Index

A

Abuja, Nigeria

drugs purchased in, 317

summit, 49, 50, 52, 76, 198, 318

ACAME, 119

Accra, Ghana, 228, 230

ACT. See Artemisinin combination therapy

ACTMalaria. See Asian Collaborative Training Network for Malaria

Adangbe people, 209

Adaptable Program Loans and Credits. See World Bank

Adults, malaria in, 154–155

Afghanistan, 210, 232

Africa, malaria in, 24, 25, 168–177

African Demographic Surveillance Systems (DSS), 172

African Development Bank, 49, 105

African Development Fund, 105

African Summit on HIV/AIDS, 52

Algeria, 128

Amazon Malaria Initiative (AMI), 237

American Civil War, 126

Amodiaquine, 219, 253, 254, 291, 308

Amoy, 129

Anemia, 149, 150–151, 205, 292

Angola, 98, 229

Animals, 210, 267, 269–270

Annan, Kofi, 52

Anopheles albimanus, 141

Anopheles arabiensis, 210

Anopheles culicifacies, 210

Anopheles funestus, 172, 202, 207, 209

Anopheles gambiae, 141, 198, 202, 211, 212

Anopheles mosquitoes, 126, 128–129, 140–144

Anopheles stephensi, 210, 212

Antifolate drugs, 253, 259–260, 291–292, 309

Antimalarial drugs

affordability issues, 61–62

availability, 42–45

cost and effectiveness, 61, 66–67

counterfeit and poor quality, 317

drug classes, 253–259

drug flows, 34–42

drug policy, 235

effective use of, 312–315

epidemics and, 233

global costs, 64–65

global subsidy, case for, 79–82, 84–96, 100

labeling and instructions, 317–318

milestones in, 130–131

pricing of, 34



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Index A Abuja, Nigeria drugs purchased in, 317 summit, 49, 50, 52, 76, 198, 318 ACAME, 119 Accra, Ghana, 228, 230 ACT. See Artemisinin combination therapy ACTMalaria. See Asian Collaborative Training Network for Malaria Adangbe people, 209 Adaptable Program Loans and Credits. See World Bank Adults, malaria in, 154–155 Afghanistan, 210, 232 Africa, malaria in, 24, 25, 168–177 African Demographic Surveillance Systems (DSS), 172 African Development Bank, 49, 105 African Development Fund, 105 African Summit on HIV/AIDS, 52 Algeria, 128 Amazon Malaria Initiative (AMI), 237 American Civil War, 126 Amodiaquine, 219, 253, 254, 291, 308 Amoy, 129 Anemia, 149, 150–151, 205, 292 Angola, 98, 229 Animals, 210, 267, 269–270 Annan, Kofi, 52 Anopheles albimanus, 141 Anopheles arabiensis, 210 Anopheles culicifacies, 210 Anopheles funestus, 172, 202, 207, 209 Anopheles gambiae, 141, 198, 202, 211, 212 Anopheles mosquitoes, 126, 128–129, 140–144 Anopheles stephensi, 210, 212 Antifolate drugs, 253, 259–260, 291–292, 309 Antimalarial drugs affordability issues, 61–62 availability, 42–45 cost and effectiveness, 61, 66–67 counterfeit and poor quality, 317 drug classes, 253–259 drug flows, 34–42 drug policy, 235 effective use of, 312–315 epidemics and, 233 global costs, 64–65 global subsidy, case for, 79–82, 84–96, 100 labeling and instructions, 317–318 milestones in, 130–131 pricing of, 34

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance procuring, international system for, 112–121 production costs, 62–64, 63 R&D, 10, 74–75, 301–311 reduction in malaria transmission, 212–213 resistance, 172, 270–272, 276–281 safe and user-friendly, 315–316 tiered pricing, 65 treatment, 67–74, 252–253 APLs. See World Bank, Adaptable Program Loans and Credits Apovia, 224 Artecef, 306 Arteether, 261, 306 Artemether-lumefantrine. See also Coartem malaria control, 214–215 toxicity of, 266–267, 268 treatment of malaria, 254, 257 Artemisia annua, x, 6, 12, 62, 81 Artemisinin combination therapy (ACT) affordability issues, 61–62 availability, 42 clinical experience with, 263 cost-effectiveness, 66–67, 70–71 delaying emergence of resistance, xi, 4–5 discoveries in, 133–134 economic considerations, 5–6 effectiveness, 19, 69 effects, 70 evidence base for, 264–265 as first-line treatment, 3, 79, 80 global costs, 64–65 global subsidy for, 6–10, 82–83, 86–110, 121, 169, 315 monotherapies, 94, 115 negative impact of—use, 84–85 priming market for, 6 production costs, 62–64 purchase of, 52 resistance to, 2, 68, 81 role in malaria control, 22–23, 214–215 stimulating—market, 81 therapeutic advantages, x, 1 treatment models, 67–74 Artemisinins, 261–262 basic properties, 255 botanical properties, 262 clinical experience with, 263 compounds, 253, 293–294 mechanisms of action, 262–263 resistance to, 275–276 safety during pregnancy, 268–269 toxicity of, 266 Artemisone, 308 Artemotil, 306 Artesunate artemisinins, 261–262 described, 265–266 drug class, 253 first-line drug, 43 national drug policy on, 235 public sector drug flows, 38 R&D, 307–309 social marketing, 41 treatment of malaria, 254, 257 wholesale prices, 63 Aristophanes, 125 Aristotle, 125 Aryl aminoalcohol compounds, 253 Asia, malaria in, 24–25 Asian Collaborative Training Network for Malaria (ACTMalaria), 237 Association of the British Pharmaceutical Industry, 47–48, 303 Atabrine (quinacrine, mepacrine), 131 Ataxia, 153 Atovaquone plus proguanil, 253, 255, 258, 294, 306. See also Malarone Australia, 99 Austria, 105 Azithromycin, 306, 309, 310 B Bacillus sphaericus (Bsph), 211 Bacillus thuringiensis subsp. israelensis (Bti), 211 Bagamoyo District, Tanzania, 59, 175, 176, 209 Bamako, Mali, 43 Bandafassi, Senegal, 175 Bastianelli, Giovanni, 129 Bayer, 308 Bayer Dye Works, 131 Bednets, xii, 2, 11, 27. See also Insecticide-treated nets Behavioral deficits, 153 Belgium, 105, 224 Benin, 98 Bhutan, 236

