Malaria medication efforts fail in objective

There aren’t many immediate obvious similarities between malaria and Coca-Cola... except when they intertwine in the field of public health. They are able to converge because the economic influence and marketing practices of one is being used in combatting the other. 

Coca-Cola is a dominant force in its market because it sets extremely low prices so that other beverage brands have no choice but to lag behind. The market for malaria treatments is not quite as simple: The only truly effective pills, such as World Health Organization-approved artemisinin combination therapies (ACTS) are very expensive. Pills that are less expensive are also less effective and cannot stand up to the malaria medication-resistant parasites that have recently emerged. 

Given the low socioeconomic status of many individuals in African countries, people often have to settle for these cheaper drugs, which can encourage parasites to resist medication and therefore counteract the purpose of the treatment entirely.

In 2004, Nobel Prize-winning economist Kenneth Arrow, inspired by Coca-Cola’s approach, conceived an idea to make the high-quality drugs just as affordable as the ones that do not work. The organization that emerged from Arrow’s efforts was termed the Affordable Medicines Facility for Malaria (AMFm).

Although truly innovative in its goal of creating a consumer market for antimalarials in order to increase affordability, the actions of AMFm have recently backfired.

They have backfired in part due to what makes many believe that AMFm was a fantastic idea: the prevalence of malaria. Individuals often self-diagnose malaria and purchase antimalarials despite having other illnesses that produce similar symptoms.

This might not result in such a problem in the U.S., where physicians can dissuade patients from taking unnecessary medication. Hospitals and private physicians are more rare in Africa. This leaves many individuals with only the option of purchasing the medication from a drug store, where profits — not health — are often the top priority.

AMFm launched in 2010, and two years later, the price of the highest quality antimalarials dropped significantly. This led to an increase in sales for the medications.

However, a proportion of the consumers did not actually have malaria. Such patients will often have a fever cured by the antimalarials, but this effect can prevent them from realizing that they have another illness such as dengue fever or pneumonia until the progression of the disease is too late to be stopped.

The organization that hosted AMFm, called the Global Fund to Fight HIV, Malaria and Tuberculosis, discontinued this method in 2014. Remaining funding is being put towards making diagnostic tests more effective and accessible to individuals.

The tests are not being used to their full potential because there is simply no incentive for employees of drug stores to offer the inexpensive tests when more expensive antimalarials are much more profitable. Many employees even offer antimalarials despite negative test results, asserting that symptoms will be reduced.

This misleads many individuals into thinking that their current disease is taken care of, which means that they do not seek the medical care they need.

Some economists believe the solution is to mandate that pharmacists charge a standard price for all malaria drugs, but this approach requires regulation and enforcement that is not yet achievable. 

A current approach is to let pharmacists know that selling diagnostic tests and then sending those who test negative to seek medical help can improve their reputation because they can save lives through this action.