ubstandard, spurious, falsified, falsely-labeled and counterfeit – or SSFFC – malaria medicines cause undue harm because they cannot effectively treat malaria. SSFFC malaria medicines can also negatively influence consumer behavior, threaten national healthcare systems and contribute to artemisinin resistance.
This Implementation Kit (I-Kit) provides national and local stakeholders, as well as program managers, with key considerations and a roadmap for designing and implementing a country-specific social and behavior change communication (SBCC) campaign that protects the public from poor quality malaria medicines and responds to the threat of SSFFC medicines in their country.
This I-Kit includes key information health practitioners need to combat issues of poor quality or diverted malaria medicines in their area, and resources to better understand their prevalence and the impact of SSFFC antimalarials. It includes suggestions for identifying partnerships and selecting appropriate audiences and theories to strengthen SBCC strategies. This Promoting Quality Malaria Medicines through SBCC I-Kit can be reviewed using its online version here, or can be downloaded as PDFs.
Provides the necessary background and information to use the I-Kit, as well as information on global and country examples to combat SSFFC malaria medicines and promote positive medicine use behaviors.
Describes five essential elements for designing and implementing a campaign to promote the use of good quality malaria medicines.
Provides guidance, tools and resources for engaging with the media to combat SSFFC malaria medicines.
Provides resources and tools for understanding the malaria medicine situation, as well as developing and advocating for strategies to address medicine quality issues. Provides descriptions and links to resources and tools for protecting and advocating for malaria medicine quality.
Substandard, spurious, falsified, falsely-labeled and counterfeit (SSFFC) malaria medicines are artemisinin-based combination therapy (ACT), or monotherapies, which cannot properly treat malaria due to poor quality. Malaria medicines are at higher risk for quality issues because they are in high demand in malaria-endemic countries. As a result, they are targeted by illicit manufacturers and are often improperly transported and stored by informal medicine vendors and drug smugglers alike. SSFFC malaria medicines generally fall into three categories (Kaur et al., 2015):
Medicine that does not contain enough active ingredient due to unintentional errors caused in manufacturing.
Medicine that does not contain enough or any active ingredient due to intentional fraudulent manufacturing, may carry false representation of their source or identity.
Medicine that does not contain enough active ingredient due to poor conditions in storage environments, handling, or transportation (light, heat, humidity, etc.). Stolen or diverted medicine is at risk of becoming degraded.
Whether they contain toxic, inactive or insufficient ingredients, SSFFC malaria medicines seriously threaten a country’s health system and the patients they serve. Because these medicines do not contain the required amount of the active ingredient, they cannot completely treat malaria and can lead to a worsened case of malaria, or even death. A 2013 study of data from 39 countries estimates that SSFFC malaria medicines may be connected with 122,350 deaths of children under five years old in sub-Saharan Africa. Read more about SSFFC malaria medicines here.
When preparing to design an SSFFC communication plan, the essential elements in Promoting Quality Medicines should be read from beginning to end. The elements are organized in order of consideration, with one leading to the next. While designing and implementing an SBCC program, refer to various elements and examples. This section explains how to share experiences and learnings with other professionals working to combat SSFFCs. SBCC aimed at protecting consumers from substandard and falsified malaria medicines is very new and not much is known about it. Help grow the knowledge base by sharing experiences and lessons learned by clicking here.
HC3 prepared this I-Kit based on its experience in Nigeria, and with input from other countries in Africa. The process involved four steps:
The examples featured in this I-Kit are primarily based on lessons learned while designing and implementing the SSFFC Malaria Medicines SBCC campaign in one state of Nigeria. Through others' contributions, it can be expanded to reflect lessons learned from other countries and contexts. Please share ideas, strategies, materials and research as well as examples via this Contact/Feedback Form.