WHO has announced the halt to monotherapy with Artemisinin derivatives and issued guidelines to pharma companies to market only Artemisinin combination therapies (ACT's). This is because of the increasing worry of drug-resistant parasites in South-East asia and Africa,although artemisinin is the only anti-malarial drug to which resistance has not been reported.
I think this is probably a good move by the WHO however, it has its own problems.
One is the perennial issue with the UN agency. It can only issue guidelines but cannot enforce drug companies to stop the production of monotherapy drugs.
Second, you cannot issue directives today and expect companies to stop their manufacture tomorrow.It would not be commercially viable for the company and therefore would only lead to resistance on the part of the companies.
Thirdly, you must first attempt to educate health professionals about these guidelines. Provide evidence to support your view and thus exert pressure on the pharma companies using their customers. In India today if you were to be treated at a private clinic in a rural district you might get monotherpay simply because your doctor does not have information about such guidelines. WHO must try and remember that it is a health organisation and it must include all health professionals in their efforts to solve problems. Monotherapy with Artemisinin is also about 8 times cheaper than using ACTs and therefore its eradication will require external funding close to $300-$500 million.
This is an important step in fighting malaria but like any leader,WHO must beware leaving its friends too far behind.
You do not lead by hitting people over the head - that's assault, not leadership
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