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Bignami, Amico, 129 Billiton Corporation, 182 Biologic management, 211 Biotech Australia Pty, 224 Blantyre coma scale, 152 Bleeding, abnormal, 149 Blindness, 153 Blister packaging, 316 Blood schizont, 138 Bolivia, 236, 271 Bolton, Dr., 179 BOMA. See Burden of Malaria in Africa Botswana, 24, 98 Brain damage, 153 Brazil, 211, 229, 280, 308 Brazzaville, Congo, 177 Brisbane, Australia, 224 British Indian Medical Service, 128 British Medical Association, 129 British Medical Journal, 129 British Petroleum, 229 Bruce-Chwatt, Leonard, 169 Brundtland, Gro Harlem, 49 Bsph. See Bacillus sphaericus Bti. See Bacillus thuringiensis subsp. israelensis Burden of Malaria in Africa (BOMA), 169, 170, 172–173 Burkina Faso, West Africa drug packaging, 316 genetic control, 212 ITN use, 203–205 microeconomic studies, 187 per capita health expenditures, 98 productivity costs of morbidity, 188–189 vaccines, 223 tax revenues, 97 Burma ACT use, 213 chloroquine resistance, 276 counterfeit drugs, 317 drug packaging, 316 malaria transmission, 263 observations in pregnant women, 268 RDTs, 222 Burundi, 96, 98, 235, 236 C Calabar Hospital, 177 Calcutta, India, 129 California Gold Rush, 127 Cambodia ACT as first-line therapy, 236 availability of antimalarials, 43 Central Medical Stores, 39 chloroquine-resistant P. falciparum, 132 drug financing, 45 drug pricing, 43, 44 economic and health indicators, 35 fake antimalarials, 33 health education messages, 320 illegal drug flows, 42, 93, 317 low-income country, 101 malaria in, 34 migration, 232 Ministry of Health Procurement, 45 Phnom Penh, 42 piperaquine, 294 private sector drug flows, 41 public sector drug flows, 38–39, 39 RDTs, 222 Cambodian National Malaria Center (CNM), 38 Cambodian Pharmaceutical Enterprise, 38 Cameroon chloroquine resistance, 280 malaria control, 229 microeconomic studies, 184 per capita health expenditures, 98 pyronaridine, 294 tax revenues, 97 Canada, 105, 197 Cape Verde, 98 Carbamates, 200, 201 Carbon taxes, 100 Caventou, Jean Biename, 130 Cerebral malaria, 152–151 Celli, Angelo, 129 Central African Republic, 98 Centralized procurement system, 9–10, 13 Ceylon, 130 Chad, 98, 187, 229 Chalcones, 309 CHAZ. See Churches Health Association of Zambia Chemoprevention, 212–219 Chemoprophylaxis children, 216–217 obstacles to targeted—, 217–218 pregnant women, 217, 302 recommendations for use, 50

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Children chemoprophylaxis in, 216–217 intermittent preventive therapy. See Intermittent preventive therapy, children malaria in, 148–150 mortality, 174, 176, 198, 203–204 severe malaria, 154–155 China ACT as first-line therapy, 236 artemisinin use, 133, 262, 266, 268 ITN programs, 203 major initiatives, 46 middle-income country, 101 piperaquine, 294 Plasmodium vivax, 157 pyronaridine, 294 R&D, 74, 307–308 spread of malaria, 126, 197 Chinese Medical Journal, 133 Chloroproguanil, 253, 291, 303 Chloroquine availability, 42 basic properties, 255 change to other treatments, 72–74 description, 291 discoveries in, 131–132 familiarity of, x, 1 plus primaquine, 216 pregnancy, 217 price of, x, 61 R&D, 306, 307 resistance, 1, 3, 19, 22, 32, 74, 80, 172, 256–257, 260–261, 273, 275–276 -resistant P. falciparum (CRPF), 131 treatment of uncomplicated malaria, 254 Chronic neurologic impairment, 153 Churches Health Association of Zambia (CHAZ), 40–41, 45 Cinchona cultivation, 130 Climate change and epidemic malaria, 231 Clindamycin, 253, 293 CNM. See Cambodian National Malaria Center Coartem. See also Artemether-lumefantrine adoption, 235 expense of companion drug, 62 first-line drug, 42, 264–265 R&D, 303 toxicity, 266 Coformulation, 61n. 1 Cognitive deficits, 153 Colombia, 132, 227, 231 Combination therapy. See Artemisinin combination therapy Commission on Macroeconomics and Health, 66, 75–77, 84 Common Market for Eastern and Southern Africa (COMESA), 42 Comoros, 98, 236 Competition in retail drug market, 94 Congo, 97, 98, 103, 177, 187 Conly, G.N., 185, 186 Consciousness, impaired, 149, 150 Convulsions, 150, 152 Coordinated Informed Buying, 119 Copenhagen, Denmark, 120, 224 Cote d’Ivoire, 98 Cotrimoxazole, 291 CRHCS. See East and Southern Africa Commonwealth Regional Health Community Secretariat Cropper, M.L., 191 “Cross border” traders, 42 CRPF. See Chloroquine, -resistant P. falciparum Curtis, C. F., 212 D Dakar, Senegal, 41, 48, 210 DALY. See Disability adjusted life-year Dapsone, 291, 303, 307 Dar es Salaam, Tanzania, 211, 317 DDT, 198–203, 207, 211 DEET. See N,N-diethyl-m toluamide Deforestation and malaria, 126 Deltamethrin, 201 Democratic Republic of the Congo. See Congo Demographic effects, 181 Denmark, 41, 105, 120, 126, 224 DHA. See Dihydroartemisinin DHFR. See Dihydrofolate reductase-thymidilate synthase DHPS. See Dihydropteroate synthase Diagnosis, 32, 219–223 N,N-Diethyl-m toluamide (DEET), 211 Dihydroartemisinin (DHA), 253, 261–262, 307 Dihydrofolate reductase-thymidilate synthase (DHFR), 259, 279–280 Dihydropteroate synthase (DHPS), 259, 280

