The MARC SE-Africa dashboard: Joining forces to counteract emerging antimalarial resistance in South and East Africa

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Abstract Regions within eastern and southern Africa (SE-Africa) carry some of the highest malaria burdens. Understanding the spatiotemporal changes in the emergence and spread of artemisinin (partial) resistance (ART-R) and how to mitigate ART-R is therefore of paramount importance in these areas. Here, we present a dashboard developed by the Mitigating Antimalarial Resistance Consortium for SE-Africa in collaboration with nineteen national control malaria programs (NCMPs) and their partners. The dashboard supports NCMPs’ decision-making by providing curated information on the latest antimalarial resistance data available. We systematically reviewed, collated, and visualized antimalarial resistance information from therapeutic efficacy studies, molecular surveillance for Pfkelch13 ART-R genetic markers, current in-country malaria treatment policies, and reported malaria cases and deaths. We identified evidence gaps in therapeutic efficacy and molecular surveillance, particularly in southern Africa. Five countries, Angola, the Democratic Republic of Congo, Kenya, Tanzania and Uganda, reported artemether-lumefantrine treatment failures above the WHO threshold of 10% after correcting for reinfections. The A675V, R561H, P574L, and C469F Pfkelch13 markers were highly prevalent in cross-border regions of several East African countries, with the C469Y marker rapidly spreading across Uganda. The dashboard provides an interactive platform for data sharing at a regional level. We discuss the implications of these findings for policy, practice, and research. Author Summary We introduce the MARC SE-Africa Dashboard, an innovative tool developed at the request of national malaria control programs to enhance the management of malaria through data-driven insights into antimalarial drug resistance in Southern and Eastern Africa. This interactive dashboard compiles and visualizes data from multiple sources, offering an up-to-date overview of resistance patterns and treatment efficacy. With its interactive maps and user-defined parameters, the dashboard enables detailed multinational and cross-border analysis, which is invaluable for identifying and monitoring emerging hotspots of resistance. This allows health professionals, researchers, and policymakers to target interventions effectively and adapt strategies in response to the evolving landscape of malaria resistance. The information visualized on the dashboard includes updated information on molecular markers of resistance, therapeutic efficacy outcomes, and national treatment policies for 19 malaria-endemic countries. The dashboard aims to facilitate regional cooperation in malaria management, which proves essential for proactive combat against malaria in high-risk areas. We discuss the insights gained from the curated and collated data and the manner in which this data and dashboard can support national malaria control programs and researchers.

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