This article is part of the supplement: Towards a research agenda for global malaria elimination .

Review

Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities

Christopher JM Whitty¹ , Clare Chandler^1,2 , Evelyn Ansah³ , Toby Leslie^1,4 and Sarah G Staedke^1,5

¹  Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK

²  Joint Malaria Programme, KCMC, Moshi, Tanzania

³  Dangme West District Health Directorate, Ghana Health Service, P.O. Box DD1, Dodowa, Ghana

⁴  HealthNet-TPO, Kabul, Afghanistan

⁵  MU-UCSF Research Collaboration/Uganda Malaria Surveillance Project, Mulago Hospital, PO Box 7475, Kampala, Uganda

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Malaria Journal 2008, 7(Suppl 1):S7doi:10.1186/1475-2875-7-S1-S7

Published:	11 December 2008

Abstract

Following a long period when the effectiveness of existing mono-therapies for antimalarials was steadily declining with no clear alternative, most malaria-endemic countries in Africa and Asia have adopted artemisinin combination therapy (ACT) as antimalarial drug policy. Several ACT drugs exist and others are in the pipeline. If properly targeted, they have the potential to reduce mortality from malaria substantially. The major challenge now is to get the drugs to the right people. Current evidence suggests that most of those who need the drugs do not get them. Simultaneously, a high proportion of those who are given antimalarials do not in fact have malaria. Financial and other barriers mean that, in many settings, the majority of those with malaria, particularly the poorest, do not access formal healthcare, so the provision of free antimalarials via this route has only limited impact. The higher cost of ACT creates a market for fake drugs. Addressing these problems is now a priority. This review outlines current evidence, possible solutions and research priorities.