HEALTH -- September 4, 2010 at 11:00 AM EDT
Global Fund Investigates Possible Theft, Sale of Malaria Medication
Malaria causes about 1 million deaths around the world each year, but not all the medication donated to fight the disease is reaching its intended targets.
The Global Fund to Fight AIDS, Tuberculosis and Malaria -- the largest international funder of malaria programs -- is investigating the possible theft and sale of donated malaria medications "in a number of countries," the group's communications director Jon Liden said this week. The United States government is the largest single contributor to the Global Fund, giving about $3.5 billion since 2001.
"There have been anecdotes about stolen drugs as long as there have been donated drugs in Africa," said Liden. "This is not a new thing at all, but we have had some more clear or concrete allegations -- though so far not substantiated -- in the last months that has led us to start a full investigation of these issues."
The Global Fund will not comment on the scale of the ongoing investigation and would not reveal the countries involved.
Liden's remarks came in response to new research published Thursday in the journal Research and Reports in Tropical Medicine that found stolen donated malaria medications for sale in several African countries.
The report, coauthored by Roger Bate of the American Enterprise Institute and two colleagues from Africa Fighting Malaria, looked at 11 cities in Ghana, Kenya, Tanzania, Uganda, Rwanda and Nigeria over a three-year period.
Nearly 900 sample medications were purchased from private pharmacies and 6.5 percent were found to be donated drugs. For artemesinin combination drugs, the most effective medications available for malaria, the percentage was higher; 15 percent were stolen drugs in 2007, and 30 percent in 2010.
Manufacturers package donated drugs differently than those meant for resale and some are specifically marked "Not for Sale," indicating to the researchers that these drugs were stolen somewhere in the distribution chain.
Bate acknowledged that the sample size for the study was small, and that the actual scale of the problem "may be less significant" than the research indicates. "What we don't know is the scale, but what I can tell you is it's worse now than it was before [when we started]," Bate said.
He pointed to a USAID audit of the U.S. President's Malaria Initiative in Angola last year that found malaria drugs were "persistently stolen."
"Four major thefts of the malaria drug, Coartem, valued at over $642,000, have occurred under PMI in Angola," the report reads."Critical malaria commodities are not reaching their intended beneficiaries and more Angolans may be unnecessary victims."
Where exactly in the supply chain these medications are being stolen from the ministries of health they were originally donated to, and who is responsible for the theft is unknown, Bate said. He and the other researchers are calling for improved oversight to stem theft and warned that failure to impose better controls could lead to stock-outs of necessary medications at hospitals and clinics.
Liden said the Global Fund is taking steps to address the root cause of malaria drug theft -- that the highest-quality malaria medications can garner high profits in the private sector. Artemesinin combination drugs would now cost between $6 and $10 on the private market in most African countries, but the group is working to reduce that to 40 cents through a new initiative.
"What we have organized through this initiative is to reduce the prices almost 80 percent from the producers and then add money from the Global Fund to make sure the prices become competitive with the older cheaper medications that no longer work," Liden said.
"In that way, we will not only give medications to all those that need it we will take away incentive for this theft."
Editor's Note: For the record, the Gates Foundation, an underwriter of NewsHour global health coverage, has been a contributor to the Global Fund.