301680
Availability, price and volumes of anti-malarial medicines and malaria diagnostics between zones with and without artemisinin resistance in Cambodia
The advancement of artemisinin resistance (AR) in the Greater Mekong Subregion threatens the international community’s ability to combat malaria. Ensuring consistent diagnostic testing, better access to artemisinin-based combination therapy (ACT) and removal of oral artemisinin-based monotherapy (OAM) are key activities to contain AR. As such, a thorough understanding of the anti-malarial market is a pre-condition for making evidence-based decisions to prevent the spread of AR.
METHODS
The ACTWatch project is a repeated cross-sectional study measuring the availability, price and volumes of anti-malarial medicines and diagnostics in 10 countries. In 2013, ACTwatch conducted a nationally representative outlet survey in Cambodia; 14,264 outlets were screened, and 2,818 anti-malarial medicines and 1,263 malaria rapid diagnostic tests (RDT) were audited.
RESULTS
Several factors related to AR including availability, price and volumes of anti-malarial medicines and diagnostics, ability of outlets to test-and-treat and provider knowledge of first-line treatment will be compared across AR zones. Preliminary results indicate that a higher percentage of outlets stock ACTs and RDTs in zones with AR (ACT=97%, RDT=93%) compared to zones without AR (ACT=92%, RDT=78%) and that OAM availability is negligible in all zones. Survey data is currently being analyzed and results will be released in April, 2014.
DISCUSSION
AR in the Greater Mekong Subregion has the potential to spread to Sub-Saharan Africa. This would complicate malaria case-management leading to increases in malaria morbidity and mortality in the worlds most malaria-affected region. The evidence generated from the current study will help inform policy-related decisions to contain AR in Cambodia.
Learning Areas:
Protection of the public in relation to communicable diseases including prevention or controlPublic health or related research
Learning Objectives:
Explain current methods used to measure malaria morbidity and mortality.
Compare the cost-effectiveness of different malaria interventions.
Design a study to assess the frequency and magnitude of informal payments for malaria diagnostic and treatment services in a Sub-Saharan African country.
Keyword(s): Public Health Research, International Health
Qualified on the content I am responsible for because: I have been working with the ACTwatch project for the last year managing multiple nationally representative surveys. I have also worked as a public health professional conducting community health needs assessments, quality of care evaluations and data analysis consultancy work. My main research interests include antimalarial resistance containment and antimalarial medicine and malaria diagnostics availability, price and market share.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.