ASAQ Sanofi-Aventis

August 3, 2012 by Malaria Q&A

QUESTION

In the summer of 2010 I went to Uganda on a medical trip where we saw hundreds of people affected by malaria. Ever since, I have had a huge heart for these children that we saw at the orphanage. This past summer, I took a Microbiology class at the University of Tennessee where we learned about Sanofi-Aventis and the affordable malaria medication made in 2007. I am starting an annual 5k in honor of my father who passed away to raise money to buy this medication to give to children in Uganda (my church has a medical clinic over there). I was wondering how I would go about obtaining this medication or if you could help me in any way. Thank you so much for your time.

ANSWER

It’s great that you have become passionate about helping people fight malaria in Uganda. In terms of helping people with access to anti-malarial medicine, I can think of three ways you could go about it.

First of all, you could raise money to donate to an organization which already works on health issues in the area of Uganda in which your church operates. You would need to do some research on what organizations operate in the area, and also try to find out a bit about their reputation and overheads (it’s frustrating to see your donations whittled away on mundane, if important, bureaucratic costs rather than going directly into buying medication). Alternatively, but along the same lines, you could look into donating the money directly to the medical clinic that your church supports, and see if they can purchase the necessary medications locally or at least within Uganda. Both of these approaches have the advantage that you will be partnering with people who already work in the area, know the local landscape, and have relationships with local government health clinics and other local authorities, who may hear of your action and feel the need to be informed. The disadvantage is that you would be reliant on drug supplies available in the area; throughout Africa, there are recurrent problems of people buying counterfeit drugs, or being given expired pills.

Similarly, supplies are not always reliable, and you might have to settle for buying whatever drug is available, regardless of the formulation or brand (though I would strongly encourage you to ONLY buy artemisinin-based combination therapies, or ACTs, of which Coarsucam and ASAQ Winthrop, both fixed dose combinations of artesunate-amodiaquine created by Sanofi-Aventis, are included).

Your third option, which is probably the most logistically challenging but over which you would have the most control, would be to solicit pharmaceutical companies directly to see if they would be willing to sell you pills directly at whole sale price, based on the money you raise from your annual race. Many pharmaceutical companies already have programs to develop health care initiatives and improve public health in the world’s poorest companies, so you could try to include your project as one of these initiatives.

Sanofi-Aventis itself has a program called Impact Malaria which works with a variety of stakeholders to tackle malaria on the ground, and which includes distribution of the drugs mentioned above. You could also look into other pharmaceutical companies that develop anti-malarial drugs, such as Novartis (which produces Coartem), Lonart (Bliss Gvs Pharma), and many others. One thing to bear in mind is that there are often restrictions on importing and exporting drugs, and also many other things to consider when doing drug donations.

This paper outlines some of the issues you should be thinking about if you want to go down the direct donation path: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121783/

Scientists Offer 2020 Vision of Vaccines for Malaria, TB & HIV/AIDS

May 25, 2011 by Malaria.com

Collectively, malaria, TB & HIV/AIDS cause more than five million deaths per year – nearly the entire population of the state of Washington – and represent one of the world’s major public health challenges as we move into the second decade of the 21st century. In the May 26, 2011, edition of the premier scientific journal Nature, Seattle BioMed Director Alan Aderem, Ph.D., along with Rino Rappuoli, Ph.D., Global Head of Vaccines Research for Novartis Vaccines & Diagnostics, discuss recent advances in vaccine development, along with new tools including systems biology and structure-based antigen design that could lead to a deeper understanding of mechanisms of protection. This, in turn, will illuminate the path to rational vaccine development to lift the burden of the world’s most devastating infectious diseases.

According to Aderem, a systems biology pioneer who recently joined Seattle BioMed to incorporate that approach with the Institute’s infectious disease research, new conceptional and technological advances indicate that it will be possible to develop vaccines for the “big three” infectious diseases within the next 10 years. “Success will be largely dependent on our ability to use novel approaches such as systems biology to analyze data sets generated during proof-of-concept trials,” he explained. “This will lead to new insights such as the identification of correlates of protection or signatures of immunogenicity and the acceleration of large-scale clinical trials.” Aderem added that innovative, new clinical and regulatory approaches will also accelerate the pathway to much-needed vaccines.

