G L O B A L M A L A R I A P R O G R A M M E

ACTs as life-saving drugsHWG

16 January 2007

WHY SHOULD ACTs BE CONSIDERED AS LIFE-SAVING?

• Malaria mortality: in the absence of an effective treatment within 24 hours of the onset of symptoms, the progression to severe disease is associated with a high case fatality rate

• Malaria kills more than one million per year, mostly young children, for lack of access to proper treatment

• An estimated 10,000 women and 200,000 of their infants die as a result of malaria infection during pregnancy, and severe malarial anaemia contributes to more than half of these deaths.

Treatment o

f uncomplic

ated

malaria with

"ACTs"

ANTIMALARIAL TREATMENT

Cu

mu

lati

ve P

roba

bili

ty o

f a

fata

l ou

tcom

e

t (hours)

Experience with ACT implementation

• Study in KwaZulu natal already published

• More studies, not yet published, show similar convincing evidence

In this context, any interruption in supply will create a major crisis resulting in unacceptable regression

• 68 out of 76 (90% of) countries in need have adopted ACT

• GFATM covers approx. 85% of ACTs purchase in 2006

• Low success rate of malaria grants in rounds 5 and 6: a number of countries with grants ending in 2007

• Round 6 will provide for 32 million additional ACT treatments, out of 130 million requested in grant submission, leaving a substantial gap

2 levels of consequences of an interrupted supply

• Direct, on mortality in vulnerable population

• Indirect, on health systems: – Impact on policy implementation, staff,… – Loss of confidence of the population

POTENTIAL UNITAID SUPPORT TO ACT IMPLEMENTATION IN 2007

• Under GFATM grant with strong performance and high need

GFATM grant

coming to its end (natural termination)

Not under GFATM grant but

good infrastruct

ure in place

operational costs include the following:

USD 340'000 for UNICEF Procurement

7-8% freight by air & insurance

1-2% taxes, administrative costs

3-5% warehousing in country

8-12% transport and distribution within country

Potential next actions in 2007 programs require discussion between partners and countries to lay out options, assess costs and impact and define the operational models for each category of country

Immediate

Actions

Potential next

actions for 2007

UNITAID will initially only fund commodities, i.e. no funds for operational costs neither for technical assistance

Ethiopia, Indonesia, Ghana, Madagascar, Mozambique, Somalia, Sudan N&S, Zambia

Burundi, Liberia

GFATM grant terminated for performance