Since 2001, the World Health Organization (WHO) recommends the use of Artemisinin-based Combination Therapy (ACT) for the treatment of uncomplicated P. falciparum malaria. Since 2010, WHO recommends that microscopy or a Rapid Diagnostic Test (RDT) before treatment confirm every suspected malaria case, as continued presumptive treatment of malaria leads to drug wastage, as well as under-treatment of other febrile illnesses.
Despite these recommendations, many people living in malaria endemic countries still do not have access to diagnosis and appropriate treatment. In addition, threats of resistance to ACT—the best treatment currently available–are being reported in South-East Asia, jeopardizing its efficacy.
Understanding the way ACT and diagnostic tests move through markets and reach consumers is key to developing health markets, as well as improving sustained access to proper fever case management.
Since 2008, ACTwatch aims to provide a comprehensive picture of markets for antimalarial drugs and diagnostic tests to inform national and international fever case management policy decision-making.
To do that, ACTwatch studies:
- Market share, price and availability of different antimalarial drugs and diagnostic tests in public facilities and private retail outlets.
- Provider knowledge and attitudes concerning appropriate case management of fever.
- Case management practices in the public and private sector.
ACTwatch measures which antimalarial drugs are available, where they are available, at what price and who uses them. ACTwatch also collects data on malaria RDTs. Indicators are measured over time and across countries through three study components:
- Outlet Surveys: Monitor trends in the availability, volumes and prices of antimalarial drugs in the public and private sectors, which includes the informal sector. These surveys also collect data on the availability and use of malaria RDTs.
- Household Surveys: Examine trends in the levels of household use of different antimalarial drugs, and identify the determinants of use (health seeking behavior) of antimalarial drugs.
- Supply Chain Research: Identifies the determinants of the price and availability of antimalarial drugs at different levels of the supply chain, including markups at each level.
In addition, ACTwatch gathers information by interviewing key stakeholders and clients:
- Key Informant Interviews: Conducted with stakeholders at all levels in the public and private sectors to provide complementary qualitative information on markets, supply chain, country context and policy environment.
- Exit interviews (as of 2013): Assess fever case management practices and client satisfaction in the public and private sectors through interviews with clients/customers as they exit facilities and other outlets.
An important part of our work is to ensure that policy makers and other stakeholders at national and international levels have access to ACTwatch findings through dissemination of the results. We share our results through our website: www.actwatch.info, as well as through in-country survey report presentations, posters and presentations at key meetings. All our study designs, questionnaires and reports are available on our website or on demand.
- The ACTwatch Project: Methods to Describe Anti-Malarial Markets in Seven Countries
This project was designed to provide a comprehensive picture of the anti-malarial market to inform national and international anti-malarial drug policy decision-making.
- Got ACTs? Availability, Price, Market Share and Provider Knowledge of Anti-Malarial Medicines in Public and Private Sector Outlets in Six Malaria-Endemic Countries
This paper presents supply side data from ACTwatch outlet surveys in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia.
- Case Management of Malaria Fever in Cambodia: Results from National Anti-Malarial Outlet and Household Surveys
The first case of artemisinin resistance in Plasmodium falciparum was documented in western Cambodia. Spread of artemisinin resistance would threaten recent gains in global malaria control. As such, the anti-malarial market and malaria case management practices in Cambodia have significance for continued progress.