One billion antimalarial treatments delivered: An extraordinary partnership journey

Who would have thought that an ancient Chinese herbal remedy would one day become the panacea for malaria? Sweet wormwood (Artemisia annua) was indeed used in traditional Chinese medicine for more than 2 000 years to treat fevers. However, it was not until the 1970s that a team of Chinese scientists discovered that the artemisinin contained in its leaves cleared malaria parasites. Today, artemisinin is the cornerstone of artemisinin-based combination therapies (ACTs), which have become the standard of care in malaria treatment.

In many ways, this discovery kicked off an extraordinary partnership journey. It started a groundbreaking collaboration between Novartis and Chinese partners to develop, test and manufacture the first fixed-dose ACT. It also marked an exceptional manufacturing scale-up for the company, from 200,000 antimalarial treatments in 2001 to 100 million in 2011. This 500-fold production increase was unprecedented in drug production. Further, it led to a landmark agreement with the World Health Organization (WHO) to supply the drug to the public sector in malaria-endemic countries without profit.

Stepping up the fight through partnerships

None of this would have been possible without funders and partners to support at every step of the way, from Research & Development (R&D), sourcing and production, access, distribution through to capacity building on the ground.

According to David Reddy, CEO of Medicines for Malaria Venture (MMV), which co-developed the child-friendly formulation with Novartis, “partnerships have been the biggest contributor to the fight against malaria in the past two decades. It has taken all of us, from community healthcare workers to national malaria control programs, from non-profits to industry, from local governments to global funders, to work together.”

Thanks to these concerted efforts, and the large-scale deployment of innovative insecticides, bed nets, rapid diagnostic tests, treatments, and other malaria control strategies, the WHO estimates that 1.5 billion malaria cases have been averted and 7.6 million lives saved since 2000

Partners have also been crucial in building the capacity of healthcare systems across Africa – which bears 94% of the malaria burden in the world – to better prevent, diagnose and treat the disease.

Watch four videos from our partners and colleagues.

Staying one step ahead of the malaria parasite

Zambia had been struggling to control malaria due to widespread resistance to existing antimalarial drugs for years prior to adopting the Novartis ACT as first-line therapy for uncomplicated malaria in 2003. When districts started administering the medicine, they experienced a significant decline in malaria mortality, and so malaria patients gave the treatment a new name: “I am happy”. Today, the majority of African countries recommend this ACT as first-line therapy.

Following the launch of the ACT, MMV and Novartis co-developed the first dispersible formulation of the drug for children, one of the most vulnerable groups affected by malaria, in 2009. Of the 1 billion treatments delivered, more than 430 million are the pediatric formulation. Today, both organizations are working together to advance a new pediatric formulation for the youngest children, those weighing less than 5 kilograms, for whom there is still no approved treatment.

Although we need new tools to combat emerging drug resistance, we must also optimally use the ones we already have. “The truth is that today we have the tools to save the vast majority of those lives that are being lost,” says David Reddy.

Novartis currently leads five malaria development programs worldwide, featuring three compounds that employ new mechanisms of action and demonstrate activity even against artemisinin-resistant strains of the disease. The objective is also to improve patient adherence by reducing the pill burden.

“Once those medicines are developed successfully, they will not only address the emergence of resistance but also help simplify treatment regimens,” says Lutz Hegemann, Group Head of Corporate Affairs and Global Health, Novartis.

Eliminating malaria is within reach

“Twenty-four countries around the world have eliminated malaria since 2000, and more countries than ever before are on the brink of elimination. Yet, we must remain vigilant and continue to drive commitment, innovation and capital to close the USD 2.6 billion annual funding gap to end malaria for good,” says Dr Abdourahmane Diallo, CEO of RBM Partnership to End Malaria.

We have so much to gain from a malaria-free world. By working together, we can become the generation that ends malaria and unlock the enormous economic and societal benefits that come with malaria elimination.

This is the meaning of the 1 billion treatment delivery milestone: Celebrating life and celebrating the future!