In this week's PLoS Medicine, the journal's editors call for concerted international action to address the crisis of malaria drug shortages across Africa.
They argue that there are now signs of an evolving "malaria activism" (akin to AIDS activism), which has scored two big successes. The first wave of malaria activism highlighted the gap between the huge burden of malaria and the tiny amount of international development assistance dedicated to its control. Such advocacy helped motivate donors to increase their malaria commitments. The second wave focused on making sure that the extra funding was used to purchase highly efficacious artemisinin-based combination therapy (ACT) rather than mono-therapies such as chloroquine, which are largely ineffective in Africa.
"These are big victories," say the editors. "But one benchmark of successful ACT scale-up is whether the drugs are available at the point of care. One of us has just returned from a health reporting fellowship in East Africa, where he found that ACT 'stock-outs' (shortages) were common."
So it's now time, they say, for a "third wave" of activism, to raise awareness of the ACT stock-out crisis, which has deadly consequences.
The editors examine reasons for the crisis—such as inadequate funding to purchase ACT, delays in procuring the drug, and weak health information systems that can't properly track national drug needs and flows—and they lay out some possible solutions.
Funding: The reporting on the ground in East Africa for this editorial was provided to GY through a Kaiser Family Foundation Mini-Fellowship in Global Health Reporting. The funder had no role in decision to publish, or preparation of the manuscript. The PLoS Medicine Editors are each paid a salary by the Public Library of Science, and they wrote this editorial during their salaried time.
Competing Interests: During GY's fellowship, ground transportation, a desk, and internet access were provided by the Malaria Consortium, an international nonprofit organization, and by the KEMRI-Wellcome Trust Research Programme. The PLoS Medicine Editors' individual competing interests are at http://www.plosmedicine.org/static/editorsInterests.action. PLoS is funded partly through manuscript publication charges, but the PLoS Medicine Editors are paid a fixed salary (their salary is not linked to the number of papers published in the journal).
Citation: The PLoS Medicine Editors (2009) Time for a ''Third Wave'' of Malaria Activism to Tackle the Drug Stock-out Crisis. PLoS Med 6(11): e1000188. doi:10.1371/journal.pmed.1000188
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