Pharmaceutical quality of artemether-lumefantrine in Rwanda's public health supply chain: a cross-sectional post-market surveillance study

Background

Substandard and falsified (S&F) antimalarial medicines undermine malaria control efforts across sub-Saharan Africa, with an estimated 19% of antimalarials failing to meet quality standards and contributing to 40,000-160,000 preventable deaths annually. ACTs, particularly artemether-lumefantrine (AL), are the cornerstone of malaria treatment, yet their effectiveness is threatened by poor pharmaceutical quality and emerging drug resistance. This study evaluated the pharmaceutical quality of AL circulating in Rwanda's public health supply chain to assess compliance with international pharmacopeial standards.