Market Formation in an Era of Drug Resistant Malaria: Understanding the formation of markets for (triple) artemisinin-based combination therapies

Abstract

This thesis explores the formation of markets for antimalarial therapies under the pressure of drug resistance. Part 1 maps the innovation system of antimalarial therapies and identifies systemic failures that jeopardize the formation of markets for new therapies. This is done by investigating in retrospect the antimalarial drug transition from conventional monotherapies to artemisinin-based combination therapies (ACTs), which is done in Chapters 2 and 3. Part 2 investigates the prospects of market formation for triple artemisinin-based combination therapies (TACTs) in African countries, where current ACTs are still effective. Introducing TACTs would therefore not directly benefit individual patients but instead they would mitigate the risks of future antimalarial drug resistance. Considering the introduction of TACTs in this context raises important ethical and practical questions which are discussed in Chapters 4 and 5. Part 3 investigates the market formation prospects of TACTs in Southeast Asia, where current ACTs are increasingly failing and where TACTs can provide direct clinical relief and can protect drug compounds.