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WHO Rejects Accusation of Promoting Wrong Malaria Drugs in Africa
Lisa Schlein
Geneva

The World Health Organization rejects claims made in a British medical journal that it is undermining its own campaign against malaria by promoting inexpensive outdated drugs in parts of Africa where drug resistance is growing.

The scientists writing in The Lancet medical journal accuse the WHO of promoting the wrong malaria drugs in Africa. They say this has resulted in tens of thousands of children dying unnecessarily every year. A spokesman for the World Health Organization, Ian Simpson, says he finds these charges offensive.

"We are slightly perplexed by some of these allegations, because since the beginning of 2001, we have been strongly recommending the use of artemisinin-based combination therapies," said Mr. Simpson. "We agree with the authors of this article that the use of artemisinin-based combination therapies is absolutely the best way to treat malaria. And, we have been saying that to countries, which have asked for advice. We have been giving that advice to all of the countries in sub-Saharan Africa, where malaria is endemic."

WHO estimates more than a million people die from malaria every year. Most are children in sub-Saharan Africa. WHO's "Roll Back Malaria" campaign aims to cut these deaths by half by the year 2010.

But, the authors of the Lancet article say WHO is undermining its own program by promoting less effective chloroquine in African countries.

The authors say the use of more powerful artemisinin-class combination therapy, known as ACT, could save many lives. They accuse the World Health Organization of having given in to pressure by the United States and other countries to promote the use of chloroquine, which is 20 to 30 times cheaper than ACT. A dose of chloroquine costs about 10 cents, compared with two to three dollars for a dose of ACT.

Mr. Simpson denies these charges. He says WHO's role is to advise governments on the best possible drug policy, not to dictate their practices.

"Since 2001, we have been recommending that governments make that review. If they conclude that chloroquine is no longer effective, or that another alternative treatment called SP is no longer effective, that they should switch to artemisinin-based therapies," he said. "Some countries have already done that. Some countries are in the process of reviewing that policy and some countries have not yet done so. But, we will continue working with all of the countries in the malaria endemic area, until all countries are using a treatment which is most effective against malaria."

Mr. Simpson says, with the establishment of the Global Fund for AIDS, Tuberculosis and Malaria, more money now is available for African governments to purchase the more expensive ACT anti-malarial drugs.