Artemisinin Combination Therapy Market - Global Forecast 2026-2032

The Artemisinin Combination Therapy Market size was estimated at USD 386.40 million in 2025 and expected to reach USD 414.27 million in 2026, at a CAGR of 6.69% to reach USD 608.26 million by 2032.

Malaria continues to impose a significant global health burden, especially in endemic regions of sub-Saharan Africa and Southeast Asia. The emergence of drug-resistant Plasmodium falciparum strains has undermined the efficacy of traditional monotherapies, reinforcing the World Health Organization’s endorsement of artemisinin combination therapy (ACT) as the frontline treatment for uncomplicated malaria. Recent data indicate that approximately 71% of children under five who tested positive in 26 African countries received an ACT regimen between 2017 and 2023, up from 38% in the 2005–2011 period, reflecting a concerted effort to expand access and adherence to recommended treatment protocols.

Furthermore, ACT has demonstrated unparalleled effectiveness in rapidly clearing parasitemia and mitigating morbidity, contributing to 236 million treatment courses delivered to public health sectors in 2023 alone. This scale of distribution underscores the critical role of ACT in malaria control strategies and highlights the necessity of maintaining robust supply chains to ensure uninterrupted access. With intensified focus on eliminating malaria by 2030, stakeholders are prioritizing innovations in formulation, delivery, and resistance monitoring to support sustainable progress in reducing malaria-related mortality and morbidity.

The landscape of artemisinin combination therapy has been reshaped by the accelerating emergence of parasite resistance across multiple malaria-endemic regions. Investigations in Uganda have revealed partial artemisinin resistance in 11% of pediatric malpractice cases, marking the first such detection in East Africa and signaling a pressing threat to treatment efficacy. Concurrently, resistance markers have been documented in the Horn of Africa and Southeast Asia, underscoring the need for vigilant surveillance and adaptive therapeutic strategies.

Meanwhile, significant innovations and policy interventions are transforming how ACT is accessed and delivered. The scale-up of seasonal malaria chemoprevention (SMC) has expanded preventive therapy for vulnerable children, with monthly drug administrations rising from 170,000 to 53 million children over a decade. In high-income markets, the U.S. government is advancing domestic pharmaceutical production through the Defense Production Act to mitigate foreign supply vulnerabilities, reinforcing supply chain resilience for critical medications including antimalarials. Additionally, proposed legislative measures such as the Drug Shortage Prevention and Mitigation Act aim to incentivize buffer stock maintenance and risk sharing among stakeholders, further strengthening the security of essential drug supplies.

In April 2025, the United States extended 10% to 25% tariffs on active pharmaceutical ingredients and key drug intermediates imported from China and India, directly impacting the cost structure of Artemisinin Combination Therapy production. With China supplying approximately 80% of global artemisinin APIs and India contributing an additional share, even modest tariff increases translate into substantial cost pressures for manufacturers and healthcare providers. As generic drug margins remain thin, these added expenses risk being passed to end users or result in supply reductions if producers withdraw from lower-margin markets.

Beyond direct cost increases, the new tariffs are prompting companies to reassess sourcing strategies and consider reshoring or diversifying suppliers. However, transitioning away from established Chinese partnerships is a complex and time-consuming process that can introduce delays and regulatory challenges, potentially exacerbating shortages of critical ACT formulations. Policymakers and industry leaders must collaborate on targeted exemptions for essential antimalarial inputs and support mechanisms for manufacturers to ensure that these trade measures do not undermine global malaria control efforts.

Insights into the market dynamics reveal that Artemether-Lumefantrine remains the cornerstone of ACT strategies, bolstered by its superior efficacy and endorsement by global health authorities. In response to diverse patient needs, Injectable forms of ACT are predominantly administered in hospital settings for severe malaria cases, while Oral Suspensions have been reformulated into Granule Sachets to enhance pediatric dosing accuracy and Syrups for caregiver convenience. Tablets continue to dominate outpatient and community programs, with Co-Packaged regimens offering logistical flexibility and Fixed Dose Combinations simplifying dosage adherence among adults.

End users exhibit distinct preferences: Public clinics in endemic areas leverage subsidized ACT supplies to reach underserved populations, private clinics cater to urban patients seeking rapid treatment, and hospital pharmacies manage complex intravenous therapies. Homecare models are evolving, with caregiver-assisted regimens empowering families to administer ACT safely, and self-administration gaining traction among educated patient groups. Across distribution channels, Hospital Pharmacies uphold stringent quality controls, Online Pharmacies are emerging to serve remote or travel-related demand, and Retail Pharmacies maintain accessibility for routine outpatient treatment. Patient group considerations underscore the need for adult formulations that balance potency and tolerability, geriatric options that address comorbidities and polypharmacy, and pediatric adaptations that ensure precise dosing for infants and children.

In the Americas, malaria incidence remains low, with approximately 2,000 imported cases reported annually in the United States, primarily linked to travel to endemic regions. Sporadic instances of local transmission underscore the importance of vigilance among clinicians and public health authorities, as exemplified by recent increases in imported cases along southern border jurisdictions, where 68 infections were recorded in 2023 compared to 28 in 2022. Demand in this region is driven by travel medicine clinics, private hospital pharmacies, and government stockpiles for potential outbreaks.

