From Chloroquine to Artemether-Lumefantrine: The Process of Drug Policy Change in Zambia


Show simple item record Sipilanyambe, Naawa en_US Simon, Jonathon L en_US Chanda, Pascalina en_US Olumese, Peter en_US Snow, Robert W en_US Hamer, Davidson H en_US 2012-01-09T20:58:40Z 2012-01-09T20:58:40Z 2008 en_US 2008-1-29 en_US
dc.identifier.citation Sipilanyambe, Naawa, Jonathon L Simon, Pascalina Chanda, Peter Olumese, Robert W Snow, Davidson H Hamer. "From chloroquine to artemether-lumefantrine: the process of drug policy change in Zambia" Malaria Journal 7:25. (2008) en_US
dc.identifier.issn 1475-2875 en_US
dc.description.abstract 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 METHODS All published and unpublished documented evidence dealing with the antimalarial drug policy change was reviewed.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. en_US
dc.description.sponsorship Zambian-Boston University Malaria Project; Novartis Pharma AG; The Wellcome Trust UK; The Zambian Government en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights Copyright 2008 Sipilanyambe et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. en_US
dc.rights.uri en_US
dc.title From Chloroquine to Artemether-Lumefantrine: The Process of Drug Policy Change in Zambia en_US
dc.type article en_US
dc.identifier.doi 10.1186/1475-2875-7-25 en_US
dc.identifier.pubmedid 18230140 en_US
dc.identifier.pmcid 2248595 en_US

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