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Dionisi, Antonio, 129 “Dipstick” diagnostic test, 41, 43, 84–85 Disability adjusted life-year (DALY), 66–67, 66n. 6, 70 Disease Control Priorities Project, 170 DNA for diagnosis, 223 DNDi. See Drugs for Neglected Diseases Initiative Doxycycline, 306 Drug administration, mass, 213, 216 Drug classes, 253–254 pharmacodynamics, 258 pharmacokinetics, 254–255, 258 Drug financing, 43–45 Drug flows, 34–35, 93 illegal, 41–42, 317 private sector, 40–41 public sector, 35–39 Drug ineffectiveness, 32–33, 276–281 Drug market, competition and regulation, 94 Drug policies and malaria control, 233–238 Drug pressure, 72 Drug pricing, 43, 114 Drug procurement bulk, 120 centralized procurement organizations, 113–114, 117–118 distribution, 114–115 forecasting demand, 114 intellectual property issues, 117 market stimulation, 116 minimizing ACT monotherapy, 115 monitoring and evaluation, 117 prices and competition, 114 quality assurance, 116 strategies, 118 technical assistance, 116–117 Drug resistance. See also specific drugs antifolate drugs, 259–260 antimalarial drugs, 261, 276–281 artemisinins, 275 chloroquine, 260–261 development of artemisinins, 3 drug pressure, 72 effects, 172 epidemics and—, 19–20, 61 global subsidy and—, 80–81 need for combination therapy, 4–5, 73–74 patterns of, 175 Plasmodium falciparum, 198, 273–275 —strains, 73 Drugs. See Antimalarial drugs; specific drugs Drugs for Neglected Diseases Initiative (DNDi), 303, 308 DSS. See African Demographic Surveillance Systems; Rufiji Demographic Surveillance Site Duffy blood group antigen, 157 Dutch East Indies, 130 E EANMAT. See East African Network for Monitoring Antimalarial Treatments Early treatment failures (ETF), 279 East Africa, 172 East African Network for Monitoring Antimalarial Treatments (EANMAT), 237 East and Southern Africa Commonwealth Regional Health Community Secretariat (CRHCS), 119 East Timor, 232 Economic considerations, 177–179 artemisinins and ACT, 5–6 cost of artemisinin treatments, 1 effects at macroeconomic level, 180–181 estimates of costs, 180 health policy and, ix hindering economic development, 90–91, 181–182, 187–194 overcoming barriers, 313–315 priming market for ACT, 6 studies, microeconomic, 183–184 Education family decision makers and traditional healers, 321–323 health—messages, 320 health professionals, 322 school-based, 323–324 training shopkeepers, 320–321 Egypt, 202, 229 EIR. See Entomologic inoculation rate El Niño Southern Oscillation, 231 Emergency Multisector Rehabilitation and Reconstruction Project, 103 EMVI. See European Malaria Vaccine Initiative

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Entomologic inoculation rate (EIR), 144, 198 Environmental strategies, xii, 2, 11, 211 EPI. See Expanded Programme on Immunization Epidemic malaria, 230–231 Epilepsy, 153 Equatorial Guinea, 98 Eritrea, 98 ETF. See Early treatment failures Ethiopia home treatment, 319 malaria early warning systems, 233 microeconomic studies, 185 migration, 232 per capita health expenditures, 98 productivity costs of morbidity, 188–189 Tigray study, 191–194 European and Developing Countries Clinical Trials Partnership, 310 European Commission, 47, 301 European Malaria Vaccine Initiative (EMVI), 47 European Union, 41, 105 Expanded Programme on Immunization (EPI), 226 Exxon-Mobil, 229, 304 F Falciparum malaria infections, x, 1, 126, 147–148 Family decision makers, educating, 321–323 Fansidar, 291, 292, 306 Far Manginhos, 308 FDA. See United States, Food and Drug Administration Feachem, Richard, 49 Field’s stain, 220 Finland, 105 Fluorescent microscopy, 221 Food and Drug Administration. See United States, Food and Drug Administration Foreign direct investment, 181–182 Formosa, 129 Fosmidomycin, 308 France, 41, 46, 99, 105, 211 Franco-Prussian War, 127 Frerichs, Friedrich Theodor, 128 Fumigants, 211 Funding. See also Global subsidy available, defined, 106–107 external, 3, 104–107 government expenditures, 185 household expenditures, 184–185, 193 international, 2 potentially available, defined, 106–107 projected financing for global control, 76–78 G G6PD deficiency. See Glucose-6-phosphate dehydrogenase deficiency Gabon, 98, 219, 264 Gambia ACT, evidence base, 264 aromatic smoke, 211 chemoprophylaxis, 216, 217 chloroquine resistance, 280 home treatment, 319 ITN use, 198, 203, 204, 205, 229 per capita health expenditures, 98 productivity costs of morbidity, 188–189 study of pregnant women, 269 tax revenues, 97 vaccines, 224, 225 Gametocytes, 139 Garki, Nigeria, 207, 208 Garnham, P. C. C., 129–130 Gates Foundation, Bill & Melinda bilateral donor, 105 boost in funding from, 46 contributions to R&D, 75–76, 304 grant to MVI, 47 study cosponsor, 20 GAVI. See Global Alliance for Vaccines and Immunization GDF. See World Health Organization, Global Drug Facility Ge Hang, 133 Genetic control, 212 Genetic diversity, 137 Germany, 99, 105, 197, 308 Ghana artesunate, 265 Accra, 228, 230 child mortality, 203–205 chloroquine treatment, 32 drug packaging, 316 educating family decision makers, 321

