Dr. Sammy Mahugu has spent most of his career trying to stay one step ahead of malaria. As head of case management for the Kenyan government’s National Malaria Control Programme (NMCP), Dr. Mahugu has seen firsthand how the disease continues to take lives across the country, and how quickly the tools used to fight it can lose their edge. Malaria is an illness caused by parasites spread through mosquito bites that cause fever, chills, and fatigue. It is treatable and preventable, but if not caught in time, it can be deadly, especially for young children. So when early signals of antimalarial drug resistance began to emerge in East Africa, Dr. Mahugu knew Kenya could be next and could not afford to wait.
For decades, artemisinin-based combination therapies (ACTs) have been the first-line treatment against malaria, saving millions of lives across Africa and the globe. But a silent threat has been gathering force. Across parts of the continent, partial resistance to ACTs is growing, and in Kenya, the widespread and prolonged use of a single ACT regimen—artemether-lumefantrine (AL)—poses a risk. Sustained pressure on one drug combination can accelerate the development and spread of resistance. Left unchecked, this trend could erode decades of hard-won gains in malaria treatment and place the most vulnerable communities back in danger.
Despite significant progress through insecticide-treated nets, indoor residual spraying, improved surveillance, and expanded treatment access, malaria remains a major public health concern in Kenya. With evolving mosquito patterns and early signs of insecticide resistance emerging in some regions, the country recognized that bold, preventive action was needed.
In response, the Ministry of Health, through the NMCP, developed Kenya’s Multiple First-Line Therapies (MFT) Implementation Plan (2026–2030) with the Unitaid-funded Scaling the Optimal Use of Multiple Artemisinin-Based Combination Therapies to Prevent Antimalarial Drug Resistance (STOP-AMDR) project. Implemented by Jhpiego, STOP-AMDR provides the technical and financial support that is making bold action possible.
“The collaborative engagement, technical rigor, and commitment demonstrated by the Jhpiego team have been instrumental in bringing the MFT process to this important milestone,” said Sammy Mahugu, head of case management for NMCP. “We truly value the spirit of partnership that has guided this work from concept development through validation.”
Rather than continuing to rely on a single ACT regimen, the plan introduces and rotates multiple approved therapies across counties in a phased rollout. Using several different first-line antimalarial treatments at the same time puts less pressure on any one drug, helping them remain effective for longer. Slowing the emergence of resistance will preserve the long-term efficacy of available treatments and life-saving medicines for years to come.
The country will also maintain its “test-before-treat” policy, continue using multiple ACTs for uncomplicated malaria, and rely on injectable artesunate for severe cases.
On February 5, 2026, that plan was put to the test when Jhpiego joined health leaders for a high-level external validation meeting. We joined the World Health Organization, the Global Fund, the Kenya Medical Research Institute, and the Kenya Non-Governmental Organization Alliance Against Malaria to discuss the urgent need to diversify treatment options by adopting MFTs. Together, we emphasized the importance of a well-coordinated national response and walked through each step of the implementation process, including:
We also discussed the need to integrate private providers into national reporting systems; strengthen pharmacovigilance and molecular surveillance so that the earliest signs of treatment failure can be detected quickly; and use community communication strategies to ensure that patients understand the new approach and trust the evolving system.
By the end of the day, Kenya’s MFT Implementation Plan had been validated, refined by stakeholders’ input, and positioned for rollout.
For Jhpiego and many health leaders like Dr. Mahugu, validation of the plan is not the endpoint; it is a mandate. Concrete next steps are already in motion to launch the plan, strengthen surveillance and supply chains, mobilize sustainable financing, and roll out phased training across the country.
In the next phase, implementation will shift to the subnational level to close gaps and coordinate across public and private sectors. County leaders are ready to play their part.
“The implementation plan is comprehensive and well done,” said Dr. Patrick Boruett, county director for health in Baringo County. “Counties will be able to engage stakeholders at all levels and emphasize capacity building for health care workers, advocacy for leaders, community engagement, and involvement of the private sector.”
Kenya’s proactive leadership demonstrates that containing malaria resistance is not a challenge to be addressed in the future. It is a responsibility that must be acted on now. With the MFT plan validated and partners working in alignment, the country is taking decisive steps to protect its malaria treatment arsenal, ensuring that every confirmed case can continue to be effectively treated and that progress toward malaria elimination remains firmly on course.
Ndinda Kusu is a Senior Technical Advisor for Health Systems Development, George Wadegu is Senior Technical Officer for Malaria, and Lisa Wagethi Kamau is a Communications Officer for Jhpiego Kenya.
Gladys Tetteh is Jhpiego's Senior Technical Director for Malaria.
