MSF will start using the fixed dose combinations and replace the use of separate tablets in all of its projects where artesunate and amodiaquine is recommended and where efficacy for this combination remains high.

The medical organisation Médecins Sans Frontières (MSF) welcomes the introduction of a new user-friendly and cheaper 2-in-1 tablet of artesunate-amodiaquine against malaria. The treatment, also called ASAQ, is the result of research by the non-profit Drugs for Neglected Diseases initiative (DNDi) in cooperation with sanofi-aventis and it demonstrates how research and development can take place without patenting for availability in the public domain.

The World Health Organisation recommends artemisinin-based combinations, or ACTs, to treat malaria through much of the world. But, the life saving treatment remains poorly available with less than 80 million treatments provided worldwide in 2006 even though there are at least 400-500 million malaria cases every year. In 2006, MSF treated about 1,7 million patients with artesunate/amodiaquine alone, but in separate tablets.

"Combining those two drugs in one tablet is a significant improvement because it will make malaria treatment much easier for patients", says Dr. Michel Queré, medical coordinator for MSF in Chad, where medical teams treated nearly 80,000 patients for malaria in 2006. "Children, for example, will only have to take one - instead of four - tablets a day for a three-day treatment. This will increase adherence and reduce the risk of drug-resistance".

The current cost of ACTs is one of the key obstacles to making them more widely available. The new fixed-dose combination ASAQ will cost less than US$ 0,50 for children under five, and less than US$ 1 for adolescents and adults, 40-50% less expensive for adults than the separate tablets. Further price decreases will be necessary, though, to make the treatment available everywhere it is needed.

"ASAQ is the first product launched by DNDi and its partners and it proves the validity of a new approach to medical research and development that focuses on the needs of patients in low income, underserved regions. The fact that the drug is not protected by a patent makes this a very promising model for further research on neglected diseases", said Dr. Christophe Fournier, MSF International Council President. "Indeed, the fact that the drug is not patented will allow for several sources of production, ensuring price competition and sufficient availability of the drug".

Médecins Sans Frontières will start using the fixed dose combinations and replace the use of separate tablets in all of its projects where artesunate and amodiaquine is recommended and where efficacy for this combination remains high. ASAQ is the second artemisinin-based 2-in-1 tablet launched on the market after artemether/lumefantrine, and additional combinations need to be developed.

Drugs for Neglected Diseases (DNDi)
The Drugs for Neglected Diseases Initiative (DNDi) is an independent, not-for-profit drug development initiative established in 2003 by five public sector research organisations: Oswaldo Cruz Foundation Brazil, ICMR (Indian Council of Medical Research), Kenya Medical Research Institute (KEMRI), the Malaysian Ministry of Health and the Institut Pasteur along with Médecins Sans Frontières.