Drugs for Neglected Diseases initiative (DNDi), Geneva 1202, Switzerland.
Malar J. 2010 Apr 23;9 Suppl 1(Suppl 3):S1. doi: 10.1186/1475-2875-9-S1-S1.
At a recent meeting (Sept 18, 2009) in which reasons for the limited access to artemisinin-based combination therapy (ACT) in sub-Saharan Africa were discussed, policy and market surveys on anti-malarial drug availability and accessibility in Burundi and Sierra Leone were presented in a highly interactive brainstorming session among key stakeholders across private, public, and not-for-profit sectors. The surveys, the conduct of which directly involved the national malaria control programme managers of the two countries, provides the groundwork for evidence-based policy implementation. The results of the surveys could be extrapolated to other countries with similar socio-demographic and malaria profiles. The meeting resulted in recommendations on key actions to be taken at the global, national, and community level for better ACT accessibility. At the global level, both public and private sectors have actions to take to strengthen policies that lead to the replacement of loose blister packs with fixed-dose ACT products, develop strategies to ban inappropriate anti-malarials and regulate those bans, and facilitate technology and knowledge transfer to scale up production of fixed-dose ACT products, which should be readily available and affordable to those patients who are in the greatest need of these medicines. At the national level, policies that regulate the anti-malarial medicines market should be enacted and enforced. The public sector, including funding donors, should participate in ensuring that the private sector is engaged in the ACT implementation process. Research similar to the surveys discussed is important for other countries to develop and evaluate the right incentives at a local level. At the community level, community outreach and education about appropriate preventive and treatment measures must continue and be strengthened, with service delivery systems developed within both public and private sectors, among other measures, to decrease access to ineffective and inappropriate anti-malarial medicines. What was clear during the meeting is that continuing commitment, strengthened interaction and transparency among various stakeholders, with focus on communities, national governments, and evidence-based policy and action are the only way to sustainably address the control of malaria, a disease which continues to have a significant health and socio-economic impact worldwide, particularly in sub-Saharan Africa. Details on the methodology employed in carrying out the studies discussed at this meeting, as well as more detailed results, data analysis and discussion of the studies are soon to be published.
在最近的一次会议（2009 年 9 月 18 日）上，讨论了撒哈拉以南非洲青蒿素为基础的联合疗法（ACT）获取受限的原因，会上介绍了在布隆迪和塞拉利昂进行的关于抗疟药物供应和可及性的政策和市场调查。这些调查是在私营、公共和非营利部门的主要利益攸关方之间进行的一次高度互动的头脑风暴会议上提出的，直接涉及两国的国家疟疾控制规划管理人员。这些调查为循证政策的实施奠定了基础。调查结果可推断至其他具有类似社会人口和疟疾状况的国家。会议提出了关于在全球、国家和社区各级为更好地获取 ACT 而采取的关键行动的建议。在全球一级，私营和公共部门都需要采取行动，加强政策，以用固定剂量的 ACT 产品替代松散的泡罩包装，制定战略禁止使用不当的抗疟药物并加以监管，并促进技术和知识转让，以扩大固定剂量的 ACT 产品的生产，这些产品应该能够让那些最需要这些药物的患者获得，并负担得起。在国家一级，应该制定和执行规范抗疟药物市场的政策。公共部门，包括供资捐助者，应参与确保私营部门参与 ACT 的实施过程。类似讨论中所进行的研究对其他国家制定和评估地方一级的正确激励措施非常重要。在社区一级，必须继续并加强有关适当预防和治疗措施的社区外联和教育，在公共和私营部门内部建立服务提供系统等措施，以减少获取无效和不当抗疟药物的机会。会议期间明确的是，继续承诺、加强各利益攸关方之间的互动和透明度，重点关注社区、国家政府以及循证政策和行动，是可持续控制疟疾的唯一途径，疟疾仍然对全球，特别是撒哈拉以南非洲的健康和社会经济产生重大影响。即将发表关于在这次会议上讨论的研究采用的方法的详细信息，以及更详细的结果、数据分析和对这些研究的讨论。
