Outdated drugs are helping fuel a rise in malaria worldwide, according to an international group of experts writing in The Lancet. They say that although effective treatments are available, pressure on the World Health Organisation (WHO) to cut costs means that the vast majority of patients are given old treatments — to which many are now resistant.

Through its Roll Back Malaria campaign, the WHO aims to halve deaths from the disease — which kills a million people a year — by 2010. But it acknowledges that the burden of malaria is increasing.

While the WHO itself recommends the newer artemisinin-class combination therapies (ACT), which can successfully treat 90 per cent of more of patients, these are costly in comparison to the older drugs such as chloroquine. Poor countries asking the WHO-backed Global Fund to pay for ACT are often refused, and forced to accept the older drugs, say the authors. Tens of thousands of children are dying every year as a direct result of these decisions, they say.

The group is calling for the WHO to publish guidelines for treatment.

Link to opinion article in The Lancet*

Link to response from the World Health Organisation in The Lancet*

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Reference: The Lancet 363, 237 (2004)