National Project Implementation Plan - NVBDCP

cost of switching from Chloroquine (CQ) to ACT with the level of drug
resistance reached. For example, it has been estimated that switching from
chloroquine to ACT becomes cost-effective as Chloroquine (CQ) resistance
reaches around 37%. Similarly, switching from Sulfadoxine Pyrimethamine
(SP) to ACT becomes cost-effective as SP resistance reaches 12 percent. This
low threshold for SP is due to the high growth rate of resistance to SP when it
is used as a first line therapy.26
The current diagnostic and treatment protocol involves (i) active surveillance
with collection of blood smears for all cases with history of fever (both current
and those in the past 15 days) (ii) presumptive treatment for all cases with
history of fever (iii) microscopy of all blood smears collected, and (iv) use of
CQ and PQ/ ACT for confirmed Pf cases.
In Table 1, 2 and 3 below, estimate the cost of current protocol, the cost of
new protocol, and incremental costs and benefits of phased transition to new
protocol in 93 malarious districts from 2008 to 2012 respectively.
26 Disease control priorities in Developing Countries, 2 nd edition, edited by Dean T. Jamison et al., Disease control
priorities project (2006), Conquering Malaria, Chapter 21, pp 413-431.
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