Antimalaria drug combination

1
KINGDOM OF CAMBODIA
Ministry of Health
CNM
National Center for Parasitology, Entomology and
Malaria Control
2
National anti-malaria drug policy

• Create and maintain access to early diagnosis and
  prompt, effective, safe and good quality
  treatment of malaria disease.
• Minimize selection pressure for drug resistance.

3

• Parasitological cure to reduce reservoir of
  infection.
• The anti-malaria drug use was based on the
  National treatment guideline for Malaria and
  recommended by WHO.

4
Anti-malaria drug combination

• National Treatment Guideline for Malaria
• National treatment Guideline was developed in
  2000 (for combination therapy)
• Artesunate and Mefloquine combination for first
  line treatment
• Quinine with Tetracycline for second line
  treatment

5
Anti-malaria drug procurement

• Plan
• MoH procurement (National budget and WB)
• CNM procurement (Global Fund)

6
AM blister packaging Facility

• Packaging facility was agreed by MoH to setting
  up this facility
• The blister packaging process was supported by
  WHO and supervised by CNM (National Malaria
  Center)
• Artesuante and Mefloquine free tablets were
  supplied by MoH (CMS) to the packaging facility

7
AMs Categories

• There are 3 categories of AM
• AM2 6 tablets of Artesunate and 2 tablets of
  Mefloquine
• AM3 9 tablets of Artesunate and 3 tablets of
  Mefloquine
• AM4 12 tablets of Artesunate and 4 tablets of
  Mefloquine

8
Quality Assurance

• Before packaging
• All of batch number of Artesunate were analyzed
• All of batch number of Mefloquine were analyzed
• After packaging
• All of lot number of each AM categories were
  analyzed
• Stability of all AM categories were done
• At the field
• 2 sides were selected for collecting the AM
• 3 monthly for collecting the AM from all fields

9
Anti-malaria drug supply system

• The AMs were supplied through the public sector
• The Malarine were supplied through the PSI
  organization to the Private sector

10
ANTI-MALARIA DRUG SUPLLY SYSTEM IN CAMBODIA
MINISTRY OF HEALTH
DEPARTMENT OF DRUG AND FOOD ESSENTIAL MEDICINE
BUREAU
CENTRAL MEDICAL STORE
NATIONAL HOSPITAL7NHs
PROVINCIAL HEALTH DEPARTMENT
OPERATIOAN DISTRICT 75ODs OFFICE AND PHARMACY
REFERRAL HOSPITAL 68RHs
HEALTH CENTER 827HCs
Outreach Activity
HEALTH POST
REPORT
SUPPLY
REPORT and SUPPLY TEMPORERY TIME
11
Anti-Malaria drug monitoring

• Drug regulation
• Efficient procurement
• Efficient distribution
• Drug efficacy
• Drug quality
• Drug use practices