Novartis tackles malaria drug supply problems

Coartem blister card. Novartis

Swiss pharmaceutical firm Novartis says it hopes to overcome a shortage of a new drug used to fight malaria worldwide.

The reassurance came after the World Health Organization (WHO) warned that it would not be able to provide all countries with the quantities of Coartem that they require.

Novartis, which provides Coartem to WHO at cost price, had earlier reported that its Chinese suppliers were unable to provide sufficient quantities of artemisinin – a key ingredient in the drug. It said this was because of increased demand over the past few years.

A Novartis spokesman said the company would hold talks with its Chinese suppliers this week to discuss how to improve the situation.

“We are working on identifying additional sources of artemisinin supply, but this process takes time as Novartis strictly adheres to good manufacturing practices in its production,” media relations officer Bruno Hofer told swissinfo.

“But we are optimistic that over time sufficient quantities of artemisinin will be available to meet global demand.”

The UN health agency has been recommending that countries, particularly in Africa, switch to the new remedy as the mosquito parasite that causes the disease has become resistant to most other cures.

Shortfall

According to the health agency, the pharmaceutical company had intended to procure 60 million treatments in 2005, but only 2.4 million treatments would be readily available from December until the beginning of March 2005.

“Poor countries will not get enough of the drug,” WHO warned.

But Johannes Blum from the Swiss Tropical Institute said the supply shortage was not expected to lead to an increase in the number of malaria-related deaths, provided that alternative treatments such as quinine were readily available in adequate quantities.

The medical aid agency Medecins Sans Frontiers (MSF), which has repeatedly issued warnings regarding the supply shortage, said that the catastrophe had been foreseeable.

“This is the story of a catastrophe known ahead of time,” MSF expert Jean-Marie Kindermans said. “It is the failure of a joint partnership.”

Production problems

The difficulties are reported to be related to the cultivation cycles of the plant artemisia, from which artemisinin is extracted.

The plant, cultivated in China, needs almost six months to grow and is harvested just once a year. Another three to five months are needed for the extraction of the principal ingredient and for the manufacturing of the final product.

WHO said that countries that had already adopted the Coartem treatment would be given priority, but it recommended the increase in the production of quinine as an alternative treatment.

Malaria, one of the leading causes of death in affected areas, is passed to humans by mosquitoes. It is widespread in 90 countries, especially in sub-Saharan Africa.

According to WHO, two billion people live in affected areas and one million African children die from the parasitic disease every year.

New remedy

WHO has advocated use of the new remedy Coartem, which is currently the most effective medicine. The artemisinin-based drug is currently used in 40 countries.

In 2001, Novartis agreed to provide WHO with Coartem at cost price for distribution to the public sector in developing countries.

“Having such a life-saving drug available and knowing that the patients who need it most would never be able to [buy] it, Novartis considered it its responsibility to … make this safe and highly effective treatment available to patients in endemic countries,” Hofer told swissinfo.

Since 2001, demand for the drug has increased from 220,000 to 10 million treatment courses. For 2005 the WHO predicts a further increase to 60 million treatment courses.

swissinfo with agencies

Key facts

The malaria parasite is growing resistant to antimalarials like quinine and chloroquine.
This led Novartis to develop Coartem, an artemisinin-based compound.
The treatment is in use in 40 countries, half of them in Africa.
In 2001, Novartis struck a legally binding deal to supply WHO with Coartem at cost price.
Owing to the drug’s effectiveness, demand has increased greatly over the past few years.

In brief

WHO has warned that Novartis will not be able to supply the health organisation with the required treatment courses of the anti-malaria drug Coartem.

The supply shortage is expected to last until the beginning of March.

This is due to increased demand for supplies of the herbal plant artemisia, from which artemisinin is extracted to produce the drug.

The rate of malaria-related deaths is not expected to rise as a result of the supply shortage.