Antimalarial drug policy in India: past, present & future.
The use of antimalarial drugs in India has evolved since the introduction of quinine in the 17 th century. Since the formal establishment of a malaria control programme in 1953, shortly after independence, treatments provided by the public sector ranged from chloroquine, the mainstay drug for many decades, to the newer, recently introduced artemisinin based combination therapy. The complexity of considerations in antimalarial treatment led to the formulation of a National Antimalarial Drug Policy to guide procurement as well as communicate best practices to both public and private healthcare providers. Challenges addressed in the policy include the use of presumptive treatment, the introduction of alternate treatments for drug-resistant malaria, the duration of primaquine therapy to prevent relapses of vivax malaria, the treatment of malaria in pregnancy, and the choice of drugs for chemoprophylaxis. While data on antimalarial drug resistance and both public and private sector treatment practices have been recently reviewed, the policy process of setting national standards has not. In this perspective on antimalarial drug policy, this review highlights its relevant history, analyzes the current policy, and examines future directions.
National Institute of Malaria Research (ICMR), New Delhi, India.
Anupkumar R
AR
Anvikar
Usha
U
Arora
G S
GS
Sonal
Neelima
N
Mishra
Bharatendu
B
Shahi
Deepali
D
Savargaonkar
Navin
N
Kumar
Naman K
NK
Shah
Neena
N
Valecha
D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000009:adverse effects / Q000627:therapeutic use; D002738:Chloroquine / Q000627:therapeutic use; D004351:Drug Resistance / Q000235:genetics*; D006801:Humans; D007194:India; D008288:Malaria / Q000188:drug therapy* / Q000235:genetics / Q000469:parasitology; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics / Q000469:parasitology
D000962:Antimalarials; D037621:Artemisinins; D002738:Chloroquine; C031327:artemisinin