The Ministry of Health has signed a deal to lower the burden of neonatal mortality.
Under the new deal, the ministry has negotiated a price reduction with the manufacturer to ensure the drug is readily available in all the facilities in the country.
It will ensure a wide access to a more efficient drug in the management of apnea of prematurity, which is one of the causes of neonatal or preterm deaths.
Apnea of prematurity occurs when newborns, especially those born prematurely, forget to breathe.
Apnea can be caused by immaturity of the brain and weakness of the muscles that keep the airway open.
The drug, Caffeine Citrate, is a stimulant that targets the brain and is effective in preventing deaths by stimulating the neonates brains to remember to breathe.
When preterm babies especially those born below 34 weeks are born, they are born when the brain is not fully developed hence experience episodes of cessation of breathing.
The drug, Caffeine Citrate when taken by the neonates stimulates and helps them to continue breathing.
Caffeine Citrate, a core medication recommended by the World Health Organisation and produced by Ethypharm in UK, is used in treatment of neonates and premature babies, hence allows for better survival for premature birth babies.
“It covers better for almost 24 hours so it is something that you give daily for 24 hours depending on the body weight of the neonates. The number of days depends at what age the neonate was born,” Key account manager at Ethypharm Kenya Kirkland Magwilu said.
Under normal conditions, a baby is supposed to spend about 40 weeks in their mother’s womb.
However, a number of factors such as poor nutrition, alcohol intake, smoking, chronic diseases and Urinary Tract Infections may make some babies to be born too soon.
Preterm babies are babies born alive before 37 weeks of pregnancy are completed. Data shows that 127,500 babies were born too soon in Kenya in 2020.
Health experts have warned that newborns, especially preterm babies, face the highest risk of dying in their first month of life.
Health DG Patrick Amoth said complications of prematurity account for a third of all neonatal deaths.
He cited the pressing need for collective efforts to reduce the burden.
Data shows that deaths in this vulnerable group have stagnated for the past 10 years, despite efforts by the Ministry of Health to lower the burden on neonatal mortality.
The successful negotiation for the 70 per cent reduction in access price for caffeine citrate in Kenya from the previous Sh1,500 to Sh400 is seen as a game changer in reducing neonatal deaths.
Currently, the drug is available in only 19 per cent of health facilities in the country due to high pricing.
“In order to fast-track public sector procurement of caffeine citrate through KEMSA and increase availability from 19 per cent in the public sector to more than 50 per cent, Ethypharm is donating 10,000 ampoules and essential equipment for use in new-born units,” Amoth said.
The Caffeine Citrate when delivered to the brain targets to stimulate various muscles in the body for the neonates.
It mainly targets the smooth muscles of the heart to increase pumping and the brain stem cells helps the neonates to remember to breathe.
Ethypharm General Manager for Middle East and North Africa Rob Bruchet said the new partnership, which brought together key stakeholders including the ministry, will see the manufacturer provide special access pricing.
“We looked at our price, we recognised that the price and the cost is a barrier to having Caffeine Citrate being used more widely in the country so we work together to provide a very low cost effective access price in the market that will allow it to be used more widely,” Bruchet said.
“With the partners we will be able to have wider use of the medication, with wider use and higher volumes it allows you to bring the cost down,” he added.
Ethypharm regional manager for Northern Sub Saharan Africa Reuben Sigei said the drug is more efficacious, is better in terms of tolerability with less side effects compared to existing molecules.
Researches on the drug have shown it has better performance and better treatment outcomes in neonates compared to other products.
Unfortunate situation is that the pricing was a little higher but of working with donors and the ministry we have seen that it is possible to scale up the uptake of this product in the event saving more lives,” Sigei said.
Currently, practitioners use various methods such as CPAP and aminophilim though there has been no major impact on reducing the mortality rate in babies.
Aminophylline belongs to a group of medicines known as bronchodilators. Bronchodilators are medicines that relax the muscles in the bronchial tubes (air passages) of the lungs.
They relieve cough, wheezing, shortness of breath, and troubled breathing by increasing the flow of air through the bronchial tubes.
From 2013 to date a lot has gone into fighting under five mortality rate but the biggest contributor to under five mortality has been apnea of maturity at around 24 per cent.
The current deal is a deliberate measure by the government to reduce the mortality rate and improve neonatal care which has been not so much invested into.
The drug is currently in use in several other countries in the region, including Rwanda and Uganda and has being registered in Tanzania, Zambia, South Africa, Ghana, Nigeria, Ethiopia and several other countries.