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The Community As the Patient in Malaria-Endemic Areas: Preempting Drug Resistance with Multiple First-Line Therapies
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Journal Article
The Community As the Patient in Malaria-Endemic Areas: Preempting Drug Resistance with Multiple First-Line Therapies
2016
Overview
Abbreviations: ACT, Artemisinin combination therapy; AS-MQ, artesunate-mefloquine; DHA-PPQ, dihydroartemisinin-piperaquine; NMCP, national malaria control program; MFT, multiple first-line therapies; WHO, World Health Organization Provenance: Not commissioned; externally peer-reviewed Summary Points * Combination therapy is an effective way to delay or prevent drug-resistance evolution in malaria, but we do not take full advantage of its potential. * Deploying multiple first-line combination therapies allows us to challenge parasite populations with many different types of drugs, and thus delay and slow down drug-resistance evolution more than with a single combination therapy. * We must take a preemptive, not reactive, policy approach to drug-resistance management in malaria. When or if new antimalarial compounds such as cipargamin (KAE609), the imidazolopiperazine KAF156, artefenomel (OZ439), and ferroquine pass through the necessary safety and efficacy trials and are adopted for wide distribution for treating uncomplicated malaria, they will be deployed as combinations, but they will still need to be introduced into the public health system in such a way that their presence does not immediately create substantial pressure for drug-resistant genotypes to evolve.
Publisher
Public Library of Science,Public Library of Science (PLoS)
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