(2009; 35 pages)
Malaria remains hyper endemic in Ghana and is the single most important cause of mortality and morbidity especially among children under five years, pregnant women and the poor. Apart from the health consequences, malaria puts a heavy burden on productivity and hence economic development. In Ghana, Malaria is estimated to cause the loss of about 10.6% Disability Adjusted Life Years (DALYs) costing an equivalent of up to 6% of GDP annually in economic burden. Therefore, the GPRS II identifies malaria control as one of the key health sector interventions. In Ghana, as well as globally, malaria control programmes are threatened by the development of drug resistance to mono therapies necessitating revisions of treatment policies. In this regard, in 2002 Ghana initiated the process of using ACTs following WHO recommendations for all countries experiencing resistance to mono-therapies in the treatment of falciparum malaria. Based on evidence of efficacy, compliance, side effects, cost effectiveness, impact on local industry and key demographic variables such as the appropriateness for treating malaria in children under five years and in pregnancy, Artesunate-Amodiaquine was selected as the first line drug for the treatment of uncomplicated malaria.
However, the implementation process was faced with challenges such as adverse drug reactions, lack of other treatment options and safety concerns. It has therefore become necessary to review the drug policy and address all identified concerns.
A team commissioned by the Minister of Health was tasked to review existing policy guidelines and select additional ACT drugs and dosage forms to cater for those who for one reason or another, cannot tolerate Artesunate- Amodiaquine. Two additional ACTs namely; Artemether- Lumefantrine and Dihydroartemisinin/Piperaquine were selected. Nevertheless, Artesunate-Amodiaquine still remains the preferred ACT for the treatment of uncomplicated malaria. This document is thus a revision of the 2004 anti-malarial policy and provides policy measures and an implementation framework for the treatment of malaria.