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ACT now: anti-malarial market complexity one decade after the introduction of artemisinin combination therapy – evidence from sub-Saharan Africa and the Greater Mekong Sub-region

Since 2002, national malaria control programmes in sub-Saharan Africa (SSA) and the Greater Mekong Sub-region (GMS) responded to increasing resistance of Plasmodium to existing drugs by adopting artemisinin-based combination therapy (ACT) as first-line treatment. From 2012, countries have increasingly adopted recommendations by the World Health Organization to confirm all suspected malaria cases with diagnostic testing. In 2015, several countries in the GMS made bold steps towards malaria elimination, in the context of evidence of a resurgence in resistance to first-line treatments. In sub-Saharan Africa, efforts continue to rationalize malaria case management and further reduce prevalence of the disease.

ACTwatch has been monitoring anti-malarial and diagnostic markets since 2008. Standardized methods allow for comparability across survey rounds and over time, and provide evidence to inform policies, strategies and funding decisions. This series provides a comprehensive contemporary view of anti-malarial markets across several countries in SSA and the GMS, examining current levels of access to quality-assured first-line treatments and malaria diagnostics, and documenting the persistence of other non-first line medicines. This evidence serves as a benchmark for public and private sector initiatives that have aimed to scale up access to first-line treatment and confirmatory testing. Evidence can guide future strategies aimed at improving malaria case management and for accelerating progress towards malaria elimination.

ACTWatch have New Content Itempublished their datasets associated with this series. Links to individual dataset publications can be found within the 'Availability of data and materials' section of the articles below. You can also view the whole series of datasets here

  1. The national policy for malaria treatment of the Democratic Republic of Congo recommends two first-line artemisinin-based combinations for the treatment of uncomplicated malaria: artesunate-amodiaquine and art...

    Authors: Doudou M. Yobi, Nadine K. Kayiba, Dieudonné M. Mvumbi, Raphael Boreux, Pius Z. Kabututu, Hippolyte N. T. Situakibanza, Solange E. Umesumbu, Patrick De Mol, Niko Speybroeck, Georges L. Mvumbi and Marie-Pierre Hayette
    Citation: Malaria Journal 2021 20:144
  2. Over the last decade, artemisinin-based combination therapy (ACT) has contributed substantially to the decrease in malaria-related morbidity and mortality. The emergence of Plasmodium falciparum parasites resista...

    Authors: Romaric Nzoumbou-Boko, Chris-Boris Gildas Panté-Wockama, Carine Ngoagoni, Nathalie Petiot, Eric Legrand, Ulrich Vickos, Jean-Chrysostome Gody, Alexandre Manirakiza, Christophe Ndoua, Jean-Pierre Lombart and Didier Ménard
    Citation: Malaria Journal 2020 19:191
  3. Seasonal malaria chemoprevention (SMC) is a new strategy to prevent malaria in children under 5 years old. It has been recommended by the World Health Organization since 2012 in malaria-endemic areas with seas...

    Authors: Drissa Konaté, Sory I. Diawara, Mahamoudou Touré, Seidina A. S. Diakité, Agnès Guindo, Karim Traoré, Ayouba Diarra, Bourama Keita, Sibe Thiam, Moussa Keita, Ibrahim Sissoko, Nafomon Sogoba, Sékou F. Traoré, Donald J. Krogtad, Seydou Doumbia and Mahamadou Diakité
    Citation: Malaria Journal 2020 19:137
  4. Since 2004, Kenya’s national malaria treatment guidelines have stipulated artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria, and since 2014, confirmatory diagnosis o...

    Authors: Anne Musuva, Waqo Ejersa, Rebecca Kiptui, Dorothy Memusi and Edward Abwao
    Citation: Malaria Journal 2017 16:494
  5. Oral artemisinin monotherapy (AMT), an important contributor to multi-drug resistant malaria, has been banned in Nigeria. While oral AMT has scarcely been found for several years now in other malaria-endemic c...

    Authors: Chinazo Ujuju, Jennifer Anyanti, Paul N. Newton and Godwin Ntadom
    Citation: Malaria Journal 2017 16:489
  6. Quality of artemisinin-based combination therapy (ACT) is important for ensuring malaria parasite clearance and protecting the efficacy of artemisinin-based therapies. The extent to which non quality-assured A...

    Authors: Paul N. Newton, Kara Hanson and Catherine Goodman
    Citation: Malaria Journal 2017 16:204
  7. The World Health Organization guidelines have recommended that all cases of suspected malaria should receive a confirmatory test with microscopy or a malaria rapid diagnostic test (RDT), however evidence from ...

    Authors: Kara Hanson and Catherine Goodman
    Citation: Malaria Journal 2017 16:205
  8. The aim of this paper is to review multi-country evidence of private sector adherence to national regulations, guidelines, and quality-assurance standards for malaria case management and to document current co...

    Authors: Sochea Phok, Saysana Phanalasy, Si Thu Thein and Asawin Likhitsup
    Citation: Malaria Journal 2017 16:180
  9. Since 2004, artemisinin-based combination therapy (ACT) has been the first-line treatment for uncomplicated malaria in Benin. In 2016, a medicine outlet survey was implemented to investigate the availability, ...

    Authors: Cyprien Zinsou and Adjibabi Bello Cherifath
    Citation: Malaria Journal 2017 16:174
  10. The private sector supplies anti-malarial treatment for large proportions of patients in sub-Saharan Africa. Following the large-scale piloting of the Affordable Medicines Facility-malaria (AMFm) from 2010 to ...

    Authors: Sarah Tougher, Kara Hanson and Catherine Goodman
    Citation: Malaria Journal 2017 16:173
  11. The containment of artemisinin resistance in Myanmar, historically an important probable origin and route of anti-malarial resistance to the India sub-continent and beyond, is crucial to global malaria control...

    Authors: Si Thu Thein, Hnin Su Su Khin and Aung Thi
    Citation: Malaria Journal 2017 16:170
  12. In 2015/2016, an ACTwatch outlet survey was implemented to assess the anti-malarial and malaria testing landscape in Myanmar across four domains (Eastern, Central, Coastal, Western regions). Indicators provide...

    Authors: Si Thu Thein, Hnin Su Su Khin and Aung Thi
    Citation: Malaria Journal 2017 16:129