ACT Availability, Price and Market Share in Kinshasa & Katanga, DRC, 2013-2015

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Background: Malaria is a leading cause of illness and death in the Democratic Republic of Congo (DRC), where malaria burden is second highest in the world. National treatment guidelines indicate use of artemisinin combination therapy (ACT) for first-line treatment.

Methods: Malaria outlet surveys were conducted in Kinshasa and Katanga provinces in 2013 and 2015. A census of public and private outlets with potential to distribute malaria testing and/or treatment was conducted among a representative sample of administrative units. In total, 1,357 outlets in Kinshasa and 1,052 outlets in Katanga were screened for availability of malaria testing and treatment. An audit was completed for all antimalarials, malaria rapid diagnostic tests and microscopy. The audit captured product information, retail price and amount distributed to consumers during the last week. World Health Organization pre-qualification and Global Fund procurement lists were used to classify ACTs as quality-assured (QA) and non-QA.

Results:  Availability of quality-assured ACTs (QA ACT) improved in both the public and private sectors of Kinshasa and Katanga. In 2015, nearly 90% of public sector outlets in Katanga, but only 64% in Kinshasa had QA ACT available. In 2015, private sector availability was lower relative to public sector availability in Katanga (52%) and Kinshasa (22%). Non-QA ACTs were widely available in the private sector and availability was higher than 80% in 2013 and 2015 in Kinshasa. In Katanga, private sector non-QA ACT availability increased from 43% to 53%.