'Coca-Cola' model for delivering malaria meds prove successful
Scholars including one of Indian origin have recommended that a controversial program that uses the private market to provide affordable malaria treatments to people in Africa should be continued, noting that it has dramatically increased access to care for the people there.
Ramanan Laxminarayan of Princeton University and other public health experts stated that the two-year old pilot program, which is up for renewal this November and enables reduced-price malaria drugs to be sold in shops and market stalls, successfully broadened the availability of effective malaria therapies and reduced the use of less effective treatments that promote drug-resistance.
The private-market approach - sometimes called the Coca-Cola model in reference to the soda's apparent ability to reach remote areas of the world - aims to deliver drugs in regions where the majority of people obtain medicines from shops rather than from district hospitals or clinics.
"This experiment demonstrates that we can use private distribution mechanisms to make treatments available in rural areas," said Laxminarayan, a research scholar in the Princeton Environmental Institute, lecturer in economics at Princeton University and director of the Center for Disease Dynamics, Economics and Policy in Washington, D.C.
The researchers found that the program, known as the Affordable Medicines Facility - malaria (AMFm), enhanced access to the most effective malaria medicine, known as artemisinin combination therapy (ACT), while reducing purchases of less-effective drugs, such as artemisinin alone, which has been shown to promote artemisinin-resistance.
ACT prices were lowered by a range of US dollar 1 to US dollar 5 per dose in the five countries that substantially implemented the program, according to results published in the Oct. 31, 2012 issue of The Lancet.
The price-reductions were achieved via negotiations with manufacturers and subsidies from donors. The program operated in seven African countries (Ghana, Kenya, Madagascar, Niger, Nigeria, Tanzania and Uganda) and was organized by the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
The success of Coca-Cola and other goods at making it to rural markets stems from the fact that someone makes money at every step in the distribution chain, Laxminarayan said.
Making malaria drugs available at low prices to distributors and retailers enables these distribution chains to carry ACTs to distant marketplaces, he added.
The scholars presented their recommendation in an article recently published in the journal Science.