Marketing of oral artemisinin-based monotherapy medicines
WHO urges regulatory measures to stop marketing of oral artemisinin-based monotherapies and to promote access to artemisinin-based combination therapies (ACTs)
- Falciparum malaria has become increasingly resistant to all previous first-line drug therapies, but new combination medicines containing artemisinin derivatives show an over 95 percent cure rate after a standard short three-day regimen.
- It is critical that the parasite remains sensitive to artemisinin derivatives. In order for this situation to continue, artemisinin derivatives need to be used in combination with other effective antimalarial medicines for the treatment of uncomplicated falciparum malaria.
- Yet, the widespread practice of using oral artemisinin-based monotherapies, which are easier and cheaper to produce and buy, places an enormous risk of losing artemisinin (and its derivative) to parasite resistance.
- Artemisinins, if used as monotherapy, require to be taken as a full seven-day treatment course in order to completely eliminate the parasite. However, due to the rapid resolution of clinical signs and symptoms, most patients do not complete the required full seven-day treatment, leaving the parasite exposed to sub-therapeutic blood levels, which promote the development of resistance.
- Artemisinin-based combination therapies remain the only medicines for effective treatment of uncomplicated falciparum malaria for several years to come, because alternative treatments are unlikely to enter the market at least until 2015.
Phasing out oral artemisinin-based monotherapy medicines
Regulatory action needed to stop the sale of oral artemisinin-based monotherapy
Marketing of oral artemisinin-based monotherapies - Countries
Marketing of oral artemisinin-based monotherapies - Manufacturers
- World Health Assembly Resolution WHA 60.18 [pdf 18.5kb]
- 2006 WHO briefing on malaria treatment guidelines and artemisinin monotherapies [pdf 265kb]
- 2007 WHO informal consultation with manufacturers of artemisinin-based products [pdf 1.79Mb]