Market Formation in a Global Health Transition

Haan, Freek de; Moors, Ellen H.M.; Dondorp, Arjen M.; Boon, Wouter

doi:10.1016/j.eist.2021.05.003

Cited by 14 publications

(20 citation statements)

References 88 publications

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“…Malaria is a poverty-related disease and high consumer prices would likely compromise acceptance [ 1 ], especially in private sectors [ 43 , 44 ]. This emphasizes the importance of donor funder support [ 45 , 46 ] and alignment with institutional frameworks to improve market prospects [ 5 ]. The majority of the expert panel expressed concern that an increased pill burden would negatively affect TACTs’ acceptance.…”

Section: Discussionmentioning

confidence: 99%

“…The expert panel envisioned challenges in obtaining support at the global policy levels, including WHO and donor funders support. The role of the WHO has been widely acknowledged in other global health transitions [ 5 , 57 , 61 ] and is likely to be essential to the market prospects of TACTs. Experts also considered relevant obtaining national-level policy support to facilitate smooth implementation.…”

Section: Discussionmentioning

confidence: 99%

“…The Delphi study was designed in adherence to the Conducting and REporting DElphi Studies (CREDES) guidelines [ 24 ]. Compared to other Delphi studies, a relative large expert panel was recruited for this Delphi exercise [ 19 , 63 ] in order to reflect the heterogenous nature of antimalarial drug transitions [ 5 ]. Given the spread in the affiliations, areas of expertise and geographical coverage of participating experts (Table 1 ) and the robustness of second-round findings (Figs.…”

Section: Discussionmentioning

confidence: 99%

“…Antimalarial drug transitions are complex and multifaceted, involving a wide range of global, national and local-level stakeholders [ 5 ]. This multifaceted nature was reflected by purposively selecting experts with different affiliations (e.g.…”

Section: Methodsmentioning

confidence: 99%

“…These drug transitions have been slow and challenging, even when new therapies were clinically superior to failing alternatives [ 1 – 4 ]. Challenges have been associated with the complex nature of the global health arena and the collective efforts that are required at the global, national, and local-levels [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Expert perspectives on the introduction of Triple Artemisinin-based Combination Therapies (TACTs) in Southeast Asia: a Delphi study

et al. 2022

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Background Triple Artemisinin-based Combination Therapies (TACTs) are being developed as a response to artemisinin and partner drug resistance in Southeast Asia. However, the desirability, timing and practical feasibility of introducing TACTs in Southeast Asia is subject to debate. This study systematically assesses perspectives of malaria experts towards the introduction of TACTs as first-line treatment for uncomplicated falciparum malaria in Southeast Asia. Methods A two-round Delphi study was conducted. In the first round, 53 malaria experts answered open-ended questions on what they consider the most important advantages, disadvantages, and implementation barriers for introducing TACTs in Southeast Asia. In the second round, the expert panel rated the relevance of each statement on a 5-point Likert scale. Results Malaria experts identified 15 advantages, 15 disadvantages and 13 implementation barriers for introducing TACTs in Southeast Asia in the first round of data collection. In the second round, consensus was reached on 13 advantages (8 perceived as relevant, 5 as not-relevant), 12 disadvantages (10 relevant, 2 not-relevant), and 13 implementation barriers (all relevant). Advantages attributed highest relevance related to the clinical and epidemiological rationale of introducing TACTs. Disadvantages attributed highest relevance related to increased side-effects, unavailability of fixed-dose TACTs, and potential cost increases. Implementation barriers attributed highest relevance related to obtaining timely regulatory approval, timely availability of fixed-dose TACTs, and generating global policy support for introducing TACTs. Conclusions The study provides a structured oversight of malaria experts’ perceptions on the major advantages, disadvantages and implementation challenges for introducing TACTs in Southeast Asia, over current practices of rotating ACTs when treatment failure is observed. The findings can benefit strategic decision making in the battle against drug-resistant malaria.

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