The World Health Organization (WHO) said Novartis, which under a 2001 agreement provides the agency with artemether + lumefantrine, an artemisinin-based combination therapy (ACT), at cost for supply to malaria-endemic poor countries, had reported a continued lack of raw materials needed to make the drug.Production is highly dependent on timely delivery of artemisinin, a raw material extracted from the plant Artemisia annua, and its derivative artemether by its Chinese suppliers. ACTs are currently the most effective treatment for falciparum malaria, the deadliest form, and artemether + lumefantrine is the only such drug currently available in fixed-dose form with the two drugs are combined in a single tablet.Forty countries, 20 of them in Africa, have officially adopted ACTs since 2001. Twenty have adopted artemether + lumefantrine as their first or second-line treatment.Last month, WHO announced the shortfall of the drug, produced under the trade-name Coartem®, just for the November-March period, but today it said Novartis had told it that despite investment and rapid scale-up to meet growing needs, it could not reach full production of 5 million treatment courses per month due to the lack of raw material.The company said it had secured artemisinin derivatives in quantities sufficient to produce approximately 60 million average treatments but because most deliveries will occur in the second half of the year, only about 30 million will be produced in 2005, half of them during the last quarter. WHO is providing technical assistance to countries facing the consequences of the shortage, while informing each country that has placed an order about availability and delivery schedules.

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