Novartis Malaria Initiative

Partnership objectives

  1. Improve access to quality-assured artemisinin-based combination therapies (ACTs) for adults and children in malaria endemic countries.
  2. Provide education and training on malaria and treatment to help communities in malaria-endemic countries deliver better healthcare.
  3. Work in partnership on the next generation of antimalarials 

Malaria  elimination requires action on several interconnected fronts – quality, affordability and accessibility of treatments, patient adherence and staying one step ahead of the parasite. Malaria elimination requires action on several interconnected fronts – quality, affordability and accessibility of treatments, patient adherence and staying one step ahead of the parasite. Copyright Brent Stirton for Novartis AG

What are the health needs and challenges?

Malaria is one of the world’s biggest killers and Africa's leading cause of mortality for children under five: every 2 minutes, a child dies of malaria in Africa. There were an estimated 212 million cases of malaria in 2015, causing an estimated 429,000 deaths.

Description of partnership activities and how they address needs and challenges

The Novartis Malaria Initiative focuses on improving access to treatment, helping communities in malaria-endemic countries deliver better healthcare and investing in research and development into the next generation of antimalarials. Focused on treatment, access, and capacity building, the Initiative is tailored to best meet patient needs. 

In 1999, Novartis  launched Coartem®, the first fixed-dose artemisinin-based combination therapy (ACT) antimalarial, prequalified by the WHO for its efficacy, safety and quality (and on the WHO’s Model List of Essential Medicines). Coartem® has a cure rate of over 95% of patients after a 3-day treatment course and a demonstrated safety profile. Coartem® combines artemether, a derivative of artemisinin (from the Chinese medicinal plant Artemisia annua), with a synthetic substance, lumefantrine. Lumefantrine has never been used as a monotherapy reducing the risk of resistance against the treatment compared to other ACTs.

In 2009, Novartis and Medicines for Malaria Venture (MMV) introduced Coartem® Dispersible, the first ACT formulation specifically developed to address the treatment needs of millions of children with malaria. Although children are the most vulnerable to malaria, there was until then no treatment adapted for this patient group. Prior to this innovative pediatric medicine, health workers and parents had to crush bitter-tasting antimalarial tablets for children to swallow.

Sweet-tasting Coartem® Dispersible tablets dissolve quickly in small amounts of water, easing administration and ensuring effective dosing for children. Coartem® Dispersible contains the same amounts of artemether and lumefantrine as Coartem® tablets (20mg/120mg) and delivers the same high cure rates.

However, rising resistance to artemisinin and decreasing drug efficiency threatens the global control of malaria, meaning new drugs are needed. In September 2016, Novartis published proof of concept study results showing that its new antimalarial compound, KAF156, demonstrated activity against both Plasmodium vivax and Plasmodium falciparum, two main parasites responsible for the majority of malaria deaths. This drug is even shown to work against artemisinin-resistant parasites. In line with WHO guidance that antimalarials be co-formulated to mitigate the risk of parasite resistance development, it is expected that KAF156 will become part of a combination regimen when used to treat malaria.

Education being a key factor in malaria control, the Novartis Malaria Initiative developed a program to train healthcare workers and the communities they serve. This includes materials and courses for healthcare workers and mothers/caregivers – translated into several languages and distributed free of charge. 

Further, Novartis also brings together the managers of national malaria control programs across Africa to share best practice in community awareness, healthcare worker training, stock management and distribution, and health impact measurement. In 2016, the fifteenth NMCP workshop was held in Senegal.

In an effort to tackle stock-outs of antimalarials in malaria-endemic countries, Novartis joined forces with private and public partners to launch SMS for Life in 2009. The program uses mobile and digital technology to track stocks of key antimalarials and other essential medicines in rural health facilities. The program was initially launched in Tanzania, but has since been rolled out in more than 10,000 public health facilities in Kenya, Ghana, the Democratic Republic of Congo and Cameroon. Over the years, the scope of the program has also expanded to more disease areas and health parameters.

Building on the success of SMS for Life, a new enhanced version, SMS for Life 2.0 was launched in 2016. In addition to stock visibility, the tablet-based platform enables to collect timely disease surveillance data and offers training programs and educational video resources to support the continuous education of health workers.

