Surge in demand creates shortage of malaria drug

Sharply increased demand for artemether-lumefantrine, an artemisinin-based combination therapy (ACT) used to treat malaria, is likely to result in a shortage from now until at least March 2005.

Since 2001, the World Health Organisation (WHO) has recommended that countries where malaria is resistant to conventional treatments such as chloroquine should switch to ACTs. Forty countries, 20 of them in Africa, have officially adopted these medicines for the treatment of malaria since 2001; 18 countries adopted them in 2004 alone; and 14 countries have opted for artemether-lumefantrine as their first-line malaria treatment.

WHO concluded an agreement in 2001 with Novartis Pharma, under which Novartis provides its co-formulated artemether-lumefantrine product (Coartem) to WHO at cost for supply to the public sector of malaria endemic developing countries. Coartem is currently the only ACT that has been prequalified by WHO.

Orders for artemether-lumefantrine have increased rapidly since 2001, when WHO requested 220 000 treatment courses for the public sector. In 2004, demand of 10m treatment courses was forecast, and for 2005, WHO projects demand for 60m treatment courses.

Novartis has informed WHO that due to insufficient supply of the key ingredient artemether from its Chinese suppliers, there is currently a shortage of the drug. As a result, WHO will not be able to procure the quantities of artemether-lumefantrine required by countries during the coming months. The shortage is likely to persist until at least March 2005.

WHO says it will offer technical assistance to any country facing interrupted supply of artemether-lumefantrine. Each country that has placed an order for artemether-lumefantrine will be provided with de-tails of expected quantities available, and delivery schedules. WHO will also establish a system to prioritise between requests for Coartem, based on a number of specific criteria (in addition to the existing eligibility criteria).