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 By The Citizen Reporter
The World Health Organisation (WHO) has released new guidelines for the treatment of malaria, which are going to have a major impact on the fight against the disease in the country.The global health watchdog has also released its first ever guide on the procurement of safe and effective medicines, in a move to intensify the campaign against the leading killer disease.
The new guidelines officially endorse the use of the artemisinin-based combination therapies (ACTs), as the major treatment regime for malaria.
“The WHO recommends that oral artemisinin-based monotherapy should be removed from the market because its use will hasten the development of parasite resistance,” the organisation said in a statement released yesterday.
Contacted for comment, a malaria research expert with National Institute for Medical Research (NIMR), Dr Leonard Mboera, said the new recommendations should lead to some changes in the country’s malaria treatment policy.
“But we need to fist study the WHO document in order to establish to what extent the new guidelines affect our current policy. This is because there are many other things, which the WHO has recommends at a time when we are already implementing them,” said Dr Mboera.
Acknowledging that he had seen the document, the expert said the government had instituted the ban on artemisinin-based monotherapy for several years now.
But he advised on the need for proper use of the ACT drugs to maintain the efficacy of the medicines.
“We have been hearing cases of people lamenting that it is cumbersome to take the ACT for five consecutive days. This suggests that there might be people who cut their malaria doses and this should alarm the authorities,” Dr Mboera said by telephone.
The WHO also cautions in its new guidelines on the need for proper application of the recommended treatments.
“In recent years, a new type of treatment called artemisinin-based combination therapy (ACTs) has transformed the treatment of malaria, but if not used properly, the medicine could become ineffective,” says the WHO statement.
Efforts to get comments from the minister for Health and Social Welfare, Prof David Mwakyusa, failed.
But his deputy, Dr Aisha Kigoda, said she could not comment on the matter, as she was attending a meeting in Iramba district in Singida region.
In order to widen the treatment base, the WHO has now added a fifth ACT - dihydroartemisinin plus piperaquine - to the previous list of recommended medicines.
According to the WHO, the guidelines provide current recommendations for countries on malaria diagnosis and treatment.
However, unlike the directives issued in 2006, the new guidelines put emphasis on testing before treating and the addition of a new ACT to the list of recommended treatments.
“The world now has the means to rapidly diagnose malaria and treat it effectively,” said Dr Robert Newman, the WHO Global Malaria Programme (GMP) director.
The WHO also recommends testing in all cases of suspected malaria, stressing that treatment based on clinical symptoms alone should be reserved for settings where diagnostic tests are not available.
The agency has pledged its support to malaria endemic countries to improve the quality of their diagnostic services using both microscopy and Rapid Diagnostic Tests (RDTs).
In 2008, just 22 per cent of suspected malaria cases were tested in 18 of the 35 African countries reporting.
“The move towards universal diagnostic testing of malaria is a critical step forward in the fight against malaria as it will allow for the targeted use of ACTs for those who actually have malaria,” says the WHO.
According to the agency, insistence on diagnosis is meant to reduce the emergence and spread of drug resistance and help identify patients who might have fever, but do not have malaria.
In the meantime, the WHO has also issued guidelines on “good procurement practices for artemisinin-based antimalarial medicines”; based on the newest stringent internationally agreed production and procurement quality standards.
“This manual aims to improve the capacities of national and international procurement officers in the understanding of key quality elements and required documentation,” says WHO.
The guidelines come with an observation that pharmaceutical markets in malaria endemic countries are often unregulated and national authorities need help to assess the quality of malaria medicines before they buy them.
“These guidelines will help countries to select and procure effective medicines of good quality and save lives by improving the way patients are diagnosed and treated,” said Dr George Ki-Zerbo, Malaria Programme Manager at the WHO Regional Office for Africa in Congo Brazzaville.
The new guidelines come only a few days after Tanzania unveiled major anti-malaria campaign known as Zinduka. President Jakaya Kikwete launched the initiative, which involves the country’s leading new generation musicians, at a well-attended concert in Dar es Salaam.
President Kikwete used the opportunity to call on every Tanzanian to get involved in the effort.
The campaign aims to promote awareness about the disease and the danger it poses to the nation, the President said, noting that 290 people die of malaria daily in the country.
According to the global mapping by the WHO, Tanzania is located in a very high malaria endemic area. For the population to stay safe, effective preventive interventions must be put in place at all times.
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