The debate over ‘outdated’ drugs
Jan 26, 2004
Recently, a team of scientists published an opinion in the Lancet, a medical journal, that developing countries, including Uganda, were wasting time and money on medicines like chloroquine and fansidar, which they considered “outdated†and no longer effective.
By Charles Wendo
Recently, a team of scientists published an opinion in the Lancet, a medical journal, that developing countries, including Uganda, were wasting time and money on medicines like chloroquine and fansidar, which they considered “outdated†and no longer effective.
They also accused the World Health Organisation, (WHO) and the Global Fund to fight HIV/AIDS, malaria and tuberculosis, of supporting such treatments.
For instance, they said the Global Fund made a mistake to approve a grant for Uganda to buy chloroquine and fansidar.
“These are very obvious errors of scientific and medical judgement,†the team, led by Dr. Amir Attaran of the British Royal Institute of International Affairs, wrote.
They want governments in malaria-prone countries to use newer drug combinations containing artemisinins, known in medical circles as ACT. Their arguments received wide coverage from the British Broadcasting Corporation, (BBC).
However, the Director General of Health Services, Prof. Francis Omaswa, considered the arguments as being out of touch with third-world realities.
Omaswa said whereas chloroquine and fansidar are not 100 percent perfect, they had drastically reduced childhood mortality and morbidity in communities where government has supplied treatment for free under the home-based management of fever (HBM) project.
“We are going to publish the evidence,†he said.
He agreed that malaria is increasingly becoming resistant to these drugs, but can be very effective.
The WHO representative in Uganda, Dr. Walker Oladapo , said there is no point in using the most expensive drugs, and then treat only a tiny fraction of the population.
Currently, an adult dose of artemisinins drugs in Uganda costs an average of sh14,000.
Comparatively, the chloroquine-fansidar combination used in the HMB project costs sh120 per dose. This means if government changes to artemisinins drugs they can treat only a tiny fraction of the malaria patients. “Any responsible government will not want to marginalise any sector of society.
The man in Kampala, as well as the man in Arua, should be able to treat his malaria,†Oladapo said.
Neither Omaswa or Oladapo says artemisinins drugs do not work.
While arguing that the artemisinins are too expensive for a poor country like Uganda, Omaswa and Oladapo say the Lancet article may have been motivated by commercial interests.
Recently, a team of scientists published an opinion in the Lancet, a medical journal, that developing countries, including Uganda, were wasting time and money on medicines like chloroquine and fansidar, which they considered “outdated†and no longer effective.
They also accused the World Health Organisation, (WHO) and the Global Fund to fight HIV/AIDS, malaria and tuberculosis, of supporting such treatments.
For instance, they said the Global Fund made a mistake to approve a grant for Uganda to buy chloroquine and fansidar.
“These are very obvious errors of scientific and medical judgement,†the team, led by Dr. Amir Attaran of the British Royal Institute of International Affairs, wrote.
They want governments in malaria-prone countries to use newer drug combinations containing artemisinins, known in medical circles as ACT. Their arguments received wide coverage from the British Broadcasting Corporation, (BBC).
However, the Director General of Health Services, Prof. Francis Omaswa, considered the arguments as being out of touch with third-world realities.
Omaswa said whereas chloroquine and fansidar are not 100 percent perfect, they had drastically reduced childhood mortality and morbidity in communities where government has supplied treatment for free under the home-based management of fever (HBM) project.
“We are going to publish the evidence,†he said.
He agreed that malaria is increasingly becoming resistant to these drugs, but can be very effective.
The WHO representative in Uganda, Dr. Walker Oladapo , said there is no point in using the most expensive drugs, and then treat only a tiny fraction of the population.
Currently, an adult dose of artemisinins drugs in Uganda costs an average of sh14,000.
Comparatively, the chloroquine-fansidar combination used in the HMB project costs sh120 per dose. This means if government changes to artemisinins drugs they can treat only a tiny fraction of the malaria patients. “Any responsible government will not want to marginalise any sector of society.
The man in Kampala, as well as the man in Arua, should be able to treat his malaria,†Oladapo said.
Neither Omaswa or Oladapo says artemisinins drugs do not work.
While arguing that the artemisinins are too expensive for a poor country like Uganda, Omaswa and Oladapo say the Lancet article may have been motivated by commercial interests.