Subject(s)
Antimalarials/supply & distribution , Dapsone/supply & distribution , Drug Industry/economics , Malaria, Falciparum/drug therapy , Proguanil/analogs & derivatives , Proguanil/supply & distribution , Africa , Antimalarials/economics , Dapsone/economics , Drug Combinations , Drug Costs , Humans , International Cooperation , Malaria, Falciparum/economics , Proguanil/economicsABSTRACT
In 1996, Glaxo Wellcome offered to donate up to a million treatment courses annually of Malarone, a new antimalarial, with a view to reducing the global burden of malaria. The Malarone Donation Programme (MDP) was established the following year. Eight pilot sites were selected in Kenya and Uganda to develop and evaluate an effective, locally sustainable donation strategy that ensured controlled and appropriate use of Malarone. The pilot programme targeted individuals who had acute uncomplicated Plasmodium falciparum malaria that had not responded to first-line treatments with chloroquine or sulfadoxine-pyrimethamine. Of the 161 079 patients clinically diagnosed at the pilot sites as having malaria, 1101 (0.68%) met all the conditions for participation and received directly observed treatment with Malarone. MDP had a positive effect at the pilot sites by improving the diagnosis and management of malaria. However, the provision of Malarone as a second-line drug at the district hospital level was not an efficient and effective use of resources. The number of deaths among children and adults ineligible for MDP at the pilot sites suggested that high priority should be given to meeting the challenges of malaria treatment at the community level.
Subject(s)
Antimalarials/therapeutic use , Communicable Disease Control/organization & administration , Malaria, Falciparum/drug therapy , Naphthoquinones/therapeutic use , Private Sector , Proguanil/therapeutic use , Public Sector , Antimalarials/supply & distribution , Cooperative Behavior , Drug Industry , Health Services Accessibility , Humans , Kenya/epidemiology , Malaria, Falciparum/epidemiology , Naphthoquinones/supply & distribution , Pilot Projects , Program Evaluation , Proguanil/supply & distribution , Uganda/epidemiologyABSTRACT
This paper describes the introduction of the Malarone Donation Programme in KENYA: Using a policy analysis approach it illustrates the political nature of donation programmes and how they are affected by a large and varied group of national, regional and international stakeholders, with different levels of influence and experience. The paper shows that interaction between these different groups may affect the development and implementation of the donation programme. It ends by raising some more general questions about public/private partnerships and corporate donation programmes, and their potential impact on national drug policies.
