Rwanda has updated its treatment guidelines for malaria as the disease has got resistant to some commonly used medicines. For the past six years, the World Health Organisation (WHO) recognised that malaria parasites had started to develop resistance against Artemisinin-based combination therapies (ACTs), which are recommended by WHO as the first-and second-line treatment for uncomplicated malaria. ALSO READ: Malaria: How is Rwanda handling insecticide resistance? Now scientists say millions of lives are at risk unless urgent and radical action is taken to stop drug-resistant malaria spreading in Africa. The 28 malaria scientists from 10 countries made the call to action in the journal Science, as numbers showed that resistance levels have soared in some areas from fewer than 1 percent to more than 20 percent of cases in the space of three years. Parasites that could resist artemisinin have reportedly spread within various African countries. It is estimated that more than 10 percent of malaria cases are caused by resistant parasites in Ethiopia, Eritrea, Rwanda, Uganda and Tanzania. Speaking to The New Times, Dr Aimable Mbituyumuremyi, Malaria Program Manager at Rwanda Biomedical Centre (RBC), noted that Artemisinin resistance is something they know about and have taken steps in reaction to it. ALSO READ: Rwanda optimistic about latest breakthrough in search for a malaria vaccine “We have updated our treatment guidelines and are developing the anti-malaria drug resistance strategic plan to address this issue,” he said. In its 2024 integrated malaria control guidelines, RBC noted that in order to fight against malaria resistance emerging in Rwanda, it will pilot the implementation of Multiple First Line Treatment (MFT) strategy, which aims at the deployment of multiple therapies for malaria. As part of it, Rwanda aims to use three ACTs accepted in the country (Artemether Lumefantrine (AL), Dihydroartemisinic- piperaquine (DHAP) and Artesunate -pyronaridine (ASPY), allowing clinicians to select treatment according to established criteria. The WHO recommends MFT in areas where there is a high risk of drug resistance, including countries like Rwanda. “The findings of the pilot study will inform the adoption and implementation strategies of multiple first line treatment of uncomplicated malaria in Rwanda,” the strategy reads in part. According to the malaria program mid-term plan published by the health ministry in 2023, Rwanda has made steady progress towards the epidemiological impact targets. ALSO READ: FEATURED: How Rwanda reduced the malaria burden in five years Nationally, the malaria incidence decreased by 76 percent, from 321 cases per 1000 persons in 2018/19 to 76 cases per 1000 persons in 2021/22, surpassing the target of 127 cases per 1000 persons set for 2024. There was also a 74 percent reduction in severe malaria cases from 7,054 (2018/2019) to 1,831 (2021/2022) and a 73 percent reduction in malaria deaths from 264 in 2018/19 to 71 deaths in 2021/2022.
