A rare success story in the fight against malaria has been the development and use of therapies based on artemisinin, originally isolated from the sweet wormwood plant. Professor Nick White and colleagues at the Wellcome Trust's South-east Asia Major Overseas Programme have pioneered the use of artemisinin combination therapies (ACTs), which have proved extraordinarily effective at controlling malaria in Vietnam and Thailand. ACTs are now the recommended World Health Organization treatment for malaria.

Artemisinin derivatives are potent, well-tolerated, rapidly acting drugs that carry a low risk of resistance, as long as they are used in combination with other antimalarial drugs. ACTs are, however, more expensive than other treatments. Nearly all countries have now in principle adopted ACTs as their first line of defence against malaria. In practice, however, ACTs do not always reach the people that need them.

The Institute of Medicine, one of the US National Academies, has called for an annual global subsidy to make ACTs more affordable. The Institute estimates that international organisations and developed countries would have to contribute up to US$300–500 million per year to reduce the cost of ACTs to 10 cents per course or less, in line with the price of the cheapest single-drug artemisinin-derived therapy.

Development of a new drug for malaria has been a remarkable scientific and technical achievement. An equally committed and concerted effort is now needed to ensure that all vulnerable people – mostly young children in Africa – can benefit from ACTs.

External links

• WHO Guidelines for the Treatment of Malaria [PDF 1.9MB]
• Institute of Medicine, Board on Global Health. Saving Lives, Buying Time: Economics of malaria drugs in an age of resistance. Washington, DC: National Academies Press; 2004.