WHO Releases New Malaria Treatment and Drug-Procurement Guidelines

The World Health Organization (WHO) released new guidelines this week for the treatment of malaria. The organization also published the first-ever guidelines for procuring safe and efficacious antimalarial drugs.

WHO’s revised version of its Guidelines for the Treatment of Malaria takes into account the recent development of artemisinin-based combination therapies (ACTs). The medicines could be ineffective if not used properly, according to a WHO press release. The new guidelines emphasize testing before treatment and add a fifth ACT-dihydroartemisinin plus piperaquine-to the list of recommended treatments. WHO also is recommending the removal of oral artemisinin-based monotherapy from the market to prevent growing drug resistance.

In addition, "WHO now recommends diagnostic testing in all cases of suspected malaria,” said Robert Newman, director of the WHO Global Malaria Program, in the press release. “Treatment based on clinical symptoms alone should be reserved for settings where diagnostic tests are not available.”

In 2008, only 22% of suspected malaria cases were tested in 18 of 35 African countries that reported the cases because most clinics had to rely on microscopy, according to the press release. Today, Rapid Diagnostic Tests (RDTs) “can reliably demonstrate the presence or absence of malaria parasites in the blood and can be performed at all levels of the health system, including community settings,” according to the press release. RDTs support WHO’s goal to improve malaria-endemic countries’ quality of diagnostic services.

The second part of the WHO announcement involves the first-ever release of guidelines on good procurement practices for artemisinin-based antimalarial medicines. Based on the latest, internationally agreed-upon standards, the new guidelines include a 16-step checklist to guide the selection and procurement of safe and effective medicines that meet global quality standards.

"Pharmaceutical markets in malaria-endemic countries are often unregulated and national authorities need practical help to assess the quality of malaria medicines before they buy them," said Andrea Bosman, coordinator of the Medicines and Diagnostics Unit at WHO's Global Malaria Program, in the press release. "Procurement channels are highly fragmented and so there are too many antimalarials of varying quality on the market."

According to WHO, malaria causes 860,000 deaths every year; 85% of these deaths are among children.