New Malaria Drugs Deliver Results in Rwanda’s Treatment Shift

Rwanda’s adoption of new malaria treatment drugs alongside the widely used Coartem is already yielding positive results, health officials and frontline practitioners say, marking a significant step in the country’s fight against the disease.

The strategy, known as Multiple First-Line Therapies (MFT), was introduced in October 2025 by the Rwanda Biomedical Centre under the Ministry of Health. It involves the use of three different first-line malaria treatments to prevent drug resistance and improve patient outcomes.

Epaphrodite Habanabakize, Malaria Prevention Senior Officer at Rwanda Biomedical Center (RBC), said the move followed research showing that Artemether-Lumefantrine (AL), commonly known as Coartem, had started to lose effectiveness in some patients.

“When we say Coartem was becoming less effective, we do not mean it was withdrawn. But there were cases where patients were not fully cured and had to return to health facilities. That is what prompted the introduction of additional drugs to support it,” Habanabakize explained.

The two new treatments, Pyronaridine-Artesunate (ASPY) and Dihydroartemisinin-Piperaquine (DHAP), are now being used alongside Coartem, giving Rwanda a total of three frontline malaria therapies.

Under the MFT approach, the country is divided into three zones, each assigned one of the treatments. The drugs are rotated annually to prevent the malaria parasite from developing resistance.

“This rotation ensures that the parasite does not adapt to a single drug, which could render all treatments ineffective,” Habanabakize said.

Fewer Return Cases at Health Facilities

Health workers report that the new approach is already reducing repeat malaria cases.

Pierre Célestin Habimana, a doctor at Shyorongi Health Center in Rulindo District, said the introduction of ASPY has significantly improved recovery rates.

“Previously, when we treated patients with Coartem, some would return after a week still sick with malaria,” he said. “But since we started using the new drug in October 2025, no patient has come back with persistent symptoms. The results are very encouraging.”

Habimana noted that facilities in Rulindo, located in Northern Rwanda, are currently using ASPY under the zonal system and expect to switch treatments as part of the annual rotation plan.

Patients Report Faster Recovery

Patients are also noticing the difference.

Cécile Muhawenimana, a resident of Shyorongi Sector, said she recovered quickly after being treated with one of the new drugs.

“I had malaria, but I was treated with the new medicine and recovered quickly” she said. “Since these new drugs were introduced, we no longer stay sick for long.”

She added that while Coartem had previously been effective, its reduced strength in some cases meant slower recovery.

Rwanda’s MFT strategy is part of a broader effort to stay ahead of artemisinin resistance, a growing concern in global malaria control.

By diversifying treatment options and rotating them geographically, the Ministry of Health aims to preserve the effectiveness of existing drugs while ensuring patients receive timely and effective care.

Currently, ASPY is being used in parts of the Northern and Southern provinces, while other regions continue with Coartem and DHAP, depending on their assigned zones.