Malaria: Boosting research and development in Africa

Addis Ababa, 25 November 2005 - Groundbreaking research is being undertaken into medicines, diagnostics, and vaccines aimed at preventing the killer disease malaria. These developments hold great promise for boosting treatment strategies.

However, these advances are hardly benefiting Africa countries where they are perhaps needed most. Research and development on the African continent is a long and costly process. And medical research is biased towards high-profit products. Added to which there is little coordination between existing research programmes and the various stakeholders. These are considerable challenges for a poor and struggling continent.

Research findings guide policy development, decision-making and the design of health programmes aimed at addressing the unique microbial diversity of tropical Africa. But diseases of the rich take precedence over those of the poor (WHO 2002).

Malaria accounted for 2.7% of the global disease burden in 2000, with 90% of cases occurring in Africa. However malaria research was only awarded 0.17% of the $60 billion spent globally on biomedical research (WHO 2001).

But Africa cannot stand still. Nations must make strategic investments in research and development to derive maximum benefits from limited resources. Promoting research partnerships, focusing on applied research, strengthening regulations and making international legislation beneficial to Africa have been effective. Malaria is a case in point.

The disease remains a major global problem, exacting an unacceptable toll on the economic welfare of the world community. An estimated 300-500 million people a year are affected. One million malaria deaths occur annually (UN 2005). It is a major cause of low birth weight in newborn children, anaemia and infant mortality. Malaria stunts a child's physical and mental development, and deprives nations of a strong and able workforce. And the malaria transmission season generally coincides with the planting and harvesting season thus reducing a country's agricultural productivity and increasing poverty.

Malaria is rife in sub-Saharan Africa and drug resistance has become one of the greatest challenges in controlling the disease. But encouraging results from a new drug - Artemisin Combination Therapy (ACT) - have given the continent fresh hope.

The preferred new drug contains a derivative of the plant Artemisia annua, grown in China and Vietnam. Since 2001, 23 countries in sub-Saharan Africa have adopted ACT, although only nine have actually implemented ACT treatment. Fourteen others are in the process of doing so.

The effectiveness of ACT holds out great hope not only in combating malaria, but also in cultivation. Close collaboration has been established between Coartem, a leading global supplier of ACTs, and three East African companies - `African Artemisinin' which operates in Tanzania, East African Botanicals in Kenya, and East African Botanicals in Uganda (Novartis 2005). The objective is to expand the 10,000 hectares of artemisia cultivation, currently mostly carried out in China, by adding 1,000 hectares in Kenya, Tanzania, and Uganda. This would increase production significantly and enable 100 million treatments globally by the end of 2006.

Thus, through a private-public partnership, applied research in health products in East Africa is being implemented. And in addition, expanding cultivation and extraction capacity in Africa itself has enormous economic potential for malaria control and poverty alleviation. Furthermore, diversifying production assists in biodiversity and reduces the risk of adverse climatic factors.

Despite these noteworthy developments, there are still a number of challenges. ACT costs are high and procurement is haphazard. The need to achieve economies of scale in production, scale up extraction, and expand manufacturing is still not being met. But the pilot project gives fresh hope and demonstrates the potential of African applied research and African ownership of development challenges.