Chloroquine, second most preferred medicine after ACTs

Accra, Aug. 9, GNA - Despite the availability of the Artemisinin-bas= ed combination therapies (ACTs) in the country chloroquine continues to be the second most used medicine in the treatment of malaria.

An Affordable Medicine Facility- Malaria (AMFm) survey conducted by th= e Pharmacy Council from March to May this year revealed this in Accra on Tuesday. The survey was to determine among other things the proportion of Pharmacists and Licensed Chemical sellers (LCS) who are aware of the AMFm, access and availability in community retail outlets and observed retail prices of Co-paid artemisinin-based combination therapies (ACTs) The AMFm is an innovative financing mechanism designed to expand acces= s to the most effective treatment for malaria, (ACTs).

The AMFm aims to enable countries to increase the provision of affordable ACTs through the public, private and NGO sectors. Mr. Daniel A Danquah, Head of Education and Training of the Pharmacy Council said of the 808 facilities surveyed, 75 per cent of respondents wer= e aware of the AMFm initiative and the Co-paid and that 75 per cent of facilities surveyed stocked ACTs.

On pricing of the ACTs which is been subsidized by the global fund to make it affordable for users, Mr Danquah said the minimum prices were between 0.80 Ghana pesewa and 1.76 and a maximum of GHc 5.00 instead of the price range of a minimum of 0.80-Ghc1.00 for minors and Ghc1.00-1.50 for adults. He attributed the difference in the prices to the presence of too many intermediaries in the distribution chain and the low awareness of the AMFm in deprived areas. According to him, sales outlets were willing to sell the co-paid ACTs but supply was a problem coupled with the perception that cheap things were always of inferior quality. He recommended the training of medicine counter assistants on the AMFm and also called for appropriate intervention to address availability in deprived areas as well as the continuing of the extensive marketing efforts of the NMCP and partners.

Ms Sybill Sory, a Research Officer at the Research and development division of the Ghana Health Service who spoke on a research finding on Knowledge, Attitudes and Practice (KAP) said most all respondents were awar= e of malaria and that it was caused by mosquitoes.

According to her, though Malaria was universally known, misconception= s about it causes still persisted and that some people still believed that malaria could be caused by houseflies, hunger and prolong sitting under the sun. Some were aware of treating malaria with ACTs but were not conscious o= f the fading out of chloroquine, she said, adding, the issue of prices was a critical one which requires attention from the National Malaria Control Programme (NMCP). The Research recommended the development of educational materials on treatment, information on ACTs as well as education on approved medication for treatment.

Mr Frank Nyonator, Acting Director of the Ghana Health Service, said b= y increasing access to ACTs and displacing aterminisin monotherapies from the market, the AMFm also seeks to delay resistance to active pharmaceutical ingredient (artemisinin). He said Ghana commenced the implementation of the initiative and that a number of activities such as training of relevant health workers, LCS and pharmacists on appropriate malaria case management have been rolled out to ensure a successful implementation after the national launch in February. Deputy Programme Manager of NMCP, Dr Keziah Malm, said seven out of th= e 22 million doses ordered have arrived in the country and that Ghana is the first to have them in all the ten regions.

She said though procurement was still underway in the public sector, the national and regional launch was to make people identify the green leaf logo on the subsidized ACTs.

As host and manager of the AMFm, The Gobal Fund, has negotiated with drug manufacturers to reduce the price of ACTs, and to require that sales prices must be the same for both public and private sector first-line buyers. The first major achievement of the AMFm is that private importers now pay up to 80 per cent less than they did in 2008-2009. The Global Fund pays most of this reduced price (a 91buyer co-payment') directly to manufactu= rers to further lower the cost to eligible first-line buyers of ACTs purchased from manufacturers.

This means that first-line buyers only pay the remainder of the sales price for the ACTs. First-line buyers are expected to pass on the highest possible proportion of this price benefit so that patients are able to buy ACTs across the public, private, not-for-profit and for-profit sectors at prices that are less than those of oral artemisinin monotherapies and competitive with the prices of CQ and SP.

AMFm Phase 1 is being implemented through nine pilots in eight countries: Cambodia, Ghana, Kenya, Madagascar, Niger, Nigeria, Tanzania (including Zanzibar) and Uganda.

Following the Global Fund Board's decisions on successful applicatio= ns to Phase 1 in November 2009, grant amendments or new grant agreements have been signed with most AMFm Phase 1 countries and implementation has started in several countries. The first co-paid ACTs were delivered to Ghana and Kenya in August 2010."