They argue that there are now signs of an evolving "malaria activism" (akin to AIDS activism), which has scored two big successes. The first wave of malaria activism highlighted the gap between the huge burden of malaria and the tiny amount of international development assistance dedicated to its control. Such advocacy helped motivate donors to increase their malaria commitments. The second wave focused on making sure that the extra funding was used to purchase highly efficacious artemisinin-based combination therapy (ACT) rather than mono-therapies such as chloroquine, which are largely ineffective in Africa.
"These are big victories," say the editors. "But one benchmark of successful ACT scale-up is whether the drugs are available at the point of care. One of us has just returned from a health reporting fellowship in East Africa, where he found that ACT 'stock-outs' (shortages) were common."
So it's now time, they say, for a "third wave" of activism, to raise awareness of the ACT stock-out crisis, which has deadly consequences.
The editors examine reasons for the crisis—such as inadequate funding to purchase ACT, delays in procuring the drug, and weak health information systems that can't properly track national drug needs and flows—and they lay out some possible solutions.