To what extent are the antimalarial markets in African countries ready for a transition to triple artemisinin-based combination therapies?

<h4>Introduction</h4>Triple artemisinin-based combination therapies (TACTs) are being developed as a response to artemisinin and partner drug resistance in the treatment of falciparum malaria in Southeast Asia. In African countries, where current artemisinin-based combination therapies (...

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Autores principales:	Freek de Haan, Oladimeji Akeem Bolarinwa, Rosemonde Guissou, Fatoumata Tou, Paulina Tindana, Wouter P C Boon, Ellen H M Moors, Phaik Yeong Cheah, Mehul Dhorda, Arjen M Dondorp, Jean Bosco Ouedraogo, Olugbenga A Mokuolu, Chanaki Amaratunga
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0b7960eec00543d4ad1eae88bff71480
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spelling	oai:doaj.org-article:0b7960eec00543d4ad1eae88bff714802021-12-02T20:19:20ZTo what extent are the antimalarial markets in African countries ready for a transition to triple artemisinin-based combination therapies?1932-620310.1371/journal.pone.0256567https://doaj.org/article/0b7960eec00543d4ad1eae88bff714802021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256567https://doaj.org/toc/1932-6203<h4>Introduction</h4>Triple artemisinin-based combination therapies (TACTs) are being developed as a response to artemisinin and partner drug resistance in the treatment of falciparum malaria in Southeast Asia. In African countries, where current artemisinin-based combination therapies (ACTs) are still effective, TACTs have the potential to benefit the larger community and future patients by mitigating the risk of drug resistance. This study explores the extent to which the antimalarial drug markets in African countries are ready for a transition to TACTs.<h4>Methods</h4>A qualitative study was conducted in Nigeria and Burkina Faso and comprised in-depth interviews (n = 68) and focus group discussions (n = 11) with key actor groups in the innovation system of antimalarial therapies.<h4>Results</h4>Evidence of ACT failure in African countries and explicit support for TACTs by the World Health Organization (WHO) and international funders were perceived important determinants for the market prospects of TACTs in Nigeria and Burkina Faso. At the country level, slow regulatory and implementation procedures were identified as potential barriers towards rapid TACTs deployment. Integrating TACTs in public sector distribution channels was considered relatively straightforward. More challenges were expected for integrating TACTs in private sector distribution channels, which are characterized by patient demand and profit motives. Finally, several affordability and acceptability issues were raised for which ACTs were suggested as a benchmark.<h4>Conclusion</h4>The market prospects of TACTs in Nigeria and Burkina Faso will depend on the demonstration of the added value of TACTs over ACTs, their advocacy by the WHO, the inclusion of TACTs in financial and regulatory arrangements, and their alignment with current distribution and deployment practices. Further clinical, health-economic and feasibility studies are required to inform decision makers about the broader implications of a transition to TACTs in African counties. The recent reporting of artemisinin resistance and ACT failure in Africa might change important determinants of the market readiness for TACTs.Freek de HaanOladimeji Akeem BolarinwaRosemonde GuissouFatoumata TouPaulina TindanaWouter P C BoonEllen H M MoorsPhaik Yeong CheahMehul DhordaArjen M DondorpJean Bosco OuedraogoOlugbenga A MokuoluChanaki AmaratungaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0256567 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Freek de Haan Oladimeji Akeem Bolarinwa Rosemonde Guissou Fatoumata Tou Paulina Tindana Wouter P C Boon Ellen H M Moors Phaik Yeong Cheah Mehul Dhorda Arjen M Dondorp Jean Bosco Ouedraogo Olugbenga A Mokuolu Chanaki Amaratunga To what extent are the antimalarial markets in African countries ready for a transition to triple artemisinin-based combination therapies?
description	<h4>Introduction</h4>Triple artemisinin-based combination therapies (TACTs) are being developed as a response to artemisinin and partner drug resistance in the treatment of falciparum malaria in Southeast Asia. In African countries, where current artemisinin-based combination therapies (ACTs) are still effective, TACTs have the potential to benefit the larger community and future patients by mitigating the risk of drug resistance. This study explores the extent to which the antimalarial drug markets in African countries are ready for a transition to TACTs.<h4>Methods</h4>A qualitative study was conducted in Nigeria and Burkina Faso and comprised in-depth interviews (n = 68) and focus group discussions (n = 11) with key actor groups in the innovation system of antimalarial therapies.<h4>Results</h4>Evidence of ACT failure in African countries and explicit support for TACTs by the World Health Organization (WHO) and international funders were perceived important determinants for the market prospects of TACTs in Nigeria and Burkina Faso. At the country level, slow regulatory and implementation procedures were identified as potential barriers towards rapid TACTs deployment. Integrating TACTs in public sector distribution channels was considered relatively straightforward. More challenges were expected for integrating TACTs in private sector distribution channels, which are characterized by patient demand and profit motives. Finally, several affordability and acceptability issues were raised for which ACTs were suggested as a benchmark.<h4>Conclusion</h4>The market prospects of TACTs in Nigeria and Burkina Faso will depend on the demonstration of the added value of TACTs over ACTs, their advocacy by the WHO, the inclusion of TACTs in financial and regulatory arrangements, and their alignment with current distribution and deployment practices. Further clinical, health-economic and feasibility studies are required to inform decision makers about the broader implications of a transition to TACTs in African counties. The recent reporting of artemisinin resistance and ACT failure in Africa might change important determinants of the market readiness for TACTs.
format	article
author	Freek de Haan Oladimeji Akeem Bolarinwa Rosemonde Guissou Fatoumata Tou Paulina Tindana Wouter P C Boon Ellen H M Moors Phaik Yeong Cheah Mehul Dhorda Arjen M Dondorp Jean Bosco Ouedraogo Olugbenga A Mokuolu Chanaki Amaratunga
author_facet	Freek de Haan Oladimeji Akeem Bolarinwa Rosemonde Guissou Fatoumata Tou Paulina Tindana Wouter P C Boon Ellen H M Moors Phaik Yeong Cheah Mehul Dhorda Arjen M Dondorp Jean Bosco Ouedraogo Olugbenga A Mokuolu Chanaki Amaratunga
author_sort	Freek de Haan
title	To what extent are the antimalarial markets in African countries ready for a transition to triple artemisinin-based combination therapies?
title_short	To what extent are the antimalarial markets in African countries ready for a transition to triple artemisinin-based combination therapies?
title_full	To what extent are the antimalarial markets in African countries ready for a transition to triple artemisinin-based combination therapies?
title_fullStr	To what extent are the antimalarial markets in African countries ready for a transition to triple artemisinin-based combination therapies?
title_full_unstemmed	To what extent are the antimalarial markets in African countries ready for a transition to triple artemisinin-based combination therapies?
title_sort	to what extent are the antimalarial markets in african countries ready for a transition to triple artemisinin-based combination therapies?
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/0b7960eec00543d4ad1eae88bff71480
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To what extent are the antimalarial markets in African countries ready for a transition to triple artemisinin-based combination therapies?

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