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An analysis by the humanitarian medical aid organization Médecins Sans Frontières (MSF, Doctors without Borders) has found that between 1996 and 2004 MSF was responsible for about a quarter of all clinical studies of malaria medicine efficacy in 18 countries of Africa and Asia. In an article published in PLoS Medicine, Jean-Paul Guthmann (Epicentre, Paris, France) and colleagues report that MSF enrolled over 12,000 patients in 43 studies in these 18 countries during this time period.

These 43 studies, say the authors, "provided extensive evidence on the efficacy of most drug regimens currently in use for uncomplicated malaria, which was often used for treatment policy changes by the concerned countries."

Guthmann and colleagues argue that MSF's greatest contribution to studying the efficacy of malaria medicines was in conflict-affected countries of sub-Saharan Africa. In these countries MSF studies comprised the vast majority of available data and "traditional" academic research institutions were not, or were barely, represented in research on this topic.

The analysis, they say, demonstrates the potential role of non-governmental organizations (NGOs) in collecting the necessary evidence to stimulate and inform policy change in international health.

"As part of their mandate, medical NGOs should be prepared to fill gaps in evidence, including evaluating current tools to control tropical diseases in hard-to-reach populations, and demonstrating the effectiveness of alternatives."

Assessing antimalarial efficacy in a time of change to artemisinin-based combination therapies: The role of Médecins Sans Frontières.
Guthmann J-P, Checchi F, van den Broek I, Balkan S, van Herp M, et al. (2008)
PLoS Med 5(8): e169. doi:10.1371/journal.pmed.0050169
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