Shortage of primaquine tablets

The American Society of Health-System Pharmacists has reported a shortage of primaquine phosphate tablets. Sanofi-Aventis, the only manufacturer, cannot provide a reason for this shortage. Two of the organisms which cause malaria, Plasmodium vivax and ovale, produce a dormant stage in the liver, appropriately named a hypnozoite (see photo).

Hypnozoites can only be killed by primaquine, and the various other malaria treatments will only affect the organisms in the blood. This will prevent the symptoms of the disease, but relapses will occur until the hypnozoites in the liver can be destroyed. The Centers for Disease Control have published treatment recommendations.

In the US, malaria prophylaxis and treatment are important to people who are traveling to areas of the world where malaria is active. Globally, the CDC is part of the World Health Organization's Roll Back Malaria campaign. As you can see from the map below, sub-Saharan Africa and southern Asia are the most affected. Worldwide, 85% (749,000) of the deaths due to malaria were children under five years old. This and other facts are available from the WHO.