From famine to feast: the transformation of the ACT malaria treatment landscape since 2004

12 Sep 2014
Africa Health

Medicines for Malaria Venture and Drugs for Neglected Diseases initiative explore the advantages of multiple ACTs for malaria and how to prolong their usefulness, co-authored by George Jagoe, Adam Aspinall and Elizabeth Poll.

As little as 10 years ago, owing to drug resistance, a clinician treating a patient for malaria would be routinely confronted with a terrible dilemma: ‘Will the drug I prescribe actually cure my patient?’ Between 1999 and 2002, rates of resistance to chloroquine and sulfadoxine-pyrimethamine (SP) in excess of 90% and up to 60%, respectively, were being reported in parts of East Africa. This dire situation continued until World Health Organization’s (WHO) prequalification of the first artemether-lumefantrine (AL) artemisinin combination therapy (ACT) in 2004, followed by growing support from donors for the large-scale introduction of ACTs. By 2005, 40 countries had adopted ACT as either first or second-line therapy and their distribution broke through the 10 million treatment mark and steadily increased over the next eight years, spurred on by the development of new fixed-dose combinations.

By 2012, 79 countries and territories had adopted ACT as first-line treatment for uncomplicated malaria....

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This article is co-authored by Adam Aspinall (MMV), Graciela Diap (DNDi), George Jagoe (MMV), Jean-René Kiechel (DNDi) and Elizabeth Poll (MMV).