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance educating health professionals, 321 IPTi trials, 219 ITN use, 209 Navrongo, 228 overcoming economic barriers to treatment, 313 per capita health expenditures, 98 productivity costs of morbidity, 188–189 Giemsa’s stain, 220 GlaxoSmithKline (GSK) chlorproguanil-dapsone, 303 chlorproguanil-dapsone-artesunate, 307 malaria vaccines, 224 quinoline antimalarial, 308 tafenoquine, 310 WRAIR malaria drug development collaborator, 306 Global Alliance for Vaccines and Immunization (GAVI), 47, 76, 112, 120 Global Drug Facility. See World Health Organization Global Forum for Health Research, 303, 304 Global Fund to Fight AIDS, Tuberculosis and Malaria bilateral donor, 105, 118, 234 Country Coordinating Mechanisms, 104 endorsement of combination therapy, 5 funding source, 8, 75, 76, 77, 80, 101, 102, 104 major initiatives, 46, 51–52 Global subsidy, 6–8, 79–80 benefits of, 95–96 broad, 86, 88–89 case for, 80–81, 82–84 centralized procurement system, 9–10, 13, 121 country-specific vs.—, 102–104 difficulties, 84–86 funding, 8, 9, 75–76, 86, 88–89, 96–97, 98–102, 104–107, 169 goals, 82, 86–87, 92–94, 95 level required, 109–110 R&D, 74–75 rationale for, 107–109, 315 recommendations, 12–13 sources of, 110 targeted, 86, 87, 90–91 types of, 88–91 Glucose-6-phosphate dehydrogenase (G6PD) deficiency, 147 Golgi, Camillo, 128 Goodman, C., 94 Grassi, Giovanni Battista, 129, 202 Greece, 126 GSK. See GlaxoSmithKline Guinea, 98, 103 Guinea Bissau, 98, 319 Guinea Population and Reproductive Health Program, 103 Guyana, 236, 276 H Haldane, J.B.S., 146 Halfan, 306 Halofantrine absorption and elimination, 255, 358 aryl aminoalcohol compounds, 253 described, 293 R&D, 306 resistance, 261 Handbook of Prescriptions for Emergency Treatments (Ge Hang), 133 Health burden of malaria, 168 cases, 169–172, 171 death, 169, 170 drug resistance, 172 hospital-based studies, 176–177 population-based studies, 175 trends, 172–175 Health care facilities conditions of, 33 evidence, 176–177 Senegal, 36 supply of antimalarials, 32 treatment of severe malaria, 254 Zambia, 44–45 Health care spending, 96–97 Health education, 320 Health professionals, educating, 322 Hemiplegia, 153 Hemoglobin C, 147 Hemoglobin E, 147 Hemoglobin S gene, 127 Hempel, J., 179 Herodotus, 202 Higher Impact Adjustment Lending, 103 Highly Indebted Poor Countries (HIPC), 107

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Hippocrates, 125 Historical estimates of costs, 179 HIV/AIDS combining drugs for treatment, 4 costs for treatment, 9 external support for control, 75 funding sources for treatment, 105 global market for drugs, 86 informed buying of drugs, 119–120 malaria and, 156–157 price discrimination for drugs, 65 HMS. See Hyperreactive malarial splenomegaly Ho Chi Minh, 133 Hoffman-La Roche, 132, 306 Holleykin, 307–308 Homer, 125 Hospital-based evidence. See Health care facilities, evidence Host genetics, 146–147 House siting and construction, 210 Household expenditures on prevention, 184, 193 expenditures on treatment, 184–185, 193 living standards, 182–183 Human capital, 187, 190, 181 Humanitarian rationale, 80 Hyperlactatemia, 149 Hyperparasitemia, 149, 278 Hyperreactive malarial splenomegaly (HMS), 158 Hypoglycemia, 149, 150, 154, 269 I IDA. See World Bank, International Development Association IFPMA. See International Federation of Pharmaceutical Manufacturers Associations I.G. Farben, 131 Illegal drug flows, 41–42 Illiad, The (Homer), 125 IMCI. See Integrated management of childhood illness Imidazolinedione derivatives, 309 Immunity, 146, 272 In vitro testing, 278 In vivo testing, 273, 274, 276–279 India Bsph toxin, 211 Calcutta, 129 chloroquine resistance, 276 cinchona plantations, 130 control programs, 234 DDT use, 198 mosquito nets, 203 pharmaceuticals from, 36 R&D, 308 spread of malaria, 126, 197 user fees, 100 Indonesia, 157, 254, 276 Indoor residential spraying. See Insecticide spraying, indoor residential Infants, intermittent preventive therapy. See Intermittent preventive therapy, infants INNs. See International Nonproprietary Names Insecticide spraying barriers to use, 207, 209 indoor residential (IRS), 11, 144, 199, 206–207 Insecticides, 200–202 Insecticide-treated nets (ITNs). See also Bednets Abuja Summit target, 50 barriers to use, 207, 209 efficiency, 204, 199 history of, 202–203 individual and community effects of, 203–209 social marketing of, 56 Institut Pasteur, 224 Institute of Lausanne, 224 Institute of Medicine (IOM) Committee on the Economics of Antimalarial Drugs, 19, 51, 113 Insurance programs, 100 Integrated management of childhood illness (IMCI), 56, 77, 220, 324 Intellectual property issues, 117 Intermittent preventive therapy (IPT) children (IPTc), 219 infants (IPTi), 219, 324 pregnant women (IPTp), 56, 77, 218–219 SP and, 22 strategy, 324 TEHIP study, 56–60

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance International Development Association. See World Bank International Dispensary Association, 40 International Federation of Pharmaceutical Manufacturers Associations (IFPMA), 47, 303 International Finance Corporation, 12 International funding, 2 International Nonproprietary Names (INNs), 40 International organizations and health programs, 46–52, 85. See also specific organizations IOM. See Institute of Medicine IPT. See Intermittent preventive therapy IPTc. See Intermittent preventive therapy, children IPTi. See Intermittent preventive therapy, infants IPTp. See Intermittent preventive therapy, pregnant women Ireland, 105 Irian Jaya, 231 IRS. See Insecticide spraying, indoor residential Italy, 105, 126, 131, 213 Iteso, 323 ITNs. See Insecticide-treated nets J Jacobus Pharmaceuticals, 309 Japan, 105 Jaundice, 149 Java, 130, 131 Jomaa Pharmaceuticals, 308 K Kafue, Zambia, 44 Karen, Thailand, 227 Kdr. See Knock-down resistance Kenya ACT, evidence base, 264 Anopheles gambiae, 202 antimalarial drug resistance, 271 azithromycin clinical trials, 310 childhood mortality, 173 chloroquine-resistant P. falciparum, 132, 235 climate change, 231 drug policy, 235 health care spending, 97, 98 home treatment, 318 hospital-based studies, 177 IPTi trials, 219 Kisumu, 207 malaria early warning system, 233 malaria treatment survey, 33 migration, 232 Ministry of Health, 235, 320 pharmaceuticals from, 36 productivity costs, 188–189 school-based education, 232 total direct and indirect costs, 187 training, 320-321 trials, 203–206, 209, 224 urban malaria, 230 Kenya Medical Research Institute, 224, 235 Kilombero, Tanzania, 94 Kinshasa, Congo, 177 Kisumu, Kenya, 207 Knock-down resistance (kdr), 202 Koch, Robert, 213 Konkola Copper Mines, 229 Korea, 157, 307 KwaZulu Natal, South Africa ACT as first-line therapy, 229, 236 DDT house spraying, 207 drug policy, 235 epidemic, 172 Ingwavuma district, 214 malaria control, 11, 14, 64 morbidity and mortality, 214–215 L Labeling and instructions, 317–318 Lagos, Nigeria, 169, 317 Laos, 101, 236, 280, 318 Lapdap, 22n. 1, 292, 307 Lariam, 306 Larvivorous fish, 211 Late clinical failures (LCF), 279 Laveran, Charles Louis Alphonse, 127–128 Ledger, Charles, 130 Lee, J.W., 120 Lesotho, 98 Liberia, 98 LICA Pharmaceuticals, 309

