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Thursday, 18 October, 2001, 00:31 GMT 01:31 UK
Row over anti-malaria drug
Insecticide treated mosquito nets would cost less than a lottery ticket
Insecticide treated mosquito nets would cost less than a lottery ticket
Experts have questioned the effectiveness of a drug its makers claim protects against malaria.

The row comes as a leading doctor calls for wider use of insecticide-treated mosquito nets in Africa.

The drug under examination is Malarone.


We believe this claim is misleading and should be withdrawn

Professor Joe Collier, Drug and Therapeutics Bulletin
Its manufacturers, GlaxoSmithKline, claim it is 97% effective in preventing malaria, and that it has as few side effects as a placebo.

But an evaluation in the Drug and Therapeutics Bulletin (DTB), published by the Consumers Association, says there is no data publicly available to back up the company's claims.

Malarone was licensed in May in the UK as prophylaxis, a preventative treatment people can take before going to an area where malaria is prevalent.

But UK residents are non-immune, whereas people living in areas hit by malaria tend to be partially immune to the disease.

The DTB says because GlaxoSmithKline is basing its claims on data from a partially immune population, the results cannot be applied to the UK population.

Benefits

The DTB said there are potential benefits with the drug, which combines atovaquone and proguanil, and can be taken for less time than other malaria drugs.

It is also used as a treatment for falciparum malaria, which causes three-quarters of the 2,000 new imported cases of malaria in the UK each year.

But it is more expensive than other drugs, and a DTB spokesman said its benefits only applied if it was as effective as it was claimed.

Professor Joe Collier, editor of the DTB, said: "There is no published evidence in non-immune travellers to support the manufacturer's promotional claim that the drug combination in Malarone is 97% effective.

"We believe this claim is misleading and should be withdrawn.

"Travellers should be made aware of the lack of evidence to support this claim and warned that all malaria drugs may fail to protect them against the parasite."

A spokesman for GlaxoSmithKline told BBC News Online: "Three trials on how effective the drug was were carried out on people resident in Africa because it wouldn't be ethical to carry out such tests on non-immune people.

"We would have to send people who have no protection to an endemic area as part of the placebo section of the trial.

"It would be unethical for us to put people in that position."

Need for nets

David Warrell, professor of tropical medicine and infectious diseases at the University of Oxford will call for wider use of insecticide-treated mosquito nets in a speech to the Royal College of Physicians in London.

He said the nets were proven to be effective, and cost "less than a UK lottery ticket".

A child dies from malaria approximately every 30 - 40 seconds in sub-Saharan Africa.

He says the best results from using the nets reduced child deaths by 60%, in Gambian villages where the nets were given out free.

But people are reluctant to pay for the nets, and Professor Warrell told BBC News Online governments or international agencies should consider paying for them.

"There is a strong argument that these nets are so potent that they should be provided free like childhood vaccinations, or the spraying of houses with residual insecticides by governments."

He added: "The principal practical obstacle to the implementation of such an effective intervention is the lack of enthusiastic promotion in some countries and the cost of providing nets to impoverished inhabitants of malaria endemic areas, particularly in Africa, and ensuring they are re-treated with insecticide every year."

See also:

23 May 01 | Health
Africa to get cheap malaria drug
15 May 01 | Health
The anti-malaria drug dilemma
31 Dec 00 | Health
Scientists 'block malaria'
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