Malaria Medicines and Diagnostics
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Malaria Medicines and Diagnostics
A. Bosman, MD PhDCoordinator, Diagnosis Treatment and Vaccines
WHO/UNICEF Technical Briefing Seminar on Essential Medicines Policies30 October 2012, WHO Headquarters, Geneva - Salle A
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PR
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Age groups
<5y 5-15y >15y
Malaria positivity rate in African health facilities
20%27%
13%
Age groups
<5y 5-15y >15y
56%50%
31%
<year 2000 >year 2000
7686 5372 7785 2118 700 2376
D’Acremont et al, Malaria J 2010
39 studies conducted between 1986 and 2007 in 16 African countries
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Interactions in malaria between medicines, diagnostics and vector control
RDT ACT
non-ACTs
Severe malaria treatment
LLIN/IRS
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Product interactions more complex in private sector (order of entry, perseverance etc.)
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Medicines for NMFI
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Deployment of RDTs in Livingstone (Zambia): impact on malaria cases and ACT consumption
Source: NMCC, Zambia MoH
Reported malaria cases, Zambia Livingstone District, 2004 - 2008
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IRS
Introduction of RDTs
Bednet introduction
ACT
RDTs
From over 25'000 ACTs in 2007 to less than 5'000 in 2008
ACTs
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The example of Senegal: ~ 0.5 million less ACT consumed in 2008-2009
World malaria report 2010
Suspected cases
Tested cases
Treated cases
Positive cases
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ACT procurement with international funds
2005 2006 2007 2008 2009 2010 20110
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
300,000,000
Public sector AMFm public sector AMFm private sector
data provided by 8 companies eligible for procurement by WHO/UNICEF
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RDT performance in Phase 2 of Rounds 1 – 3 against wild type (clinical) samples containing P. falciparum at low (200 parasites/μl) and
high (2000 or 5000 parasites/μl) parasite densities and clean-negative samples
Invalid RateFalse Positive
Rate
PDS at 200 parasites/μl
PDS at 2000 parasites/μl
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Malaria RDT sales
Sales to public and private sectors
Sales by panel detection score (PDS)
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RDT Product Testing: Rounds 1 - 4
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Infographic disponible: http://www.youtube.com/watch?v=vnsoTPE_PUc&feature=youtu.be
T3 – Test. Treat. Track.Scaling up diagnostic testing, treatment and surveillance