Countries can hold the line against antimalarial resistance in Africa - but we must act now
Authors: Prof Gilbert Kokwaro, Strathmore University, Dr Issiaka Soulama, IRSS Burkina Faso and Adam Aspinall, Senior Director, Access and Product Management, MMV.
Throughout the 1980s and 90s, Africa faced a worrying challenge: chloroquine, the first-line treatment for malaria, was quickly becoming ineffective. Another drug introduced around this time - sulfadoxine/pyrimethamine (or SP) – soon met a similar fate. In the early 2000s, however, the global malaria community responded by rolling out a new family of malaria medicines - artemisinin-based combination treatments (ACTs).
ACTs have since transformed the fight against malaria in Africa, working alongside insecticide-treated nets and other vector control tools to contribute to a rapid decline in malaria cases and resulting deaths. Indeed, over 2 billion malaria cases have been prevented globally since the start of the century, and the malaria mortality rate in Africa has declined by over 60%.1
Although six ACTs are currently recommended by WHO, artemether-lumefantrine (AL) is currently used to treat between 80-90% of malaria cases on the continent. It is very affordable, costing around $0.26 for a paediatric dose and around $0.60 for adults. As the most widely-used first-line treatment in Africa, the continent is heavily reliant on AL to keep the disease at bay.
Since 2020, several studies have confirmed the emergence of partial artemisinin resistance – a delay in the time it takes for treatments to successfully clear the parasite - in a growing number of African countries.
1WHO World Malaria Report 2022
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