The Gambia, on Wednesday, ventured officially into using a new drug in malaria treatment called Coartem, following studies across the country showing resistance to chloroquine (CQ) exceeding levels recommended by the World Health Organisation globally.

Officially launching the new anti-malarial treatment policy (ACT), Dr Malick Njie, secretary of state for Health and Social Welfare, said his department and partners had conducted a series of consultative meetings since October 2004 to share information on the introduction of chloroquine resistance in The Gambia with a view to reaching concensus on the need to change as well as identify the new drug to replace CQ. Consequently, Artemether + Lumefantrine (Coartem) has been identified as the new drug to replace CQ for the treatment of uncomplicated malaria in The Gambia.

According to SoS Njie, the policy change had been consented to by the Cabinet and the Gambian leader, Dr Alhaji Yahya Jammeh in February, 2007, and procurement and distribution of the drugs have also been effected. Health worker trainings and community sensitizations on coartem are also ongoing. "This policy change is a vital step given the importance of effective malaria treatment as a key strategy in our overall malaria control and prevention program," he said.

For his part, the Director of Medical Services, Dr. Tamsir Mbowe, said malaria is not the only disease that affects the health of a nation but has serious negative economic impacts, thereby encouraging poverty and social injustice.

According to him, in The Gambia, for the past three years, there has been significant reduction in malaria cases, thanks to the political will of our leader, Dr Alhaji Yahya Jammeh and his continued support to the health sector in providing aircrafts for the control of the mosquito vector, billarvicides that take care of the mosquitoes larvae and the introduction of the set settal programme, to name a few.

"In the fight against malaria, I have the firm belief that the introduction of ACTs in our anti-malaria drug chain will help significantly in the management of the disease. We should all continue to work as a team and combine all the preventive and control measures in the fight against malaria," he said.

Mrs Markieu Janneh Kaira, acting chief pharmacist, National Pharmaceutical Services, also speaking at the ceremony, said it had been a long journey to reach this goal post but we can congratulate ourselves that it has successfully come to this since a lot has been achieved to date. To name a few:

• Registration of the new drug, Artemether-Lumefantrine, which is a combination of two drugs formulated into one tablet (Coartem)

• Guidelines have been updated to include this new treatment policy change in 2005

• Sensitization of the public has started and is still ongoing

• Procurement and distribution of the ACTs to all the regional medical stores across the country and most public health facilities.

"I would like to inform Gambian people that this is a very effective treatment that is currently being adapted for the treatment of malaria and we are lucky to benefit from it. However, if this medicine is to serve us well, let us be prepared to use this medicine rationally to delay resistance. Use medicine only when prescribed by health workers, complete the full course treatment - twice daily for 3 days, do not share your treatment," she emphasised.

Speaking earlier, Malang Fofana, manager, National Malaria Control Programme, said the launching of the new drug marks a major turning point in the history of malaria control and prevention in The Gambia. "It is only through effective partnership such as this anti-malaria policy change that we can a roll back malaria in our country," he said.

The malaria problem, according to him, cuts across many sectors and needs a multi-sectoral approach to fight it effectively.

Agnes Kuye, acting WHO Rep, also speaking at the ceremony, said WHO, from 1998 to 2003, has been providing both financial and technical support in drug efficacy studies conducted in Basse, Mansakonko, Brikama, Essau and Polyclinic.

The drug efficacy studies have revealed increased chloroquine resistance which has surpassed the WHO threshold. Based on this evidence, the department of state for Health & Social Welfare requested WHO's technical assistance to facilitate drug policy change for the treatment of malaria. "It was at this meeting that The Gambia has selected

Artmether-Lumefantrine as a drug of choice for the treatment of uncomplicated malaria, following a consultative meeting with all relevant partners."

Min-Whee Kang, UNICEF country rep, for her part, said nearly all sub-Saharan countries have rapidly shifted their national drug policies to promote more effective treatment with artemisinim-based combination therapies with financing and procurement significantly increased since 2005.

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