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance LICUS. See Low Income Countries Under Stress Initiative Light microscopy, 220–221 Lincoln, Abraham, 126 Linnaeus, Carl, 130 Liver schizont, 138 Living standards, 174, 182–183 London School of Hygiene and Tropical Medicine, 130 Low Income Countries Under Stress Initiative (LICUS), 103, 105 Lugo, Juan de, 130 Lumefantrine, 62, 253, 255, 258, 294 Lusaka, Zambia, 40, 41, 44 M Macdonald, G., 144 Macrolides, 309 Madagascar, 96, 97, 98, 146, 207 Magic spells, 30 Malaria cerebral, 152–151 clinical, 252–253 control, 197–238 cost of illness, 192 current situation, 2–4, 19–21, 23–24, 26–27 economic burden of, 177–194 epidemic, 142–143, 230–231 health burden of, 168–177 historical estimates of costs, 179 history of discoveries, 125–127 immunity, 144–147 in specific areas, 24–26, 25 integrated control of, 11 medicines and supplies service, 120–121 mortality rates, 2, 19, 169, 170, 172–175, 174, 176, 198, 203–205 pathogenicity, 144 recrudescence, 140 recurrent, 140 severe, 256–257 symptoms, 27 transmission, 212–213 treatment. See Treatment uncomplicated, 254 urban, 230 Malaria early warning systems (MEWS), 232–233 Malaria Medicines and Supplies Service, 120–121 Malaria Vaccine Initiative (MVI), 47 Malarine, 38, 41, 43 Malarone, 65, 253, 294, 306 Malawi antimalarial drug resistance, 270, 271 chloroquine resistance, 132 drug policy, 235 HIV, malaria, and pregnancy, 157 hospital-based evidence, 176–177 household expenditures on prevention and treatment, 184 indirect costs, 185 IPT, 218 migration, 232 per capita health expenditures, 98 productivity costs of morbidity, 188–189 total direct and indirect costs (of malaria), 186 Malaya, 132 Mali, 43, 271, 280, 318 Malignant tertian malaria. See Plasmodium falciparum Maloprim, 217 Management Sciences for Health (MSH), 34, 119 Manson, Patrick, 129 Mao Tse Tung, 133 Mapping Malaria Risk in Africa (MARA), 47, 169 Mass drug administration (MDA), 208, 212–213, 216, 233 Mauritius, 179 Mawanhgolui Han dynasty, 133 Mbarara, Uganda, 321 McClellan, George, 126 McGregor, I.A., 216 MDA. See Mass drug administration MDGs. See Millennium Development Goals MDR. See Multidrug resistant Meckel, Johann Friedrich, 128 Médecins Sans Frontières (MSF), 62, 64, 75 Medicines for Malaria Venture (MMV) antimalarial drugs R&D, 10, 15, 81 major initiatives, 47 partnerships, 48, 74, 76, 302 R&D, 301, 303–305, 304, 307–309 synthetic artemisinin, 64 Mefloquine analogs, 310

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance availability, 43 basic properties, 255 chemoprophylaxis, 217 description, 132–133, 293 drug class, 253 public sector drug flows, 38 R&D, 306, 308 social marketing, 41 tier pricing, 65 Melbourne, Australia, 224 Metabolic acidosis, 149, 150, 151–152 Metakelfin, 291 Methylene blue, 309 MEWS. See Malaria early warning systems Microeconomic studies, 183–184 Conly’s study in Paraguay, 186 direct costs, 184–185 indirect costs, 185 total direct and indirect costs, 185–187 Microscopy, 32, 84, 220–221 Migration, 231–232 Millennium Development Goals (MDGs), 51 MIM. See Multilateral Initiative on Malaria Minimum parasiticidal concentration (MPC), 258 Mission Pharma, 41 Mlomp, Senegal, 175, 176 MMSS. See Malaria Medicines and Supplies Service MMV. See Medicines for Malaria Venture Modern care, 28–29, 58, 60 Molecular diagnostic methods, 223 Molecular markers of resistance, 279–281 Monotherapies discouraging of, 13, 82 resistance, 4, 5 vs. ACT, 7, 73, 95 Montreal, Canada, 197 Mortality rates. See Malaria, mortality rates Mosquito Anopheles, 126, 128–129 breeding, limiting of, 2, 11 discovering stages of, 128–129 Mozambique chloroquine resistance, 280 IPTi trials, 219 malaria control, 214–215 migration, 232 per capita health expenditures, 98 trade and foreign direct investment, 182 vaccines, 224 MPC. See Minimum parasiticidal concentration Mpumalanga, South Africa, 235 MSF. See Médecins Sans Frontières MSH. See Management Sciences for Health Muheza, Tanzania, 132 Multidrug resistant (MDR), 260, 309 Multilateral Initiative on Malaria (MIM), 48 Multi-Stage Malaria DNA Vaccine Operation (MuStDO), 227–228 MVI. See Malaria Vaccine Initiative Myanmar, 236 N Najera, J.A., 179 Namibia, 24, 96, 97, 98 National Institute of Allergy and Infectious Diseases Challenge Grant Program, 305 National Institutes of Health, 224, 301 Naval Medical Research Center. See U.S. Naval Medical Research Center Navrongo, Ghana, 228 Navrongo Health Research Centre, 228 Netherlands, the bilateral donor, 105 contributions to R&D, 304 German invasion of, 131 International Dispensary Association, 40 malaria in, 97 per capita health expenditures, 99 Neurotoxicity studies, 267–268, 310 New Guinea chloroquine resistance, 132, 276, 280 malaria control, 209–210 mosquito netting, 202 Plasmodium malariae, 158 New York, New York, 197 New York University, 224 NGOs. See Nongovernmental organizations Niakhar, Senegal, 175, 176 Nicaragua, 216 Niger, 96, 98 Nigeria Abuja 50, 52, 76, 198, 317, 318 Calabar Hospital, 177 drug labeling and instructions, 318 drug resistance, 261 Garki, 207, 208

