title: Malaria drug shortages in Kenya: a major failure to provide access to effective treatment.
abstract: A key bench mark of successful therapeutic policy implementation, and thus effectiveness, is that the recommended drugs are available at the point of care. Two years after artemether-lumefathrine (AL) was introduced for the management of uncomplicated malaria in Kenya, we carried out a cross-sectional survey to investigate AL availability in government facilities in seven malaria-endemic districts. One of four of the surveyed facilities had none of the four AL weight-specific treatment packs in stock; three of four facilities were out of stock of at least one weight-specific AL pack, leading health workers to prescribe a range of inappropriate alternatives. The shortage was in large part caused by a delayed procurement process. National ministries of health and the international community must address the current shortcomings facing antimalarial drug supply to the public sector.
authors.affiliation: Malaria Public Health and Epidemiology Group, Kenya Medical Research Institute/Wellcome Trust Programme Nairobi, Kenya. bkangwana@nairobi.kemri-wellcome.org
authors.forename: Beth B
authors.initials: BB
authors.lastname: Kangwana
authors.forename: Julius
authors.initials: J
authors.lastname: Njogu
authors.forename: Beatrice
authors.initials: B
authors.lastname: Wasunna
authors.forename: Sarah V
authors.initials: SV
authors.lastname: Kedenge
authors.forename: Dorothy N
authors.initials: DN
authors.lastname: Memusi
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Goodman
authors.forename: Dejan
authors.initials: D
authors.lastname: Zurovac
authors.forename: Robert W
authors.initials: RW
authors.lastname: Snow
mesh_terms: D000962:Antimalarials / Q000600:supply & distribution*; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins / Q000600:supply & distribution*; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D004349:Drug Packaging; D004983:Ethanolamines / Q000600:supply & distribution*; D005449:Fluorenes / Q000600:supply & distribution*; D033161:Government Regulation; D006268:Health Facilities / Q000592:standards*; D006297:Health Services Accessibility; D006801:Humans; D007391:International Cooperation; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control*; D011635:Public Health Administration / Q000592:standards*
chemical_list: D000962:Antimalarials; D000077611:Artemether, Lumefantrine Drug Combination; D037621:Artemisinins; D004338:Drug Combinations; D004983:Ethanolamines; D005449:Fluorenes