The demand for artemisinin-based combination therapy (ACT) has grown sharply since its recommendation by the World Health Organization in 2002. However, the rates at which endemic countries have scaled-up their use have varied, resulting in a cycle of volatile supply and demand. Although various short-term solutions have alleviated country-level stockouts, without robust mechanisms to build resilience in the supply chain, these uncertainties have the potential to disrupt global ACT supply. A mix of strategies is required to stabilize the artemisinin and ACT markets.