Anti-Malarial Drug Development and Diffusion in an Era of Multidrug Resistance: How Can an Integrated Health Framework Contribute to Sustainable Development Goal 3?

The ability to ensure healthy lives and well-being (SDG3, healthy lives) is dependent on accessible and affordable healthcare for everyone in need. However, people in low and middle-income countries (LMICs) often lack access to health interventions such as innovative medicines to treat medical needs. This chapter develops a sustainable drug development and diffusion framework for LMICs. The framework is applied to evaluate a global health threat that challenges the achievement of SDG3 targets: the emergence of multidrug resistance to anti-malarial medicines. Malaria is a poverty-related infectious disease that is caused by parasites and transmitted through mosquitos. Malaria is well treatable and effective drugs do exist, but they often fail to reach the infected patients. These days, the first-line anti-malarial medicines are becoming less effective because of multidrug resistance. This requires urgent and coordinated action at the levels of drug development, diffusion, and utilization. The integrated framework evaluates this emerging health threat by discussing four themes: availability, affordability, accessibility, and acceptability. Moreover, the interdependence between those themes is assessed. Finally, policy implications are proposed to address this global health challenge and to proceed toward a sustainable system of drug development and diffusion in LMICs.