In response to the recent posting linked to a Los Angeles Times article on on malaria treatment, Prof Gilbert Kokwaro writes.....
1. Chemotherapy; Kenya is now moving towards deployment of artemisinin-based combination therapy (ACTs) for which there is currently only one fixed-dose (co-formulated) combination i.e artemether plus lumefantrine (Coartem) although there are several other co-packaged combinations in the market for the treatment of non severe malaria. For pregnant women, quinine is now the recommended drug since artemisinin derivates are generally to be avoided in this group. For IPTP (Intermittent Preventive Treatment of malaria during pregnancy), we still don't have an alternative to SP (Chloroquine) and the Ministry is "silent" on what should be done since resistance to SP is now widespread and nobody knows whether it would work if used for IPTP.
2. Accessibility. There is no realistic measure of financial accessibility to antimalarial drugs, but the general consensus is that any medicine costing more than 50 US Cents per treatment is going to be out of reach for most rural folks. Coartem is fairly expensive and one issue that the Ministry of Health will deal with to make sure that accessibility is not compromised by the shift to ACTs.
3. On growing artemisis annua in Western Kenya, I understand that some organization is already liking up with Moi University to start growing somewhere near Eldoret. There is also another company doing the same in Athi River (where there is a factory for processing the plant material) so I do not know about the viability of the Western Kenya site.
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