The malaria parasite and man have coexisted for millions of years – each influencing the other in their fight for survival. Historically, the parasite has become resistant to each medicine developed to kill it. One of the main reasons for the failure of the first global malaria eradication campaign, initiated in 1955, was the development of widespread resistance to chloroquine. Now, at the Thai–Cambodian border, the first signs of resistance to artemisinin, the key component of the current treatment of choice, have begun to emerge. In conversation with MMV’s Tim Wells, Chief Scientific Officer, and George Jagoe, Executive Vice-President, Global Access, we explore the real significance of this issue and what it means for antimalarial drug development.