Antimalarial stewardship programs are urgently needed for malaria elimination: a perspective.

Area of Science:

• Global Health
• Infectious Diseases
• Pharmacology

Background:

• Global malaria control efforts have seen stagnation in case reduction over the past three years.
• Significant financial investment (over USD 3 billion) has not translated into substantial progress.
• Complex and multi-factorial reasons contribute to this lack of significant reduction.

Purpose of the Study:

• To highlight the stagnation in global malaria case reduction.
• To identify critical issues in antimalarial drug supply and administration.
• To advocate for the implementation of antimalarial stewardship programs.

Main Methods:

• Analysis of global malaria case data over the last three years.
• Review of antimalarial treatment course supply data from 2010-2017.
• Identification of treatment practices associated with malaria tests and dosage.

Main Results:

• Global malaria cases have not significantly decreased despite substantial investment.
• Nearly three billion antimalarial treatment courses were supplied between 2010-2017.
• A significant proportion (30%) of treatments were administered without malaria tests, and some with suboptimal doses, increasing resistance risk.

Conclusions:

• Antimalarial drug supply and administration practices require significant improvement.
• Suboptimal dosing and lack of testing contribute to the risk of antimalarial resistance.
• Implementing antimalarial stewardship programs at all healthcare and population levels is essential to bridge the gap between policy and practice.