Rwanda to introduce new drugs to combat malaria resistance

The government is set to deploy new drugs in a bid to fight malaria resistance to the existing medication, according to an official at Rwanda Biomedical Centre (RBC). The two anti-malaria drugs are dihydroartemisinin-piperaquine (DHAP), and artesunate-pyronaridine (ASPY). They are among the drugs recommended by the World Health Organization (WHO) for the treatment of uncomplicated malaria among children and adults – under what it calls artemisinin-based combination therapies (ACTs). ALSO READ: Minister urges redoubled prevention efforts as Malaria cases surge Dr. Aimable Mbituyumuremyi, Malaria and Other Parasitic Diseases Division Manager at RBC, told The New Times that the new anti-malaria drugs serve as alternatives to the commonly used Coartem in the treatment of the mosquito-borne disease that – in some instances – has put up resistance both in Rwanda and other countries. He said that the first batch of the drugs was imported into the country in last week, and will be used at hospitals based on doctors’ prescription to patients in need. “We expect to send the drugs [to hospitals] in the week that starts tomorrow [on Monday, January 6], so that doctors can use them to treat patients who took initial medicines but they did not recover,” he said, adding that all hospitals will be having them such that patients in needs will get them. The resistance is attributed to various factors, he said, citing the use of given drugs for a long time without replacement, non-compliance with the right recommended doses, and getting infected with an already resistant malaria parasite. ALSO READ: Malaria drug resistance: Rwanda updates treatment guidelines The use of the drugs as a new strategy countrywide is expected to start in April – and will feature the two new drugs, plus the common anti-malaria drug Coartem, he pointed out. For the effective integration of the new two drugs in malaria treatment, Mbituyumuremyi said that the guidelines for medicine use that had been in existence were already updated. Also, he said that healthcare workers for all hospitals were trained on the new treatment approach, adding that the next phase is to train medical personnel for health centres and community health workers. Once the strategy is rolled out, he said, the drugs will be prescribed by healthcare workers at hospitals, health facilities, as well as community health workers. By the time other batches of the drugs are available to have enough quantity, he said, community health workers, and nurses at health centres will have already been trained. ALSO READ: Drug resistance threatens core of healthcare Malaria situation in Rwanda According to data from the Ministry of Health, there was a 90 per cent reduction in malaria cases between the fiscal year 2016/2017 and 2023/2024 (from 4.8 million to 620,000 cases), and a drop in malaria-related deaths from around 650 to 67 was recorded in the same period. ALSO READ: Rwanda on track to achieve zero malaria in 2030 However, as per the data, a progressive increase in malaria cases was noted from January to October 2024 compared to January to October 2023 as they rose by 45.8 per cent to 630,000 during the 10 month-period of 2024 from 432,000 cases recorded during the same period of 2023. Potential causes of malaria surge include emerging anti-malaria drug resistance documented in Rwanda (same in other countries), lack of integrated (combined) malaria vector control interventions (budget constraint), and shift in mosquito-biting behaviour (from indoor to more outdoor biting) exposing people who stay some hours outside the night, the Ministry of Health indicated. Others causes, it added, are increasing mosquito breeding sites not properly managed (rice fields, dams, mining sites, among others), and possibility of cross-border malaria issues (some cases are imported since almost all the most affected sectors are in the cross-border areas of Nyagatare, Gisagara, and Bugesera). Apart from the deployment of new drugs to deal malaria resistance, the Ministry of Health indicated that ongoing response includes interventions such as indoor residual spraying in Nyagatare, Kirehe, and Ngoma, Nyanza, Gisagara, Kamonyi, Bugesera, Rwamagana, and Kayonza. Others, it added are investigations of all malaria hot spot sectors to identify possible root causes, establishing a Malaria Task Force to work with all sectors involved in malaria response at district level, community and local leadership mobilisation, and increase access to diagnosis and treatment at community level.

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Rwanda to introduce new drugs to combat malaria resistance