Introduction: Falsified and substandard medicines (SFs) and their contribution to the development of antimicrobial drug resistance present a threat to regional health security. In addition, SF antimalarial medicines undermine the goal of malaria elimination and eventual eradication of the disease. This challenge requires a stronger cross-sectoral and cross-border policy response aimed at strengthening national drug regulatory systems.
Methods: This paper explores how the interpretation and perception of the challenge of SF antimalarials among policy actors in three Greater Mekong Subregion (GMS) countries influences policy responses to SFs. Data was collected through semi-structured interviews with key policy makers involved in the regulation of medicines and interactions through the Regional Regulatory Partnership for Malaria Elimination.
Findings: The GMS’ porous borders increase the circulation of SFs and underscores the need for a coordinated regional response. This is particularly urgent due to the threat of the spread of drug-resistant malaria. Improving the regulatory capacity of countries to effectively monitor the quality of medicines, to respond to SF antimalarials and to expedite the registration of new medicines for the treatment of drug-resistance malaria and crowding in of quality products for hard-to-reach populations such as Mobile Migrant Ethnic and Vulnerable Populations will be essential for malaria elimination.
Conclusion: Policy developments against SFs can be successful only if the threat of SFs for drug resistant malaria is considered a shared regional responsibility; encouraging both the cross-border exchange of information and cross-sectoral cooperation with ministries of trade, industry and agriculture as well as law enforcement agencies. Framing drug-resistant malaria as ‘regional health security’ nurtures both a sense of shared responsibility and can drive the allocation of resources to address this health security threat.