In 2009 Novartis and MMV launched the first high-quality artemisinin combination therapy (ACT) formulated especially for children – Coartem®Dispersible (artemether-lumefantrine). Since then, 300 million treatments of this life-saving medicine have been delivered to 50 malaria-endemic countries.
This notable increase in part reflects a welcome acceleration in the uptake of the medicine by government health systems. Nevertheless, given that the adoption of new technologies and medicines sometimes takes longest in the public sector, MMV will continue to focus on generating national policy acceptance and implementation of paediatric treatment rollout to ensure Coartem Dispersible continues to save as many young lives as possible.
There has always been a paradox at the heart of drug treatment for acute P.falciparum malaria: More than 85% of those who die are children, yet the available drugs have always been developed as tablets for adults. These then need to be broken up or crushed for children, making it difficult to give the exact dose. Additionally, many of the most widely available antimalarials are bitter to taste, causing children to gag or spit out the very medicine that could save their lives.
Coartem Dispersible was developed to overcome such barriers. By taking the powerful but bitter ingredients of the parent drug Coartem® and reformulating them into a sweet-tasting, paediatric tablet, MMV and its partner Novartis have developed a drug that is both highly effective and easy to give to children, which helps improve compliance with the medicine. Coartem itself is a highly successful artemisinin-based combination therapy (ACT) launched in 2001, which combines the rapid parasite-killing action of artemether with the slower-acting drug lumefantrine.
As with other ACTs, the combination is well tolerated and clinically effective, rapidly kills blood parasites, and helps to block transmission of malaria to others. Furthermore the two-in-one (combination) formulation helps delay parasite resistance to artemisinin-based treatments – one of the key reasons that the WHO insists on the use of combination therapy for acute malaria treatment.
Coartem Dispersible is the first child-friendly ACT developed to stringent international regulatory standards.