science, health and technology

by the World Health Organization

Q: What is the best treatment against malaria?

A: The combination of artemisinin derivatives with another effective antimalarial medicine (artemisinin-based combination therapies or ACTs), is currently the most effective treatment for falciparum malaria --- the most lethal form of the disease. Over the past decade, the use of ACTs has become more and more widespread. They produce a very rapid therapeutic response and are well tolerated by people with malaria. ACTs also have the potential to reduce transmission of malaria.

As of October 2005, 53 countries --- 35 of them in Africa --- have officially adopted ACTs as their first line of treatment against malaria, although many of these countries are not yet using the treatment widely. Thirty countries have adopted ACTs since January 2004 alone, creating a surge of new demand for the medicines.

It is critical that countries get ACTs instead of another drug as in most parts of the world falciparum malaria has become resistant to conventional treatment, such as chloroquine, sulfadoxine/pyrimethamine, and other antimalarial medicines used singly. That is why WHO recommends that countries in which the malaria parasite is resistant to single therapies in more than 10 percent of cases use a combination of drugs.

To date, there is no documented falciparum resistance to the artemisinin derivatives. Yet, the efficacy of ACTs depends on the partner drug. For example, artemisinin derivatives combined with chloroquine are not effective, because of a high resistance against chloroquine.

Our best weapon against these resistant malaria parasites is a combination of drugs that includes a compound derived from artemisinin --- a substance extracted from the plant Artemisia annua --- and another antimalarial drug.