Glob Health Res Policy. 2025 Dec 15;10(1):66. doi: 10.1186/s41256-025-00454-6.
ABSTRACT
BACKGROUND: Malaria elimination in the Asia-Pacific region has stalled in recent years, partially due to disrupted access to antimalarial drugs during public health emergencies. This study aims to explore the access to antimalarial drugs and its contextual factors in health emergencies based on investigation into six Asia-Pacific countries during the COVID-19, including Bangladesh, India, Indonesia, Pakistan, Thailand and Viet Nam.
METHODS: We extracted the quarterly data for 37 antimalarial drugs using the IQVIA database from the first quarter in 2020 to the second quarter in 2022. We used standard units (SU) sold per 1000 incident cases and US dollars per 1000 incident cases to evaluate consumption (accessibility). Changes in consumption were estimated using compound annual growth rate (CAGR). Associations between consumption and country’s socioeconomic, health performance and product supplier indicators were measured using least squares (pooled) panel data regression model.
RESULTS: Available antimalarial drugs ranged from 31 in India, and 6 in Bangladesh and Viet Nam. The predominant medicine category in all six countries was quinine and other quinoline derivatives. The highest level of average consumption per 1000 incident cases was observed in Viet Nam (2004141.9 SU per 1000 incident cases). The country presenting the lowest level of accessibility was Indonesia (3668 SU per 1000 incident cases). Between 2020 and 2022, all countries except Viet Nam presented a decreased consumption per 1000 incident cases, with CAGRs being respectively – 15.11% in Bangladesh, – 3.66% in India, – 23.56% in Indonesia, – 13.28% in Pakistan and – 12.07% in Thailand. Increased Log consumption per 1000 incident cases was associated with higher proportion of health expenditure out of total government expenditure (coefficient 1.84, 95% confidence interval 0.47-3.21) and higher proportion of local supply (coefficient 0.43, 95% confidence interval 0.06-0.80).
CONCLUSIONS: There has been a disruption in the access to antimalarial drugs during the COVID-19 pandemic in the Asia-Pacific region, and the predominant available medicines were those with documented resistance. Greater priority should be given to drug innovation aimed at improving availability, along with strengthening health systems and local production to maintain accessibility to these drugs, especially during health emergencies.
PMID:41398305 | DOI:10.1186/s41256-025-00454-6
