In a bid to combat growing resistance to malaria medications, the Rwandan government is set to roll out new anti-malaria drugs across the country, according to officials at the Rwanda Biomedical Centre (RBC). The new medications—dihydroartemisinin-piperaquine (DHAP) and artesunate-pyronaridine (ASPY)—are part of the World Health Organization’s (WHO) recommended treatment plans for uncomplicated malaria. These drugs are designed to replace or supplement current treatments and are known as artemisinin-based combination therapies (ACTs), which are widely recognized for their effectiveness in fighting malaria.
Dr. Aimable Mbituyumuremyi, who manages the Malaria and Other Parasitic Diseases Division at RBC, highlighted that these two new drugs will act as alternatives to Coartem, which has been used for malaria treatment but is now facing increasing resistance in both Rwanda and several other countries. The first batch of DHAP and ASPY arrived in the country last week, and these will be made available in hospitals where doctors can prescribe them to patients who have not responded to the standard treatments.
The new drugs are expected to be distributed to healthcare facilities starting January 6, 2025. The plan is for hospitals nationwide to receive adequate supplies so that doctors can prescribe the drugs to patients who continue to experience malaria symptoms after receiving initial treatment. This effort aims to enhance treatment options and ensure that patients get the necessary care when existing medications fail to provide relief.
Dr. Mbituyumuremyi explained that the increasing resistance to malaria treatments can be attributed to several factors, including the long-term use of the same medications without introducing alternatives, improper dosing, and the spread of drug-resistant malaria parasites. The resistance problem has led to concerns that malaria may become harder to treat, especially in regions with frequent outbreaks.
To effectively integrate these new treatments into the healthcare system, the Ministry of Health has already updated its guidelines for malaria medication use. Healthcare workers across the country have been trained in the new treatment protocols. The next phase will involve training medical staff at health centers and community health workers to ensure that everyone involved in malaria treatment is well-prepared. Once the strategy is fully rolled out, the new drugs will be prescribed by doctors, health facility staff, and trained community health workers.
The national strategy to address malaria will officially begin in April 2025. This comprehensive approach includes the use of DHAP and ASPY, alongside Coartem, which will remain part of the treatment regimen. The Ministry of Health has made it clear that the availability of these new drugs will be a crucial step in combating malaria resistance, particularly as more communities are impacted by the disease.
In terms of malaria trends, Rwanda has seen significant progress in recent years. According to data from the Ministry of Health, the country has reduced malaria cases by 90% between the fiscal years 2016/2017 and 2023/2024, from 4.8 million cases to 620,000. Malaria-related deaths have also dropped substantially, from approximately 650 to 67 during the same period. These improvements are largely attributed to efforts such as increased access to treatment, malaria prevention programs, and control measures like indoor spraying.
However, recent data indicates a worrying increase in malaria cases in 2024. From January to October, the number of reported malaria cases surged by 45.8%, reaching 630,000, up from 432,000 during the same period in 2023. This rise in cases can be traced to several contributing factors, including the spread of drug-resistant malaria parasites, inadequate management of mosquito breeding sites, changes in mosquito behavior (with mosquitoes biting more outdoors rather than indoors), and potential cross-border malaria transmission, particularly in areas bordering Uganda and Tanzania, such as Nyagatare, Gisagara, and Bugesera.
The Ministry of Health has acknowledged that despite significant progress, the malaria burden remains high, and new strategies are required to control the disease. Alongside the introduction of new drugs, the government is implementing ongoing interventions such as indoor residual spraying in several malaria-prone districts, including Nyagatare, Kirehe, Ngoma, and Bugesera, and conducting investigations into malaria hotspots to understand the root causes of recent surges.
Additionally, the Ministry is focused on strengthening malaria prevention and response at the community level by establishing a Malaria Task Force, which will work with local leadership and health sectors. This task force will coordinate efforts, mobilize resources, and improve access to diagnosis and treatment, ensuring that all communities, particularly those in high-risk areas, receive timely and effective care. By combining these efforts with the new drug treatments, Rwanda aims to continue its progress in reducing malaria transmission and mitigating the impact of the disease on its population.