AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 80(5), 2009, pp. 737-738
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Malaria Drug Shortages in Kenya: A Major Failure to Provide Access to Effective Treatment

Beth B. Kangwana*, Julius Njogu, Beatrice Wasunna, Sarah V. Kedenge, Dorothy N. Memusi, Catherine A. Goodman, Dejan Zurovac, AND Robert W. Snow
Malaria Public Health and Epidemiology Group, Kenya Medical Research Institute/Wellcome Trust Programme Nairobi, Kenya; Kenya Red Cross, Malindi, Kenya; Eastern and Southern Africa Centre of International Parasite Control/Kenya Medical Research Institute, Nairobi, Kenya; Division of Malaria Control, Ministry of Health, Nairobi, Kenya; Health Policy Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom; Department of International Health, School of Public Health and Center for International Health and Development, Boston University School of Public Health, Boston, Massachusetts; Centre for Tropical Medicine, University of Oxford, John Radcliffe Hospital, Headington, United Kingdom

 

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.

Received December 3, 2008. Accepted for publication February 16, 2009.

Acknowledgments: We thank the field teams and all health workers for participating in the study. This paper is published with the permission of the director of the Kenya Medical Research Institute.

Financial support: This study was supported by the Wellcome Trust, UK and the Kenya Medical Research Institute. Robert W. Snow is a Principal Wellcome Trust Fellow (#079081). Catherine A. Goodman is a member of the Consortium for Research on Equitable Health Systems, which is supported by the UK Department for International Development.

* Address correspondence to Beth B. Kangwana, Malaria Public Health and Epidemiology Group, Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute/Wellcome Trust Programme, PO Box 43640, GPO 00100, Nairobi, Kenya. E-mail: bkangwana{at}nairobi.kemri-wellcome.org

Authors’ addresses: Beth B. Kangwana, Beatrice Wasunna, Sarah V. Kedenge, Catherine A. Goodman, Dejan Zurovac and Robert W. Snow, Malaria Public Health and Epidemiology Group, Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute/Wellcome Trust Programme, PO Box 43640, GPO 00100, Nairobi, Kenya, E-mails: bkangwana{at}nairobi.kemri-wellcome.org, bwasunna{at}nairobi.kemri-wellcome.org, skedenge{at}nairobi.kemri-wellcome.org, cgoodman{at}nairobi.kemri-wellcome.org, dzurovac{at}nairobi.kemri-wellcome.org, and rsnow{at}nairobi.kemri-wellcome.org. Julius Njogu, Kenya Red Cross, PO Box 1369, Malindi, Kenya, E-mail: ngigi.julius{at}kenyaredcross.org. Dorothy N. Memusi, Division of Malaria Control, Ministry of Health, 00100 GPO, PO Box 20750, Nairobi, Kenya, E-mail: dnaisiae{at}domckenya.or.ke.




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