 The study examined the potential effect of increasing the use of artemisinin combination therapy, ACT, in Burkina Faso, a country with high burden and high impact malaria. It was found that the elimination of private market drugs could lead to lower treatment failure rates than the current situation, however, scenarios involving multiple first line therapies, MFT, with equal deployment of artemather, lumafantrin, AL, and dihydro artemisinin piperoquine, DHPAPQ, could accelerate the development of artemisinin resistant genotypes and increase treatment failure rates. This article was authored by Robert Jay Zupko, Tren Deng Nguyen, Nurekan Fabrisum, and others.