NEW MEDICINE PIONEERED BY WHO COULD SOON PREVENT 100,000 CHILD DEATHS A YEAR IN AFRICA

The World Health Organisation (WHO) has developed a drug for malaria specifically targeted at children with severe symptoms who do not have prompt access to intra-venous treatment. Artesunate, derived from the Chinese herb Artemisia Annua has been developed for rectal use. Quickly absorbed, the drug halts the course of the disease, allowing the patient to regain consciousness and reach a health centre for further definitive curative treatment with oral anti-malarial drugs.

Trials of artesunate suppositories carried out in Malawi, Ghana, South Africa, and Thailand have shown rapid recovery within 24 hours with a single dose. WHO is seeking approval for this new drug from the regulatory authorities of the US, UK and Switzerland, on the basis that the highest level of review will facilitate rapid approval by the national authorities of malaria affected countries.

The widespread distribution and use of these suppositories in Africa is expected to reduce the number of children dying of malaria by at least 100,000 per year. To ensure the broadest possible access, the suppository should be made available at a cost of less than $1 per treatment.

In tropical Africa, young children are at the greatest risk of dying from malaria.

One to five out of every hundred young children with severe malaria suffer symptoms that make it impossible for them to take drugs by mouth. The most common of the symptoms are cerebral malaria, coma, recurrent convulsions, malaria with severe respiratory distress, severe malarial anaemia, impaired consciousness, and dehydration.

Severe malaria can be fatal if untreated. To survive, a child must be given injectable anti-malarial drugs immediately and safely. At present, many African children do not have prompt access to such medical facilities nor to trained health workers. Of those suffering from severe malaria who are referred for treatment only 18% reach hospital. Evidence shows that in some parts of rural Africa the remaining 82% either die on route to hospital or at home.

WHO, other RBM partners and national Governments are now working to ensure that this new medicine becomes readily available for children at high risk of malaria. One idea is to provide the suppositories as an emergency standby medication to all parents when their children are given routine immunisation. The suppositories could be mounted on a brightly coloured card which would be pinned to the wall of the house, with instructions that the suppositories are only to be administered to young children who are too sick to take any medicine by mouth.

This is one of the new tools that Roll Back Malaria hopes to use to reduce child deaths from malaria in Africa. Plans are under way to introduce this drug early next year.