Enhancing access to antimalarials
Delivery of Novartis ACTs to Nigeria
During the first week of April, Novartis shipped 2.5 million artemisinin-based combination therapy (ACT) treatments to Nigeria – the initial delivery under a groundbreaking new international program designed to bring effective and affordable medicines against malaria within the reach of millions of people across Africa and Asia.
Employees at the Society for Family Health warehouse in Abuja, Nigeria, load boxes of artemisinin-based combination treatments from Novartis for distribution to hospitals and pharmacies around the country.
The shipment is part of a multi-year agreement with Nigeria calling for delivery of 10 million treatments during 2010 and 2011. Financing will be provided under the Affordable Medicines Facility – malaria, or AMFm, an international partnership formed to expand access to ACTs.
Critical complement
Novartis provides ACTs at no profit for public sector use in developing countries under a pioneering partnership with the World Health Organization, United Nations agencies such as UNICEF and other procurement partners. Since 2001, Novartis has provided more than 300 million ACT treatments to patients in more than 60 malaria-endemic countries, the vast majority in Africa.
The AMFm program represents a critical complement to access-to-medicine programs focusing on public healthcare systems. Because people in many African countries lack immediate access to public health facilities, they usually buy antimalarial drugs at local market stalls and drug shops. Many poor Africans still purchase older medicines because of their lower price. Currently, only one in every three patients treated for malaria worldwide has access to ACTs.
Through the AMFm initiative, funds from international donors will be used as subsidies, to slash the price of ACTs at retail outlets across Africa. The Global Fund To Fight AIDS, Tuberculosis and Malaria that will manage the AMFm initiative expects the retail price of ACTs to plummet to between USD 0.20 to USD 0.50 per treatment, from current prices ranging from USD 6 to USD 10 per treatment.
“As a result of the AMFm program, retail prices will be significantly lower and access expanded - especially for the working poor living in remote rural areas of Nigeria and other parts of Africa where regular pharmacies are almost non-existent,”
says Silvio Gabriel, Executive Vice President and Head of Malaria Initiatives at Novartis
During the first two years of the AMFm initiative, costs estimated at USD 225 million will be shared by the government of the United Kingdom and UNITAID, a drug purchasing facility funded by a surtax on airline tickets, which is supported by 29 countries.
The Global Fund will provide a co-payment enabling manufacturers to sell ACTs to local buyers at about five cents per treatment. In Nigeria, the local buyer is the Society for Family Health, one of the country’s largest nongovernmental organizations. Society for Family Health is active in family planning, as well as nationwide health programs to combat HIV/AIDS, diarrheal diseases and malaria.
Filling gaps in Nigeria
Malaria is endemic in Nigeria with 97% of the population at risk of infection. With an estimated 120 million malaria cases and 300,000 deaths from malaria each year, Nigeria accounts for about 25% of Africa’s total number of cases and mortality. The country’s recommended first-line treatment for malaria is an ACT from Novartis.
Malaria quick facts
- An estimated 863,000 malaria deaths occurred in 2008
- 89% of malaria-related deaths occur in sub-Saharan Africa
- Young children, pregnant women and people who lack any immunity to the disease are the most affected
- Malaria costs USD 12 billion every year in lost GDP to Africa
In a July 2009 application to the Global Fund seeking funding from the AMFm program, the Society for Family Health cited a nationwide survey showing that 73% of public health facilities and 97% of registered pharmacies had the Novartis ACT treatment in stock – but only 15% of private health facilities and 7% of private medicine vendors stocked the drug. Despite rising investments in malaria control programs, overall national access to ACTs remains low – with only 2.4% of children under five years of age receiving ACTs within 24 hours of the onset of symptoms. Nigeria’s goal is to provide coverage with ACTs to more than 80% of malaria patients by 2011. “The AMFm program provides a timely opportunity to make significant progress toward filling the gaps,” the Society for Family Health wrote.
“Novartis is proud to be the first company supplying large volumes of customized ACT products to this new segment of the retail market,” said Silvio Gabriel, Executive Vice President and Head of Malaria Initiatives at Novartis. “As a result of the AMFm program, retail prices will be significantly lower and access expanded – especially for the working poor living in remote rural areas of Nigeria and other parts of Africa where regular pharmacies are almost non-existent. We welcome the initiative as yet another example of the power of partnerships and international cooperation which has the potential to benefit millions of patients and save lives.”
