The Novartis Malaria Initiative: lessons from a
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Adoption of integrated, malaria-control programs across Africa during the past decade has reduced the burden of disease significantly. Interventions combine prevention – use of insecticide-treated bed nets and indoor residual spraying of traditional dwellings – with improved treatment based on artemisinin-based combination therapy (ACT), the class of medicines pioneered by Novartis.
According to the WHO estimates, the number of malaria cases worldwide decreased by 18,000 between 2009 and 2004, while the number of malaria deaths declined by 166,000 during the same period.1
In 2008, UN Secretary-General Ban Ki-moon unveiled a new Global Malaria Action Plan, calling for malaria prevention and treatment programs to become universally available for at-risk populations by the end of 2010. Reiterating those objectives in April 2010, he declared: "Where countries have been able to provide bed nets and treatment to significant proportions of their populations, malaria cases and deaths have fallen by as much as 50 per cent. Overall child mortality rates have declined too. These achievements show that the battle against malaria can be won...and give great cause for optimism in our work towards the Millennium Development Goals."
At the United Nations summit in 2010 held to assess progress toward Millennium Development Goals, data were presented indicating that the lives of more than 1 million children could be saved in sub-Saharan Africa alone if existing control efforts were scaled up by 2015.
Traditional Chinese remedy
Coartem was discovered by Chinese scientists and jointly developed with Novartis, transforming a remedy used for centuries in traditional Chinese medicine into a modern medicine. First launched in 1999, Coartem is currently available in more than 85 countries and is currently the only ACT approved by the US Food and Drug Administration.
While Coartem demonstrated a cure rate of more than 95% in clinical trials, actual effectiveness falls short of that level because of pitfalls ranging from frequent disruptions in supply chains that limit availability to failure of patients to take the medicine according to recommendations. Novartis has addressed these obstacles through support to countries that goes far beyond just supplying the drug.
Working closely with national malaria control program managers (NMCPs), Novartis has designed comprehensive training programs for healthcare professionals to improve diagnosis of malaria and optimal use of Coartem. Educational materials from Novartis help parents and children understand how to prevent as well as treat malaria.
To tackle stock-outs, an issue repeatedly voiced by NMCP managers, Novartis has joined forces with Vodafone Group PLC, IBM Corp. and the Roll Back Malaria Partnership in a project adapting mobile phones as a tool for supply chain management. Called SMS for Life, the system enables central warehouses to monitor stock levels at remote health centers – as well as to receive orders – via short, inexpensive text messages. In another refinement of logistics and distribution, Novartis has broadened distribution. Many recipient countries prefer to pool purchases of essential medicines through a single procurement agency and Novartis now works directly with many recognized international development agencies, from UNICEF and the UN’s Development Program (UNDP) to The US PMI and Doctors Without Borders.
Together with Medicines for Malaria Venture, a nonprofit research organization, Novartis developed a new pediatric formulation of Coartem that is sweet-tasting and designed to disperse quickly in small amounts of water. Dispersible tablets contain the same amount of active ingredients and work the same way to cure malaria as the regular tablet – but represent an attractive alternative for infants and children who find it difficult to swallow crushed, bitter tablets.
"There is no better partner than Novartis in the fight against malaria," said Jeffrey Sachs, director of the Earth Institute at Columbia University. "The company’s contribution is exemplary and inspiring."
- WHO World Malaria Report, 2010. Available at www.who.int/malaria/world_malaria_report_2010/world_malaria_report_2010.pdf Last accessed April 2011