Novartis Italy and Ethiopia collaborate in the Tigray Project
May 16, 2006 - A Malaria Control Project, which was launched in 2005 by Novartis Italy and the Italian Ministry of Health - in collaboration with the Tigray Health Bureau, the World Health Organization (WHO), the Italian Dermatological Hospital of Quiha and the Department of Preventive Medicine of San Gallicano Dermatological Institute IRCCS in Rome, designed to fight malaria in Tigray a significantly affected region of Northern Ethiopia - is achieving its first positive results. Malaria is endemic in Tigray (about 56% of the population lives in malarious areas) and about 50% of the population lives beyond the reach of health care facilities. In this region, as in most parts of Ethiopia, falciparum malaria has become resistant to conventional antimalarial treatments, such as cWoroquine, sulfadoxine-pyrimethamine and amodiaquine.
According to the agreement between Novartis Italy and the Italian Ministry of Health, more than 500,000 USD have been allocated in two years (Novartis Italy assigned 400,000 USD and the Italian Government 125,000 USD), in order to provide free RDTs, supplies of artemether/lumefantrine (Coartem®) and health education and training to about 140,000 people living in the region as part of the project.
One year after the implementation of the project, the strategy of fighting malaria by combining rapid diagnostic tests (RDTs), drugs and health educational activities has so far turned out to be successful: thanks to a network of 114 health workers operating both at health institutional level and at community level - through free distribution of the fixed dose antimalarial drug combination artemether/lumefantrine (Coartem®) among rural communities, including the villages lacking health care facilities, and educational programmes - a preliminary analysis shows that hospital admissions and case fatality rates caused by malaria may have decreased in Tigray.
The project aims at measuring the efficacy of rapid diagnostic sticks, early Coartem treatment through a network of Community Health Workers - operating, after a proper training, directly in the villages where they live - which are the real differentiating element of this initiatitive. Two major districts of the Tigray Region are involved: an intervention area in Alamata compared with the control one in Raya-Azebo, in order to measure the efficacy of the intervention in terms of reduction of hospitalization and mortality vs. usual standard approach. Novartis Italy is also supporting training at different levels and upgrading of some facilities, e.g. computers for data-analysis, etc.
The innovative aspect of the Tigray project consists of its community-based disease management approach achieved through:
- health education focused on early diagnosis, effective treatment and promotion of compliance;
- Community Health Workers (CHWs) training activities to promote accurate diagnosis and early treatment of malaria with artemether/lumefantrine (Coartem®);
- free distribution of RDTs for diagnosis of malaria by health workers in health facilities without microscopy and by community health workers in order to optimize treatments;
- monitoring of the disease through data collection and analysis.
This strategy is not only supplying remote rural areas with access to diagnostic tests and a highly effective treatment, but is also providing the community with appropriate know-how of disease management. This is an "added value" which, according to WHO, is an essential component to fight one of the most serious diseases of the developing world. WHO is providing technical assistance for the implementation of the project as well as the monitoring of the entire activities.
"This project - said Marco Venturelli, CEO of Novartis Italy - further confirms our efforts to guarantee a wider access to effective treatments against deadly diseases. The private public collaboration in the Tigray project provides one of the most affected populations with an effective antimalarial drug and contributes to the scientific evaluation of community-based management of the disease, through health educational programmes addressed to local population and the direct involvement of CHWs trained to adequate diagnosis and treatment. This approach -continued Venturelli - represents the first experience in the African continent to provide RDTs and artemether/lumefantrine (Coartem®) at the community level".
The Tigray project is part of a greater effort made by Novartis in pursuing humanitarian goals. Coartem®) has been included in the WHO's Essential Medicines list, and is currently the only arteminisinin-based combination therapy prequalified by WHO.