Drug stockouts and treatment delays in African health systems: impact on malaria morbidity and mortality

Malaria remains a leading cause of illness and death in Africa, particularly affecting vulnerable populations such as children and pregnant women. Effective management of malaria relies heavily on timely access to antimalarial medications, primarily artemisinin-based combination therapies. However, drug stockouts and treatment delays are persistent challenges in many African health systems, significantly undermining malaria control efforts and contributing to increased morbidity and mortality. This review explores the multifactorial causes of drug stockouts and treatment delays, including weaknesses in procurement, supply chain management, health infrastructure, and human resources. It highlights how these systemic challenges lead to interruptions in malaria treatment, worsening disease outcomes, and facilitating the spread of drug resistance. The negative impact extends beyond clinical consequences, eroding public trust in healthcare services and pushing patients toward ineffective alternatives. To address these issues, the review underscores the need for comprehensive strategies that strengthen supply chains, improve forecasting and inventory management, and enhance healthcare delivery capacity. Integrating innovative technologies, fostering partnerships, and promoting community engagement are critical to ensuring consistent drug availability and timely treatment. Ultimately, overcoming drug stockouts and treatment delays is essential to reduce the malaria burden and advance toward elimination goals in Africa.