Improving Malaria Case Management in the Private Sector: Artemisinin Monotherapy Replacement Project

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Abstract

In 2012, oral artemisinin monotherapy was available in 70% of private sector outlets.

Continued use of oral artemisinin-based monotherapy (AMT) is widely considered to be one of the main contributing factors to the development and spread of resistance to artemisinin and its derivatives. In 2012, alarmingly high rates of oral AMT availability and use were detected in the private sector where the majority of people seek care across Myanmar.

In response to this situation, the international Non-Profit Organization (NGO) of Population Services International (PSI) implemented the Artemisinin Monotherapy Replacement Malaria (AMTR) project. The projects aims to rapidly displace oral AMT with subsidized, quality assured Artemisinin-based Combination Therapy (ACT) in the private sector.

This quality assured ACT is distributed through AA Pharmacy and Polygold – key suppliers in the country who previously distributed most of the oral AMT found in Eastern Myanmar. Distribution of oral AMT was replaced with the sale of quality assured ACT branded as SupaArte ®. An additional brand, Artel Plus ®, was introduced in 2013 to facilitate market competition. Both SupaArte ® and Artel Plus ® are branded with a quality seal.

Complementing the private sector distribution of subsidized ACT are a variety of demand creation activities targeting antimalarial providers and patients. Underserved outlets (pharmacies, general retailers and itinerant drug vendors) are also targeted by product promoters in project intervention areas. These types of outlets are referred to as ‘priority outlets’. Private facilities and community health workers (‘non-priority’ outlets) who have access to the public sector or other INGO/NGO did not receive this product promoter outreach intervention.