Exploring the feasibility of introducing triple artemisinin-based combination therapy in the malaria treatment policy in Vietnam

Van Anh Thi Cao; Thieu Quang Nguyen; Duong Le Quyen; Wouter P C Boon; Ellen H M Moors; Arjen M Dondorp; Freek de Haan; Chanaki Amaratunga

doi:10.1186/s12936-023-04763-4

Exploring the feasibility of introducing triple artemisinin-based combination therapy in the malaria treatment policy in Vietnam

Van Anh Thi Cao^*, Thieu Quang Nguyen, Duong Le Quyen, Wouter P C Boon, Ellen H M Moors, Arjen M Dondorp, Freek de Haan, Chanaki Amaratunga

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: This study investigates the processes regarding changing malaria treatment policies in Vietnam. Moreover, it explores the feasibility of introducing triple artemisinin-based combination therapy (TACT) in Vietnam to support the national malaria control and elimination plan.

METHODS: Data were collected via 12 in-depth interviews with key stakeholders, combined with a review of policy documents.

RESULTS: TACT is considered as a useful backup strategy in case future treatment failures with current artemisinin-based combination therapy (ACT) would occur. Moreover, TACT is also considered as a promising strategy to prevent the re-establishment of malaria. However, regulatory procedures and implementation timelines for TACT were expected to be lengthy. Therefore, strategies to engage national decision-makers, regulators, and suppliers should be initiated soon, stipulating the benefits of TACT deployment. In Vietnam, a procedure to apply for an import permit without registration that has previously been applied to the introduction of artesunate-pyronaridine was proposed to accelerate the introduction of TACT. Global-level support through the World Health Organization recommendations and prequalification were considered critical for supporting the introduction of TACT in Vietnam.

CONCLUSIONS: Appropriate approach strategies and early stakeholder engagement will be needed to accelerate the introduction of TACT in Vietnam.

Original language	English
Article number	326
Pages (from-to)	1-8
Number of pages	8
Journal	Malaria Journal
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12936-023-04763-4
Publication status	Published - Dec 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s).

Funding

We would like to express our sincere gratitude to UK Aid from the UK government’s Foreign, Commonwealth and Development Office for their financial support. We also wish to thank the leaders of the National Institute of Malariology, Parasitology and Entomology (NIMPE) to support to connect with malaria experts in Vietnam to engage in interviews. Finally, we are grateful to all of the interview participants who generously gave their time and effort to this project. The Ministry of Health (MoH) is responsible for the national malaria control and elimination program, including formulation of policies and strategies. The National Institute of Malariology, Parasitology and Entomology (NIMPE) in Hanoi is responsible for development, coordination and technical oversight of the national program in collaboration with two regional Institutes of Malariology, Parasitology and Entomology (IMPEs) in Quy Nhon and Ho Chi Minh. The provincial, district, and commune levels are responsible for implementation of activities following the guidance of the national program. Malaria case detection and treatment are provided free of charge at the commune level and in public healthcare facilities. Malaria cases detected by private health care providers are referred to the public sector for treatment. Malaria control activities are supported financially by the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM). Technical support is provided by the WHO. The Drug Administration of Vietnam (DAV) under the management of MoH is responsible for drug regulation in Vietnam. We would like to express our sincere gratitude to UK Aid from the UK government’s Foreign, Commonwealth and Development Office for their financial support. We also wish to thank the leaders of the National Institute of Malariology, Parasitology and Entomology (NIMPE) to support to connect with malaria experts in Vietnam to engage in interviews. Finally, we are grateful to all of the interview participants who generously gave their time and effort to this project.

Funders	Funder number
NIMPE
National Institute of Malariology, Parasitology and Entomology
Tuberculosis and Malaria
Global Fund to Fight AIDS, Tuberculosis and Malaria
Wellcome Trust	220211

Keywords

Humans
Antimalarials/therapeutic use
Malaria, Falciparum/drug therapy
Vietnam
Feasibility Studies
Plasmodium falciparum
Artemisinins/therapeutic use
Malaria/drug therapy
Drug Therapy, Combination
Policy
Triple artemisinin-based combination therapy (TACT)
Introduction strategies
Drug resistance

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s12936-023-04763-4Licence: CC BY

s12936-023-04763-4Final published version, 828 KBLicence: CC BY

Cite this

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title = "Exploring the feasibility of introducing triple artemisinin-based combination therapy in the malaria treatment policy in Vietnam",

abstract = "BACKGROUND: This study investigates the processes regarding changing malaria treatment policies in Vietnam. Moreover, it explores the feasibility of introducing triple artemisinin-based combination therapy (TACT) in Vietnam to support the national malaria control and elimination plan.METHODS: Data were collected via 12 in-depth interviews with key stakeholders, combined with a review of policy documents.RESULTS: TACT is considered as a useful backup strategy in case future treatment failures with current artemisinin-based combination therapy (ACT) would occur. Moreover, TACT is also considered as a promising strategy to prevent the re-establishment of malaria. However, regulatory procedures and implementation timelines for TACT were expected to be lengthy. Therefore, strategies to engage national decision-makers, regulators, and suppliers should be initiated soon, stipulating the benefits of TACT deployment. In Vietnam, a procedure to apply for an import permit without registration that has previously been applied to the introduction of artesunate-pyronaridine was proposed to accelerate the introduction of TACT. Global-level support through the World Health Organization recommendations and prequalification were considered critical for supporting the introduction of TACT in Vietnam.CONCLUSIONS: Appropriate approach strategies and early stakeholder engagement will be needed to accelerate the introduction of TACT in Vietnam.",

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AU - Boon, Wouter P C

AU - Moors, Ellen H M

AU - Dondorp, Arjen M

AU - de Haan, Freek

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AB - BACKGROUND: This study investigates the processes regarding changing malaria treatment policies in Vietnam. Moreover, it explores the feasibility of introducing triple artemisinin-based combination therapy (TACT) in Vietnam to support the national malaria control and elimination plan.METHODS: Data were collected via 12 in-depth interviews with key stakeholders, combined with a review of policy documents.RESULTS: TACT is considered as a useful backup strategy in case future treatment failures with current artemisinin-based combination therapy (ACT) would occur. Moreover, TACT is also considered as a promising strategy to prevent the re-establishment of malaria. However, regulatory procedures and implementation timelines for TACT were expected to be lengthy. Therefore, strategies to engage national decision-makers, regulators, and suppliers should be initiated soon, stipulating the benefits of TACT deployment. In Vietnam, a procedure to apply for an import permit without registration that has previously been applied to the introduction of artesunate-pyronaridine was proposed to accelerate the introduction of TACT. Global-level support through the World Health Organization recommendations and prequalification were considered critical for supporting the introduction of TACT in Vietnam.CONCLUSIONS: Appropriate approach strategies and early stakeholder engagement will be needed to accelerate the introduction of TACT in Vietnam.

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Exploring the feasibility of introducing triple artemisinin-based combination therapy in the malaria treatment policy in Vietnam

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

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