Since the start, the Novartis Malaria Initiative has worked with its Chinese suppliers of artemether and lumefantrine to help them to improve manufacturing processes and productivity, raise product quality and achieve international GMP standards. Assistance provided has included training in quality assurance, quality control, laboratory analysis, regulatory requirements and cost management. More recently, the Novartis Malaria Initiative has also worked with partners to expand cultivation of Artemisia annua in Madagascar. 

Lessons learned    

Malaria elimination requires action on several interconnected fronts – quality, affordability and accessibility of treatments are crucial, as well as effective case management, ensuring patient adherence and staying one step ahead of the parasite – but most importantly, it requires joint action and partnerships.

Summary of impact and forward looking information

Since 2001, Novartis has provided more than 850 million treatment courses of Coartem® and Coartem® Dispersible. Further, since its launch in 2009, more than 300 million treatments of Coartem® Dispersible alone have been delivered without profit to 40 countries, mainly in Africa, making it the first pediatric ACT to have been delivered in such large quantities.

Altogether, from 2001 to 2015, the WHO estimates that 6.2 million lives have been saved and the upward disease spiral reversed thanks to a concerted international effort to scale up interventions.

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Partnership information

Company(ies) Novartis

Partner(s) Academy of Military Medical Sciences, Chin, African Leader Malaria Alliance (ALMA), Bill and Melinda Gates Foundation, China International Trust and Investment Company, Crown Agents, Genomics Institute of the Novartis Foundation, Global Fund to Fight AIDS, Tuberculosis and Malaria, Global Health Delivery Project, Harvard University, Ifakara Health Institute, iMRES, John Snow Inc, Kenya Medical Research Institute, Malaria Consortium, Malaria No More, Medecins Sans Frontieres (MSF) / Doctors without Borders, Medical Stores Departments, Medicines for Malaria Venture (MMV), Novartis Institute for Tropical Diseases, Novartis Institutes for BioMedical research, PFSCM, Plan International, Population Services International (PSI), Roll Back Malaria Partnership (RBM), Swiss Tropical and Public Health Institute (Swiss TPH), UNDP, UNICEF, UNITAID, United Against Malaria, United Nations Special Envoy Office on Malaria, US Agency for International Development (USAID), World Bank, World Health Organization (WHO)

Type of Partner(s) Academia / Hospitals, Government, IGOs, Multilaterals, NGOs, Other Business, PDPs

Therapeutic Focus Women and Children's Health, Infectious Diseases

Disease(s) Children's Health, Malaria, Women's Health

Program Type(s) Availability of Treatment - Differential Pricing, Availability of Treatment - Technology Transfer - Scientific Collaboration and Knowledge Sharing, Health System Infrastructure - Training, Prevention Programs - Awareness & Outreach, Research & Development - Pediatric R&D

Targeted Population(s) Children, Elderly, Marginalised / Indigenous People, Men, Mothers, People with low income, Women, Youth

Region(s) East Asia & Pacific, Latin America & Caribbean, Middle East & North Africa, South Asia, Sub-Saharan Africa

Number of Countries 44

Country(ies) Angola, Bangladesh, Benin, Botswana, Brazil, Burkina Faso, Cameroon, Central African Republic, China, Colombia, Comoros, Democratic Republic of the Congo, Egypt, Ethiopia, Gabon, Guinea-Bissau, Guyana, Kenya, Lao PDR, Malawi, Mali, Mozambique, Myanmar, Namibia, Nepal, Niger, Nigeria, Papua New Guinea, Philippines, Rwanda, Sao Tome and Principe, Senegal, Solomon Islands, Sudan, Suriname, Swaziland, Tanzania, The Gambia, Timor-Leste, Togo, Uganda, Vanuatu, Zambia, Zimbabwe

Start Date 2001

More information Novartis Malaria Initiative

Anticipated completion date Ongoing

« The story of the Novartis child-friendly ACT is proving that partnerships are key, not only to develop new, high-quality medicines for malaria but also to deliver these to vulnerable populations. »

Dr. David Reddy, CEO, Medicines for Malaria Venture