In its most recent newsletter “Malaria Bytes” Care Net Nigeria raises an important health and development question – can Local African pharmaceutical manufacturers play a bigger role in production of needed drugs to treat malaria. Although this issue is not yet posted to the website, the two previous offerings are available for download. In West Africa several drug exporters (e.g. IPCA) and manufacturers (e.g. SWIPHA) have stepped in with branded artesunate-amodiaquine (AS-AQ) products in both adult and child packets. There are many other AS-AQ producers and suppliers. As we know, Coartem, the artemether- lumefantrine (AS-AL) ACT is only produced by Novartis to date. This ‘monopoly’ is supported by WHO’s prequalification processes, although one AS-AQ manufacturer has been added. Mepha also markets its artesunate + mefloquine product in Africa.
Even with these pharmaceutical participants, there are still challenges. For example, when Ghana introduced AS-AQ as a first line ACT, there were problems with formulation and strong side effects. Quality control is needed. In 2005 Ghanaian health authorities had to withdraw the drug for more safety testing.
Recent discussions with representatives of the private sector in Kenya aired concerns that technical assistance is needed to help the African based pharmaceutical manufacturers improve their quality and capacity. In parallel there was also a call for technical assistance to help national Food and Drug Agencies/Authorities improve their capacity for testing and monitoring. Care Net Nigeria echoes this view: “Rather than continue with the monopoly already created by the Global Fund and WHO, manufacturers in developing countries should be assisted to catch up with the quality standards through this financial boom.” Such assistance is needed if the growing gap in malaria treatment needs is to be closed.