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance health care expenditures, 96, 98 home treatment, 318 hospital-based evidence, 177 Lagos, 169, 317 productivity costs, 188–189 total direct and indirect costs, 187 training shopkeepers, 320 NMRC. See U.S. Naval Medical Research Center Nobel Prize, 128, 129 Noguchi Memorial Institute of Medical Research, 228 Nongovernmental organizations (NGOs), 42, 45, 75 North America, malaria in, 26 Norway, 105 Novartis, 303, 309 NYVAC-Pf7, 227 O Oceania, 254 OptiMAL dipstick, 222 Organophosphates, 200, 201 Oxford University, 224 Oylset, 206 P Packaging, drug, 315–316 Pakistan, 186, 210, 231, 232 Pan-African Malaria Conference, 48 Papua, New Guinea chloroquine resistance, 132, 276, 280 malaria control, 209–210 mosquito netting, 202 overcoming economic barriers to treatment, 313 Plasmodium malariae, 158 Papua New Guinea Institute of Medical Research, 224 Paraguay, microeconomic study in, 185, 186 Paralysis, 153 ParaSight-F, 222 Parasitemia, 205, 208 Pare-Taveta Malaria Scheme, 207 PATH. See Program for Appropriate Technology in Health PCR. See Polymerase chain reaction Peace Corps, 305 Pelletier, Joseph, 130 Permanet, 206 Permethrin, 201 Peru, 157, 236 Pesticide Evaluation Scheme. See World Health Organization Petroleum oil, 211 Pfcrt, 280 Pfdhfr, 279–280 Pfdhps, 279–280 Pfizer, 306, 310 Pfmdr, 280–281 Pharmacie Regionale d’Approvisionnement (PRA), 36 Pharmacodynamics, 258 Pharmacokinetics, 254–255, 258 Philippines, 203 Phnom Penh, Cambodia, 42 Pinotti, M., 216 Piperaquine, 253, 255, 294, 307 Plasmochin (pamaquine), 131 Plasmodium berghei, 133 Plasmodium falciparum diagnostic testing, 41 drug resistance, 130, 198, 256, 273–275 fluorescent microscopy, 221 Garki project, 208 human malaria, 136–140, 144–147 MDA, 213 natural immunity, 225 RDTs, 221–222 severe manifestations, 149 vaccines, 223, 226 Plasmodium malariae, 126, 128, 136–137, 158–159 Plasmodium ovale, 132, 136–137, 140, 144, 159 Plasmodium relictum, 129 Plasmodium vivax chloroquine resistance, 275 described, 157–158 discoveries, 128–131 human malaria, 136, 144 MDA, 216 primaquine tolerance, 276 recurrent malaria, 140 transmission of, 126 vaccines, 223

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Plasmodium yoelii, 275 Plato, 125 PLIVA Pharmaceuticals, 309 PNA. See Senegalese Pharmacie Nationale d’Approvisionnement Policy making issues, ix Polymerase chain reaction (PCR), 137, 146, 279 Polypharmacy, 32, 65 Population-based studies, 175 Population movements and malaria, 231–232 Poverty and malaria, 180 Poverty Reduction Support Loans and Credits, 102 PRA. See Pharmacie Regionale d’Approvisionnement Pregnancy anemia, 205 artemisinins and, 13, 268–269 azithromycin, 310 chemoprophylaxis, 50, 217, 302 intermittent preventive therapy (IPTp). See Intermittent preventive therapy, pregnant women ITN use, 198 malaria in, 155–157 mortality, 205 reducing high-risk, 103 sulfadoxine-pyrimethamine and, 22 susceptibility during, 26 treatment, 255 Price, R.N., 266, 267 Price discrimination, 65 Primaquine, 276, 292, 306 Private sector drug flows, 40–41 Procurement. See Drug procurement Productivity costs, 188–189 Program for Appropriate Technology in Health (PATH), 47 Proguanil, 132, 217, 253, 291, 294 Prostration, 149 PRSCs. See Poverty Reduction Support Loans and Credits Public good, 79, 80–81 Public sector drug flows, 36 Pulmonary edema, 149, 154 Pyrethrum, 200–201, 203, 206 Pyrimethamine, 217, 253, 254, 255, 291 Pyronaridine, 294, 307 Pyrroloquinazolines, 309 Q Qinghaosu. See Artemisinins Quartan malaria. See Plasmodium malariae Queensland Institute RESA of Medical Research (QIMR), 224 Quinidine, 253, 256 Quinine absorption and elimination, 255 aryl aminoalcohol compounds, 253 described, 130–131, 291 severe malaria, 256 uncomplicated malaria, 254 Quinoline, 308 R R&D. See Research and development RACTAP. See Réseau d’Afrique Centrale des Thérapeutiques Antipaludiques Ranbaxy, 308 Rapid diagnostic test (RDT), 68, 69–71, 221–223 RBCs. See Red blood cells RBM. See Roll Back Malaria RDT. See Rapid diagnostic test Recrudescence, 140, 272 Rectal artesunate, 309 Rectocap, 262 Recurrent malaria, 140 Red blood cells (RBCs), 138, 220 Regulation in retail drug market, 94 Renal impairment, 149, 255 Repellants, 211 Republic of the Congo. See Congo Research and development (R&D) antimalarial drugs, 10, 301–311 impetus for, 81 global investment, 15, 74–75 Réseau d’Afrique Centrale des Thérapeutiques Antipaludiques (RACTAP), 237 Resochin (chloroquine), 131 Respiratory distress, 149, 151–152 Riamet, 294 Risk mapping, 47, 169 RNA for diagnosis, 223 Rockefeller Foundation, 199 MMV funding, 47 R&D contributions, 304

