Generic praziquantel in South Africa: the necessity for policy change to provide cheap, safe and effcacious schistosomiasis drugs for the poor, rural population

Abstract

An estimated 4.5 million South Africans, mainly in settings of rural poverty, are in need of treatment for urogenital schistosomiasis. In spite of severe morbidity and mortality, schistosomiasis remains a neglected disease with an important gender impact. The World Health Organization recommends regular mass treatment of all school-aged children. In areas endemic for schistosomiasis children are treated with a single dose of praziquantel, used for almost 30 years as the drug of choice. If administered in childhood, praziquantel has been proven to effectively prevent schistosomiasis-related morbidity, as well as reduce the socio-economic impact of the disease. Moreover, preventing urogenital schistosomiasis may also reduce HIV transmission in sexually active females. In this paper we examine the impact of the disease, the use of generic praziquantel and the need for a change in health and drug policy in order to make generic praziquantel available for mass treatment campaigns in South Africa. Generic praziquantel has been on the market for almost 30 years. Although elsewhere available free of charge, or at low cost, affordable generic versions of praziquantel are not obtainable in South Africa.