (7/10). Writing in a Business Day opinion piece published on Tuesday, “Roger Bate, lead author of the studies and a scholar at the conservative American Enterprise Institute, warned of ‘unthinkable’ public health consequences from drug resistance,” GlobalPost notes.
Cuban Company's Sales Of Larvicides To Fight Malaria-Carrying Mosquitoes In Africa Continue Despite U.N. Concern, Miami Herald Reports
The Cuban state-owned company Labiofam “is increasing sales of its mosquito larvicides to fight malaria in Africa, despite cautions by U.N. experts that such products have limited use and are not the most cost-effective method of attacking the disease,” the Miami Herald reports. The company’s website “says its larvicide Griselesf is used in anti-malaria programs in Ghana, Angola, Gambia, Tanzania, Nigeria, Burkina Faso, Equatorial Guinea, and Zambia,” according to the newspaper.
IRIN reports on allegations that a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria to Uganda was misused. “Evidence of the mismanagement of a $51 million malaria grant to Uganda from the Global Fund resulted in the July arrest of three Ministry of Health employees and prompted a police investigation into the matter,” the news service writes, adding, “In September, the organization called for the refund of any ineligible expenses under the grant and the strengthening of safeguards to prevent future misappropriation of funds.”
The Affordable Medicines Facility-malaria (AMFm) — an innovative financing mechanism that subsidizes the cost of artemisinin-based combination therapies (ACTs) in order to expand access to the most effective treatment for malaria — “brought more than 100 million doses of malaria drugs to clinics and pharmacies in 2011” and “also increased access to the top malaria medicines by 26 to 52 percent in six countries,” according to results from the first phase of the program, which is hosted and managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria, NPR’s “Shots” blog reports. The results of the evaluation, released on Wednesday in Washington, D.C., do not estimate how many lives were saved because of improved access to effective malaria medications, as “AMFm ran for only a year and half in most countries,” according to the blog. “The AMFm negotiated with drugmakers to reduce ACTs prices, and then the Global Fund subsidized the initial purchasing of the drugs by clinics and pharmacies,” the blog notes.
The annual number of child deaths worldwide has fallen more than 40 percent since 1990, “the result of myriad improvements in nutrition, access to vaccines and antibiotics, cleaner deliveries, better care of infants immediately after birth, and the use of insecticide-treated mosquito nets,” according to “the findings of a report released Wednesday by three United Nations agencies and the World Bank,” the Washington Post reports (Brown, 9/12). “In 1990, there were 12 million deaths of young children, but the latest figures … show that deaths had fallen by nearly half, to 6.9 million, by 2011,” the Guardian writes (Boseley, 9/12). “[T]he number of deaths is down by at least 50 percent in eastern, western and southeastern Asia, as well as in northern Africa, Latin America and the Caribbean,” the report says, VOA News notes (Schlein, 9/12). However, “[i]n some, mainly sub-Saharan countries, the total number of deaths of children younger than five increased,” BBC News writes, adding, “The Democratic Republic of Congo, Chad, Somalia, Mali, Cameroon, and Burkina Faso saw annual deaths of children under five rise by 10,000 or more in 2011 as compared with 1990” (Doyle, 9/13).
Secretary of State Hillary Clinton reflects on changes in U.S. global health diplomacy since taking office in this Global Health and Diplomacy opinion piece. “America had been leading the global health fight for decades,” but “we recognized that to sustain the impact of our work, we needed to change the way we did business,” she writes. “For example, while our agencies were providing tremendous leadership in isolation, they could still do more to collaborate effectively,” she writes, adding, “[W]e weren’t doing enough to coordinate our efforts with other donors or our partner countries,” and “we weren’t building sustainable systems to eventually allow our partner countries to manage more of their own health needs.” She says, “We were unintentionally putting a ceiling on the number of lives we could save.”