Via The Lancet: Artesunate for severe malaria. Excerpt:
There are over 1 million deaths a year from severe malaria, mostly in children in sub-Saharan Africa. Quinine has been the mainstay treatment but it is painful, complex to administer, and has serious side-effects.
Last week, in the run up to World Malaria Day (April 25), WHO revised its malaria treatment guidelines to recommend parenteral artesunate rather than quinine as the first-line treatment for severe malaria in children.
The evidence supporting this switch is overwhelming. Last year, the AQUAMAT trial undertaken in nine African countries, showed a significant mortality reduction of 22% in the artesunate group compared with the quinine group. And, more recently, a Cochrane review further supported the superiority of parenteral artesunate over quinine in both adults and children worldwide.
The challenge now is to translate this evidence into practice and without delay. In a new report, Making the Switch, Médicins Sans Frontières makes a strong case for switching to artesunate, citing that around 195 000 lives would be saved each year.
Rightly, they call for a global plan to be put in place led by the international community. WHO and Roll Back Malaria should assist with technical support and training.
National governments need to lead by revising their guidelines. Given the higher cost of artesunate (US$3·3 to treat a child with severe malaria compared with $1·3 for quinine), donors need to put up the money to support the switch and give manufacturers confidence to produce quality artesunate.
Traditionally, international donors have not supported treatment for severe malaria given the cheapness of quinine, but this must now change. As noted in the report, the additional yearly drug cost of $31 million for artesunate is a small price to pay.
Especially when you consider that the US government plans to spend a third of a trillion dollars on 2,443 F-35 fighter planes whose only purpose will be to blow stuff up real good while adding to the death toll.
If the self-styled Great Powers were really serious about their national security, they would find themselves far more secure on a planet where everyone had clean water, an effective sewage system, cheap and nutritious food, and adequate resources for public health. A third of a trillion dollars would pretty well cover that with a couple of hundred billion left over.