The article discusses the strengths and criticisms of the systems biology approach, with the key strength of the approach lying in its ability to capture and integrate massive amounts of biological data to visualize emergent properties that are not demonstrated by their individual parts and cannot be predicted from the parts alone. “The power of systems biology comes from its capacity to predict the behavior of an entire biological system,” Aderem said. “From there, we can optimize vaccine candidates and predict whether a drug or vaccine candidate can work before it moves into large scale, very expensive clinical trials.”

Systems biology can also be used to speed the often lengthy clinical trial experience. Aderem and Rappuoli estimate that in trials of new vaccines for malaria, TB and HIV/AIDS, only one hypothesis has been tested every eight years in the past three decades. “We cannot afford this approach if we want to have an impact on disease in a reasonable timeframe,” Aderem said. “We can accelerate clinical development by performing more efficacy trials and by improving their design using systems biology approaches to test several hypotheses in parallel and having an adaptive design to expand the outcomes that prove most promising.”

Aderem and Rappuoli also debunk one of the key criticisms of systems biology – that it is overly reliant on computation. “Much of this comes from a misunderstanding on the role of computers in systems biology,” Aderem explained. “Computers are not expected to come up with biological insights from the outset, but are meant to facilitate an integration of discovery science with hypothesis-driven science to yield a holistic description of a biological system.”

While progress has been made over the past few years in the development of novel vaccines against the three most challenging infectious diseases in the world, Aderem and Rappuoli conclude that innovative design of clinical trials, testing several vaccines in parallel and getting early information using systems biology approaches will accelerate vaccine development and increase understanding of the human immune system.

Source: Seattle Biomedical Research Institute (Seattle BioMed)

“SMS for Life” Malaria Initiative for Tanzania Announced

April 18, 2011 by Malaria.com

In commemoration of World Malaria Day 2011 (25 April), organizations in an innovative public-private initiative announce the nationwide roll-out of a unique malaria treatment access initiative, “SMS for Life,” across the United Republic of Tanzania. The roll-out follows a successful pilot project where mobile and electronic mapping technology was used to track the stock levels of anti-malarial drugs at health facilities to manage supplies of these essential treatments.

Launched in 2009, the “SMS for Life” pilot ran across three districts in Tanzania, ensuring access to essential malaria treatments for 888,000 people. 99% of health facilities involved avoided stock-outs of the artemisinin-based combination therapy (ACT), one of the main anti-malarial medicines.² “SMS for Life” will now be deployed across 5,000 health facilities in 131 districts in Tanzania, covering a population of over 40 million.

Under the auspice of the Tanzanian Ministry of Health and Social Welfare, this roll-out is led by Novartis and supported by Vodacom, Medicines for Malaria Venture (MMV) and the Swiss Agency for Development and Cooperation, all under the umbrella of the global Roll Back Malaria Partnership.

Malaria kills about 800,000 people each year, the vast majority of whom live in sub-Saharan Africa where the disease is a leading cause of death for children under five, claiming the life of a child every 45 seconds.² Although malaria is preventable and treatable, life-saving medicines do not always reach the patients who need them, particularly those living in remote areas. Stock-outs are a major hurdle in the maintenance of access to essential malaria treatments.

H.E. Dr Hadji Hussein Mponda, Minister for Health & Social Welfare in Tanzania, said “the simple truth is that if there are no effective malaria treatments available in the health facilities then people will likely die, especially young children and pregnant women who are most at risk of the disease. Reducing antimalarial drugs stock-outs saves lives, and so we are delighted that the SMS for Life programme that improves stock position information will now be rolled-out across Tanzania and we welcome this innovation.”

“SMS for Life” has demonstrated that we can overcome the longstanding problem of stock-outs at the health facility level. This flexible scheme can be implemented quickly and at relatively low cost in any country to track any medicine,” said Jim Barrington, “SMS for Life” Program Director and former Chief Information Officer at Novartis. “It’s rewarding to see how a unique partnership, which combines the specific skills and experience of its various members to deliver an innovative use of everyday technologies, positively impacts the lives of malaria patients, their families and communities. “SMS for Life” also has great potential to be implemented in all malaria endemic countries and within other disease areas.”