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Roll Back Malaria (RBM), 13 financing and procurement of drugs, 113 goals, 232–233 increased funding since advent of, 105–106 major initiatives, 49–51, 50, 76, 198 Malaria Medicines and Supplies Service (MMSS), 120–121 market stimulation, 116 Roman Campagna, 126 Rome, Italy, 126 Ross, Ronald, 128–129, 178, 202 Ross Institute, 130 RTS,S, 225 Rufiji Demographic Surveillance Site (DSS), 28, 56 Rufiji District, Tanzania, 56, 94 Russell, Paul, 199 Rwanda drug policy, 235 epidemics and climate change, 231 microeconomic studies, 187 migration, 232 per capita health expenditures, 98 productivity costs of morbidity, 188–189 tax revenues, 97 S Sachs, Jeffrey, 180 SACs. See Structural Adjustment Credits SADCC. See Southern African Development Cooperation Conference SALs. See Structural Adjustment Loans Sao Tome & Principe, 98 School-based education, 323–324 Schultz, L.J., 218 SEACAT. See South East African Combination Antimalarial Therapy Evaluation Sector-wide approach (SWAp), 102–103, 103n. 2, 104 Senegal ACT, evidence base, 264 availability of antimalarials, 42 Bandafassi, 175 childhood mortality, 173, 176 Dakar, 41, 48, 210 drug financing, 43–44 drug pricing, 43, 44 economic and health indicators, 35 health care expenditures, 98 illegal drug flows, 41–42 IPTc, 219 malaria in, 34 Mlomp, 175 Niakhar, 175 population-based studies, 175 private sector drug flows, 40 public sector drug flows, 36, 37 subclinical infections, 146 Senegalese Pharmacie Nationale d’Approvisionnement (PNA), 36, 40 Severe malaria, defined, 150 Shillcutt, S.D., 69 Shin Poong, 307 Shopkeepers, training, 320–321 Shortt, H.E., 129–130 Sicily, Italy, 131 Sickle cell anemia, 127, 147 Sidewalk medication, 41 Sierra Leone, 96, 97, 98, 229 SIT. See Sterile insect technology Snow, R.W., 169, 170, 172–173 Social marketing of antimalarials, 41, 43, 56 Solomon Islands, 203 Somalia, 98 Sontochin (3 methyl chloroquine), 131 Sophocles, 125 South Africa ACT use, 213 health care spending, 96, 98 KwaZulu Natal, 11, 14, 172, 207, 214–215, 229, 236 malaria in, 24 Mpumalanga, South Africa, 235 pharmaceuticals from, 36 South East African Combination Antimalarial Therapy Evaluation (SEACAT), 237 Southern African Development Cooperation Conference (SADCC), 42 Soviet Union, 198, 203 SP. See Sulfadoxine-pyrimethamine Spasticity, 153 Speech disorders, 153 Spirit possession, 30 Sporozoites, 138 Sri Lanka, 198, 210, 211, 231 Statens Serum Institut, 224 Sterile insect technology (SIT), 212

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Sterling Winthrop, 306 Structural Adjustment Credits (SAC), 102 Structural Adjustment Loans (SAL), 102 Subsidy. See Global subsidy Sudan chloroquine resistance, 132, 280 malaria early warning systems, 233 migration, 232 per capita health expenditures, 98 productivity costs of morbidity, 188–189 seasonal transmission, 146 Sulfadoxine-pyrimethamine (SP) antifol combination drugs, 291 artesunate and, 235 combination treatment and, 22n. 1 discoveries in, 132 effectiveness, 22 Garki project, 208 IPT with, 218–219 low-cost drug, 3, 42 R&D, 306 resistance, 4n. 2, 172, 198–199, 237, 271, 274 stopgap drug, 66, 80 Sulfalene, 291 Sulfamethoxazole, 291 Supernatural intervention, 30 Supranational subsidy, 88, 92–93 Suriname, 236 Swamp fever. See Malaria SWAp. See Sector-wide approach Swaziland, 24, 98 Sweden, 105 Sweet wormwood. See Artemisia annua Swiss Agency for Development and Cooperation, 47, 303 Swiss Tropical Institute, 224 Switzerland, 105, 224, 304 Symptomatic cases, treatment of, 212–213 T Tafenoquine, 253, 292–293, 306, 310 Tajikistan, 232 Tanzania Bagamoyo District, 59, 175, 209 childhood mortality, 173 chloroquine-resistant P. falciparum, 132 climate change, 231 Dar es Salaam, 211, 317 drug policy, 235 economic barriers to treatment, 313 educating family decision makers and traditional healers, 322 health care expenditures, 98 health education messages, 320 HIV and malaria, 156 hospital-based evidence, 177 IPT use, 219 Kilombero, 94 malaria early warning systems, 233 Muheza, 132 Pare-Taveta Malaria Scheme, 207 pharmaceuticals from, 36 poor drug supply, 33 population-based study, 175 retail drug competition and regulation, 94 Rufiji District, 56, 94 severe malaria, 145 single vs. combination candidates, 227 SWAp, 103n. 2 traditional medicines, 31 Ulanga, 94 Tanzania Essential Health Interventions Project (TEHIP) description, 28–29 key observations, 59 malaria-related deaths, 57 research area, 56 results, 29 verbal autopsies, 57 types of care, 58 Tax revenues, potential for increased, 97–99 TB. See Tuberculosis TDR. See World Health Organization, Special Programme on Research and Training in Tropical Diseases TEHIP. See Tanzania Essential Health Interventions Project Tennessee Valley Authority, 127, 197 Tertian malaria. See Plasmodium vivax Tetracycline, 253, 292 Thailand ACT as first-line therapy, 213, 229, 236, 263, 264, 266 azithromycin clinical trials, 310 chloroquine-resistant P. falciparum, 131–132, 280 counterfeit drugs, 317 DEET use, 211 informal sector, 31

