Containing resistance 他AMFm offers best chance to making ACTs available widely and displacing monotherapy 他But resistance could arise before AMFm enters full operation or even after 他What then?
Should we plan for instances of resistance tolerance? ¾Yes – global public good arguments ¾Lessons from Cambodia is that it is difficult to figure out who should be in charge of coordinating a response (both technical and financing aspects) ¾What would be the elements of such a plan?
At what level of tolerance should we act? 他What is the scale of the problem o search around places where tolerance is first detected.
他Are there downside risks to waiting too long? 他Are there downside risks to intervening too early? 他What kind of evidence is sufficient to mount a response?
What are appropriate response strategies? 他Eliminate malaria through IRS and ITN (where applicable) 他Exchange artemisinin monotherapies for combinations in private sector 他Speed up distribution of free ACTs in public sector (i.e. deal immediately with stock outs and other supply problems on priority basis) 他Others?
Who would pay for the response? ¾Countries ¾AMFm? ¾Global Fund? ¾Special Fund set up at WHO? ¾Malaria researchers?
Antimalarial Treatment Strategies: Next Steps ¾Modeling ¾Implementation Research ¾Economic case ¾Framing the problem and solution ¾Policy updating: challenges and solutions