From chloroquine to artemether-lumefantrine: the process of drug policy change in Zambia
| Autor: | Jonathon L Simon, Davidson H. Hamer, Naawa Sipilanyambe, Pascalina Chanda, P.E. Olumese, Robert W. Snow |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Program evaluation
Economic growth lcsh:Arctic medicine. Tropical medicine Artemether/lumefantrine Health Planning Guidelines lcsh:RC955-962 030231 tropical medicine Zambia Developing country Legislation Lumefantrine lcsh:Infectious and parasitic diseases Antimalarials 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Procurement Tropical medicine medicine Humans lcsh:RC109-216 030212 general & internal medicine Health policy Fluorenes Government Case Study business.industry Health Policy Chloroquine Artemisinins Malaria 3. Good health Infectious Diseases chemistry Ethanolamines Drug Therapy Combination Parasitology business medicine.drug |
| Zdroj: | Malaria Journal, Vol 7, Iss 1, p 25 (2008) Malaria Journal |
| ISSN: | 1475-2875 |
| DOI: | 10.1186/1475-2875-7-25 |
| Popis: | Background Following the recognition that morbidity and mortality due to malaria had dramatically increased in the last three decades, in 2002 the government of Zambia reviewed its efforts to prevent and treat malaria. Convincing evidence of the failing efficacy of chloroquine resulted in the initiation of a process that eventually led to the development and implementation of a new national drug policy based on artemisinin-based combination therapy (ACT). Methods All published and unpublished documented evidence dealing with the antimalarial drug policy change was reviewed. These data were supplemented by the authors' observations of the policy change process. The information has been structured to capture the timing of events, the challenges encountered, and the resolutions reached in order to achieve implementation of the new treatment policy. Results A decision was made to change national drug policy to artemether-lumefantrine (AL) in the first quarter of 2002, with a formal announcement made in October 2002. During this period, efforts were undertaken to identify funding for the procurement of AL and to develop new malaria treatment guidelines, training materials, and plans for implementation of the policy. In order to avoid a delay in implementation, the policy change decision required a formal adoption within existing legislation. Starting with donated drug, a phased deployment of AL began in January 2003 with initial use in seven districts followed by scaling up to 28 districts in the second half of 2003 and then to all 72 districts countrywide in early 2004. Conclusion Drug policy changes are not without difficulties and demand a sustained international financing strategy for them to succeed. The Zambian experience demonstrates the need for a harmonized national consensus among many stakeholders and a political commitment to ensure that new policies are translated into practice quickly. To guarantee effective policies requires more effort and recognition that this becomes a health system and not a drug issue. This case study attempts to document the successful experience of change to ACT in Zambia and provides a realistic overview of some of the painful experiences and important lessons learnt. |
| Databáze: | OpenAIRE |
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