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance ITN use, 205 introduction of sulfadoxine-pyrimethamine, 132 Karen, 227, 232 mefloquine resistance, 275 middle-income country, 101 migration, 232 pyronaridine, 294 RDTs, 222 study of pregnant women, 269, 270 Thalassemias, 147 Therapeutic treatment failure (TTF), 273 Tiered pricing, 65 Tigray, Ethiopia, 191–194 Tobin taxes, 100 Trade investment, 181–182 Traditional care, 31, 58 Traditional healers, educating, 321–323 Trape, J.F., 175 Treatment, 27–28 antimalarial, aims of, 252–253 close-to-home, 318–319 decisions to seek—, 30–33 epidemics and, 233 government expenditures, 185 household expenditures, 184–185, 193 models, 67–74 self-—, 30, 41, 59, 85–86, 315 severe malaria, 256–257 symptomatic cases, 213 uncomplicated malaria, 254 Trimethoprim, 253, 291 Tropical splenomegaly syndrome. See Hyperreactive malarial splenomegaly TROPIVAL, 308 Tryptanthrins, 309 TTF. See Therapeutic treatment failure Tuberculosis (TB) combining drugs for treatment, 4 external support for control, 75 Global Drug Facility, 9, 112 global market for drugs, 86 price discrimination for drugs, 65 Tunis, Tunisia, 131 Tunisia, 131 U Uganda antimalarial drug resistance, 271 chloroquine resistance, 132, 280 drug labeling and instructions, 318 drug packaging, 316 educating family decision makers and traditional healers, 321–322 epidemics and climate change, 231, 233 Iteso, 323 per capita health expenditures, 98 Poverty Reduction Support Loans and Credits process, 102 Ulanga, Tanzania, 94 UNICEF. See United Nations Children’s Fund United Kingdom bilateral donor, 105 contributions to R&D, 304 health care expenditures, 99 major initiatives, 46 malaria, spread of, 126, 197 United Nations agencies of, 105 Children’s Fund (UNICEF), 104, 105, 112–115, 117, 120, 302–303, 323 Millennium Summit, 51 Office of—High Commissioner for Refugees, 105 United States Army Medical Research and Development Command, 132 bilateral donor, 105 Centers for Disease Control and Prevention, 127 Department of Defense, 305 Food and Drug Administration (FDA), 303, 305, 306 funding source, 8 health care expenditures, 99 major initiatives, 46 R&D, 74 spread of malaria, 126–127 State Department, 305 University of Edinburgh, 129 University of Liverpool, 308 University of Maryland, 223 University of Nairobi, 317 University of Nebraska, 308 Urban malaria, 230 U.S. Agency for International Development (USAID), 20, 101, 104, 228. See also Roll Back Malaria U.S. Army Medical Research and Materiel Command (USAMRMC), 305

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance U.S. Naval Medical Research Center (NMRC), 224, 227, 306 User fees for health services, 99–100 V Vaccines, 223, 225 candidate, 224 development, 47 natural immunity, 225 strategies, 225–226 testing and use, 228–229 trials, 228 Vanuatu, 203 Vector control, 209–212 Venezuela, 132 Verbal autopsy, 28, 57 Vestergaard nets, 206 Vical, 224 Vietnam ACT as first-line therapy, 213, 236 concerns about drug resistance, 74 counterfeit drugs, 317 household living standards, 181, 182–183 ITN programs, 203 low-income country, 101 neurotoxicity, 268 piperaquine, 294 Vietnam Living Standards Surveys (VLSS), 182 Vietnam War, 127, 133, 305 Virchow, Rudolf Ludwig Karl, 128 VLSS. See Vietnam Living Standards Surveys W Wage rate method, 188–189 Walter and Eliza Hall Institute of Medical Research, 224 Walter Reed Army Institute of Research (WRAIR) antimalarial drug R&D, 10, 15, 262, 307–310 Division of Experimental Therapeutics, 305 drug budget, 307 mefloquine production, 132–133 Military Infectious Disease Research Program, 305–307 R&D, 301 vaccine clinical trials, 224 WANMAT I and II. See West African Networks for Monitoring Antimalarial Treatments Washington, D.C., 126, 262, 305 Washington, George, 126 Wasps, The (Aristophanes), 125 Wellcome-Kenya Medical Research Institute, 224 Wellcome Trust, 46, 48, 301, 303 R&D contributions, 304 West Africa Anopheles gambiae, 202, 212 Burkina Faso, West Africa, 97, 98, 187, 188–189, 202, 203–205, 212, 223, 316 drug resistance, 172 genetic expression of Duffy blood antigen, 157 Plasmodium malariae, 158 productivity costs of morbidity, 188–189 West African Networks for Monitoring Antimalarial Treatments (WANMAT I and II), 237 Wet agriculture and malaria, 126 WHO. See World Health Organization WHOPES. See World Health Organization, Pesticide Evaluation Scheme Williams, Hervey Vaughan, 215 Willingness-to-pay approach, 184, 190–191, 192, 194 Winthrop Stearns, 131 World Bank Abuja Conference, 49 Adaptable Program Loans and Credits (APLs), 103 emergency recovery loans and credits, 103 evidence from experimental animals, 269 funding data, 107 funding source, 101, 102–103, 105 International Development Association (IDA), 8, 75, 103, 105 International School Health Initiative, 323 market stimulation, 116 Medicines for Malaria Venture initiative, 47

OCR for page 347
Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance Poverty Reduction Support Loans and Credits (PRSCs), 102 R&D, 302–303 Structural Adjustment Loans and Structural Adjustment Credits (SALs and SACs), 102 World Health Organization (WHO) Abuja Conference, 49 artemisinins, 12, 263 centralized procurement system, 9, 112–113 control strategies, 199–200, 234 endorsement of combination therapy, 5, 61, 72, 79, 80, 237 environmental controls, 211 Global Burden of Disease program, 169 Global Drug Facility (GDF), 118–119, 119, 120 global eradication of chloroquine, 131 Higher Impact Adjustment Lending, 103 in vivo antimalarial drug sensitivity classification, 277, 277 IPT recommendations, 218 ITN approval, 206 major initiatives, 46, 174 Medicines for Malaria Venture initiative, 47 mefloquine development, 132 partnership with U.S. Agency for International Development, 20 Pesticide Evaluation Scheme (WHOPES), 200 pre-qualification for drug suppliers, 40 quality assurance strength, 116 school-based education, 323 severe malaria, defined, 150 Special Programme on Research and Training in Tropical Diseases (TDR), 10, 46–49, 48, 203, 301, 302–303, 304, 306, 307–309, 315 support for Cambodian Pharmaceutical Enterprise, 38 treatment benchmarks, 66 World Health Report, 67 World Trade Organisation, 99 World War I, 131 World War II, 127, 130, 132, 198, 200, 206 WRAIR. See Walter Reed Army Institute of Research Wright’s stain, 220 Y Ya chud, 31 Yorktown, Virginia, 126 Z Zaire, 205, 232 Zambia ACT as first-line therapy, 236 availability of antimalarials, 42 Central Board of Health, 36 chloroquine-resistant P. falciparum, 132 control methods, 229 drug financing, 44–45 drug pricing, 43, 44 economic and health indicators, 35 health care expenditures, 98 home treatment, 319 illegal drug flows, 42 Kafue, 44 Lusaka, 40, 41, 44 malaria in, 34 Medical Stores Ltd., 36 private sector drug flows, 40–41 public sector drug flows, 36, 38 Zambian National Formulary, 41 Zanzibar, 235, 236 Zhou En Lai, 133 Zimbabwe, 24, 36, 98, 222 Zoophagic, 141 Zoophilic, 141 Zooprophylaxis, 210