Within Europe, the Middle East & Africa region, Sub-Saharan Africa continues to bear the brunt of malaria’s toll, accounting for over 95% of global cases and deaths, with children under five disproportionately affected. Expanding seasonal chemoprevention programs, integration of rapid diagnostic testing, and donor-funded procurement initiatives are critical in sustaining progress. Meanwhile, the Middle East and North Africa have witnessed sporadic outbreaks linked to migrant and labor movements, necessitating coordinated cross-border surveillance.

Asia-Pacific remains a hotspot for both high malaria burden and emerging drug resistance, particularly in the Greater Mekong Subregion where multidrug-resistant Plasmodium strains challenge treatment protocols. Strong local manufacturing capacity in China and India underpins global ACT supply, while national control programs in India, Indonesia, and Papua New Guinea focus on integrating ACT delivery with vector control and digital surveillance platforms.

Novartis has spearheaded pediatric innovation with its recent approval of Coartem Baby, the first ACT formulation for infants under 4.5 kilograms. Developed in collaboration with the Medicines for Malaria Venture and approved by Swissmedic in July 2025, the cherry-flavored, easily dissolvable formulation addresses a critical treatment gap and underscores the value of tailored pediatric therapies in high-mortality settings. By deploying this product on a largely not-for-profit basis, Novartis is reinforcing equitable access in malaria-endemic regions.

Sanofi’s partnership with PATH to scale semisynthetic artemisinin production has transformed raw material availability, leveraging fermentation and photochemistry to deliver consistent, quality-assured APIs. This initiative, funded by global health foundations, enhances supply resilience by reducing dependency on traditional artemisia harvest cycles and stabilizing price volatility. Meanwhile, the Drugs for Neglected Diseases initiative and Sanofi’s ASAQ fixed-dose artesunate-amodiaquine combination has been introduced across sub-Saharan Africa, reflecting successful public-private collaboration in developing affordable, high-impact therapies.

Regional manufacturers are also rising to the challenge. Uganda’s Quality Chemical Industries, in partnership with Cipla, has achieved WHO prequalification for local artemisinin extraction and ACT formulation, bolstering domestic production capacity and providing a reliable supply source for East African markets. These developments illustrate how strategic alliances and technology transfers are critical in scaling access and fostering regional self-reliance.

Industry leaders should prioritize diversification of artemisinin API sourcing by establishing multiple supplier agreements and investing in semisynthetic production capacity. Creating a blend of physical buffer stocks and financial reserves can mitigate the “bullwhip effect” that arises from demand and supply uncertainties, as evidenced by historical raw material price volatility in the ACT market. Engaging in pooled procurement mechanisms and transparent contracting models can further distribute risk and prevent stock-outs during funding or logistical disruptions.

Simultaneously, accelerating next-generation ACT research-including triple combination therapies and novel partner drugs-will address emerging resistance before it compromises treatment outcomes. Policymakers should advocate for targeted tariff exemptions on essential antimalarial ingredients and collaborate on regulatory pathways that streamline approval of new formulations. Finally, integrating digital health platforms for case management, resistance tracking, and distribution monitoring will enhance real-time decision making, ensuring that both public and private health systems can rapidly respond to evolving malaria challenges.

This research employs a hybrid methodology combining secondary desk analysis of peer-reviewed literature, regulatory and policy documents, and publicly available health data with in-depth primary interviews conducted with key stakeholders across the supply chain, including manufacturers, distributors, clinicians, and policymakers. Secondary data sources encompass WHO World Malaria Reports, government trade and tariff records, and published clinical trial outcomes to ensure a rigorous foundation of factual context.

Primary research involved semi-structured interviews with representatives from pharmaceutical companies, public health organizations, and logistics providers, alongside expert consultations with resistance monitoring networks. Qualitative insights were triangulated with quantitative supply chain metrics-such as tariff schedules, production volumes, and distribution statistics-to validate key findings. Finally, data were synthesized through thematic analysis and cross-validated against multiple independent sources to achieve balanced, actionable conclusions.

The evolving Artemisinin Combination Therapy market underscores the importance of holistic strategies that span drug innovation, supply chain resilience, and policy advocacy. As resistance patterns shift and global trade dynamics impose new challenges, stakeholders must collaborate across sectors to harness emerging technologies and protective regulatory frameworks. By blending proven ACT regimens with next-generation compounds and maintaining agile procurement systems, the malaria community can safeguard treatment efficacy and extend the impact of life-saving therapies.

Ultimately, sustained progress against malaria hinges on continuous innovation, data-driven decision-making, and equitable access initiatives. The investments made today in pediatric formulations, semisynthetic API production, and cross-border partnerships will determine the trajectory of global malaria control efforts and bring us closer to a malaria-free future.

To discuss how your organization can harness the insights presented in this comprehensive analysis and stay ahead in the evolving Artemisinin Combination Therapy landscape, please reach out to Ketan Rohom, Associate Director, Sales & Marketing. She can guide you through tailored data offerings and customization options that align with your strategic priorities. Engaging directly with Ketan will ensure you receive exclusive access to detailed findings, supplemental case studies, and expert commentary that can empower your decision-making. Don’t miss this opportunity to leverage the definitive market research report to inform policy, investment, and product development strategies.