Uganda’s Independent newspaper has published an attack on the Affordable Medicines Facility for Malaria (AMFm). AMFm is an initiative to increase access to effective malaria treatment for people in endemic countries, by making artemisin combination therapies (ACTs) available at a much lower price.

The article (which can be read online here) argues that the initiative is expensive and there is no evidence that it will cut infant mortality and general sickness or that it will be cost-effective or maintain quality control. The author is Roger Bate who is a Resident Fellow of a right-wing think-tank known as the American Enterprise Institute, which says its purposes are ‘to defend the principles and improve the institutions of American freedom and democratic capitalism - limited government, private enterprise, individual liberty and responsibility, vigilant and effective defense and foreign policies, political accountability, and open debate.’

Bate is particularly concerned by AMFm’s emphasis on locally produced drugs, which he argues are often of very low quality. He also points out that, ‘…in rural Africa, the availability of prevention and treatment is poor, regardless of price. Public dispensaries are rare and most people get their medicines from private shops and travelling traders. The AMFm would provide subsidised medicines through wholesalers to this rural private market, reaching far more people than any scheme working just with the public sector. Yet rural markets in Africa are not sufficiently understood.’

Roger Bate says that the $2bn which AMFm will cost over the next five years ‘…could probably save many more lives in existing preventative efforts such as indoor insecticide spraying or treated mosquito nets.’

There are many who will disagree with him. Getting effective treatment to those who need it is an essential part of malaria control and subsidising the cost of ACTs is surely the only way this can be done. If proper safeguards are put in place, then the quality of locally produced drugs can hopefully be assured.

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