The eEML is a comprehensive, freely accessible online database containing information on essential medicine
This document provides an overview of malaria rapid diagnostic tests (RDTs) for Principal Recipients (PRs) of Global Fund grants, indicating their eligibility for procurement under the Global Fund's Quality Assurance Policy. The included products have been assessed and approved by the WHO Prequalifi...cation of Diagnostics Programme (WHO PQ), the relevant regulatory authorities of the GHTF founding members or the Global Fund Expert Review Panel for Diagnostics (ERPD). Updates are made based on new evidence and regulatory assessments.
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Antimalarial chemotherapy is crucial for reducing morbidity, mortality, and drug resistance, and is the cornerstone of malaria control. Existing antimalarial drugs act at different stages of the parasite’s life cycle. These drugs range from classic agents such as chloroquine and quinine to newer a...rtemisinin derivatives. They include tissue schizonticides, blood schizonticides, gametocytocides, and sporontocides. Artemisinin and its derivatives are the most effective and fastest-acting treatment against drug-resistant Plasmodium falciparum, achieving rapid parasite clearance and reducing transmission potential. Other key drugs include mefloquine, halofantrine, proguanil, sulfadoxine–pyrimethamine, atovaquone–proguanil, tetracyclines, clindamycin and azithromycin. Each of these drugs has a specific mechanism of action, pharmacokinetics, efficacy, safety profile and contraindications. Rational drug combinations and adherence to national treatment guidelines are essential for managing resistance, ensuring safety in vulnerable populations such as children and pregnant women, and optimising therapeutic outcomes in cases of both uncomplicated and severe malaria.
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Combination therapy is a cornerstone of modern malaria treatment, particularly in the context of widespread multidrug resistance. Using two or more antimalarial drugs with different mechanisms simultaneously enhances efficacy, shortens treatment duration, improves compliance and delays the developme...nt of resistance. Artemisinin-based combination therapies (ACTs), such as artemether–lumefantrine, artesunate–amodiaquine and artesunate–sulfadoxine/pyrimethamine, are highly effective in rapidly clearing parasites and reducing gametocyte carriage. They are also generally well tolerated. Non-artemisinin combinations, quinine-based regimens and novel combinations (e.g. piperaquine–dihydroartemisinin) offer alternative therapeutic options, although clinical experience with these remains limited. Although ACTs are the preferred first-line treatment, factors such as cost, local drug resistance patterns, safety during pregnancy and paediatric use must inform implementation and policy decisions.
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Antimicrobial resistance (AMR) and malaria remain significant public health challenges in the WHO Eastern Mediterranean Region (EMR). In 2021, the region reported 1.7 million sepsis-related deaths, with 373,000 associated with bacterial AMR. High antibiotic consumption, particularly in high-income c...ountries, combined with rising usage in middle-income countries, has accelerated the emergence of drug-resistant infections. Malaria management is further complicated by biological threats, including vector insecticide resistance, PFHRP2/3 gene deletions, and antimalarial drug resistance, alongside insufficient trained personnel and limited molecular surveillance capacity. Effective strategies to address these challenges include strengthening regional and cross-border surveillance networks, designating WHO collaborating centers for molecular monitoring, enforcing national treatment policies, and raising public and healthcare provider awareness about rational antimalarial and antibiotic use. These measures, coupled with sustainable funding and enhanced therapeutic efficacy studies, are essential to reduce the development and spread of drug-resistant malaria and improve overall health outcomes in the EMR.
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