WHO spearheads push away from monotherapeutic malaria treatments

13 pharmaceutical companies, "including the main producers of high quality artemisinin monotherapies", have agreed to comply with The World Health Organisation's (WHO) recommendation to phase out single-drug artemisinin medicines for oral treatment of malaria and instead focus their marketing effort primarily on Artemisinin Combination Therapies (ACTs).

The WHO appealed to all companies to stop marketing oral artemisinin monotherapies in January 2006, as the use of single-drug artemisinin treatment - especially on a wide scale in uncomplicated malaria - hastens the development of resistance to artemisinin in malaria parasites. The Organisation instead urged companies to direct their production efforts towards ACTs, which, when used correctly in combination with artemisinin, is nearly 95% effective in curing uncomplicated malaria and reduced the likelihood of the parasite becoming drug resistant.

Following the January appeal, 23 companies were identified and informed of WHO's recommendation. 13 said they would comply with the WHO guidance while others have said that they are willing to collaborate with the WHO in this endeavour.

The Organisation has also called on national drug regulatory authorities in malaria-endemic countries to prohibit marketing of oral artemisinin monotherapies.

"To eliminate demand for single-drug artemisinin pills, national governments have a critical role to play," said Dr Arata Kochi, director of the WHO Global Malaria Programme. "We are monitoring this situation closely and we will work with authorities and health professionals in countries to support the use of quality ACTs in line with the WHO guidelines."

WHO will continue to closely monitor those companies that have not yet declared their position and will provide guidance to companies manufacturing ACTs that are seeking pre-qualification of their products.