First child-friendly antimalarial 10 year anniversary

Malaria can strike at any time. You’ll find mostly children falling ill at night and I can tell you, when a child goes to hospital with all these symptoms the level of parasitemia can be quite high. A young child could easily have a billion parasites in the blood. And this is even more than the number of cells, red blood cells, that this child has. It’s quite overwhelming and the child can die. We had a pretty good drug, however the challenge was that to administer it to children, which were the biggest patient population pretty much for malaria. There is a very strong need for a child-friendly formulation. I think this was without question. Antimalarials in general are not nice tasting drugs. So, a 2-year-old child trying to take a bitter pill, crushed up on a spoon into their mouth with little bit of water is a really, really hard proposition. When you develop a product, when you go through the design phase it is crucial to understand what are the needs of the target population. And we’re talking about patients but also the healthcare providers, the nurses or the parents. Predominantly the taste was one of the critical parameters. The other thing was about how can I make it easy to use. The taste masking is really important, because remember we are giving it twice a day for three days. If the child doesn’t take all six doses two things happen: one is that the risk is, they don’t get cured and the other is the drug is also at risk of parasites generating resistance against it. In the case of the dispersible we also have to conduct trials, also just to show that it was as safe and as efficacious as the standard tablet. We visited two countries. We were really on the ground in the village, where people mostly fell sick and are far from any hospital. We had medical people from Novartis based in Kenya, in Nigeria and in South Africa, who were instrumental in managing all this on a daily basis. We have been working day and night to make it happen and it has been a rewarding experience when we saw the product coming to the market. Having the drug developed doesn’t mean that patients have access. We were able to speed up the access to this drug in the countries because of the quality of our drug, the collaboration with key stakeholders and also the fact that the drug was pre-qualified by the WHO and approved by Swissmedic. It really is hard to overestimate how important that dispersible medicine was in changing the whole frame of thinking about treating children with malaria. There was no quality medicine designed with children’s needs in mind before that. Celebrating the 10th anniversary since the launch of the pediatric product still makes me dream about the future and where I would like us to be. I do think that the ultimate goal of eradicating malaria should still be our vision and hopefully it will become true.

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