In addition to the roll-out in Tanzania this year, two further pilots will start. Kenya, with funding from Novartis via the global employee survey donation program, will implement a five district pilot to track ACTs and rapid diagnostic tests (RDTs), in addition to collecting weekly case management data. MMV, through partnership with University of Oxford, will provide technical support for the implementation and evaluation of the pilot project. Ghana, with funding from Swiss TPH, will implement a six district pilot to track malaria medicines, an antibiotic and RDTs. Accurately monitoring the amount of essential medication, such as ACTs and quinine injectables, available in a given location, reduces the risk of shortages and stock-outs and ensures that treatments are available to malaria patients, even in the most remote areas, where and when they are needed.

Each week, automated SMS messages are sent to staff at participating healthcare facilities, prompting them to check the stock of anti-malarial medicines, and reply with an SMS detailing current stock levels. These messages are collected in a central web-based system that provides the District Medical Officers and other users with real-time stock level information, accessible via the Internet or their mobile phone. Using this information, District Medical Officers are able to redistribute essential medicines to where they are most needed and coordinate emergency deliveries to health facilities if necessary.

The Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria (GBC) Business Action on Health Awards Review Committee has recently selected the “SMS for Life” program as a Finalist for the Technology for Health award.

About “SMS for Life”
“SMS for Life” is an innovative public-private partnership that harnesses everyday technology to improve access to essential malaria medicines in rural areas. It uses a combination of mobile phones, SMS messages and electronic mapping technology to track weekly stock levels at public health facilities in order to eliminate stock-outs, increase access to essential medicine and reduce the number of deaths from malaria.

“SMS for Life” was initially piloted across three districts in the United Republic of Tanzania, covering 129 health facilities and 226 villages, representing 1.2 million people. When launched in 2009, 26% of all health facilities did not have any ACTs in stock, but by the end, 99% had at least one ACT dosage form in stock. In addition, 888,000 people in the three pilot districts had access to all malaria treatments at the close of the pilot, versus 264,000 people at the start, which helped to reduce the number of deaths from malaria.

About the partners
Under the Tanzanian Ministry of Health and Social Welfare and the National Malaria Control Programme (NMCP) is the Directorate of Preventive Services. NMCP is the custodian of all malaria prevention and control activities in the country. The NMCP is the owner and main user of the ‘SMS for Life’ solution and coordinates all project activities in the country, including planning, implementation & evaluation of the project. The NMCP also makes sure that all the districts selected are fully engaged in the process.

Novartis drives the overall initiative and has taken the lead in defining the solution, sourcing the partners, establishing a steering committee, liaising with the Ministry of Health in Tanzania and RBM Partnership Secretariat and providing all the resources and funding necessary to complete the pilot in Tanzania.

Medicine for Malaria Venture (MMV) is, along with SDC, one of two funders of the country implementation of the solution. They also manage funds from SDC, giving them the role of managing all project funding. In addition, MMV is coordinating the national training program and is contracting technology deployment required to affect this rollout.

The Swiss Agency for Development (SDC) is the second and major funder of the Tanzanian nationwide roll-out. Its grant is managed by MMV.

Vodacom, a local Tanzanian Mobile operator is providing, in addition to promotional materials like tshirts, smart phones with Internet and data access for use by all District Medical Officers and Malaria Focal persons.

Vodafone supported the design, development and the implementation of the technical solution for the Tanzanian Pilot in 155 health facilities until its completion in February 2010.

IBM supported the overall management of the pilot project and the provision of an on-line collaboration tool, “Lotus Live”. The tool allowed all the project partners to coordinate their inputs.

RBM Partnership Secretariat facilitates oversight, including the work of the steering committee and leads advocacy activities. It helps provide ongoing guidance throughout the project, placing it in the broader context of RBM’s activities.

About RBM
The Roll Back Malaria (RBM) Partnership is the global framework for coordinated action against malaria. It provides a neutral platform for consensus-building and developing solutions to challenges in the implementation of malaria control interventions and strategies. RBM is a public-private partnership that also facilitates the incubation of new ideas and lends support to innovative approaches.

The Partnership promotes high-level political commitment and keeps malaria high on the global agenda by enabling, harmonizing and amplifying partner-driven advocacy initiatives. Founded by UNICEF, WHO, the World Bank and UNDP and strengthened by the expertise, resources and commitment of more than 500 partner organizations, the Partnership secures policy guidance and financial and technical support for control efforts in countries and monitors progress towards universal goals.

Source: World Health Organization (WHO), Roll Back Malaria