Exploring the feasibility of introducing triple artemisinin-based combination therapy in the malaria treatment policy in Vietnam

• Published in: Malaria journal Vol. 22; no. 1; pp. 1 - 326
• Main Authors: Cao, Van Anh Thi, Nguyen, Thieu Quang, Le Quyen, Duong, Boon, Wouter P. C, Moors, Ellen H. M, Dondorp, Arjen M, de Haan, Freek, Amaratunga, Chanaki
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 28-10-2023; BioMed Central; BMC
• Subjects: Artemisinin; Artesunate; Clinical trials; Combination therapy; Data collection; Drug resistance; Drug resistance in microorganisms; Drug therapy; Drug therapy, Combination; Entomology; Failure; Human diseases; Interviews; Introduction strategies; Malaria; Market positioning; Parasites; Parasitology; Patient outcomes; Pharmaceutical industry; Prevention; Provinces; Pyronaridine; Risk factors; Tafenoquine; Triple artemisinin-based combination therapy (TACT); Vector-borne diseases; Web portals; Vietnam
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/s12936-023-04763-4

Abstract
Background
This study investigates the processes regarding changing malaria treatment policies in Vietnam. Moreover, it explores the feasibility of introducing triple artemisinin-based combination therapy (TACT) in Vietnam to support the national malaria control and elimination plan.
Methods
Data were collected via 12 in-depth interviews with key stakeholders, combined with a review of policy documents.
Results
TACT is considered as a useful backup strategy in case future treatment failures with current artemisinin-based combination therapy (ACT) would occur. Moreover, TACT is also considered as a promising strategy to prevent the re-establishment of malaria. However, regulatory procedures and implementation timelines for TACT were expected to be lengthy. Therefore, strategies to engage national decision-makers, regulators, and suppliers should be initiated soon, stipulating the benefits of TACT deployment. In Vietnam, a procedure to apply for an import permit without registration that has previously been applied to the introduction of artesunate-pyronaridine was proposed to accelerate the introduction of TACT. Global-level support through the World Health Organization recommendations and prequalification were considered critical for supporting the introduction of TACT in Vietnam.
Conclusions
Appropriate approach strategies and early stakeholder engagement will be needed to accelerate the introduction of TACT in Vietnam.