One of the concerns of those involved in teaching antiparasitic chemotherapy is the relatively superficial treatment that it receives from textbooks of pharmacology. However, there are specialist reviews, review journals and collections of articles such as this volume that help to redress the balance. Malaria is the world's most serious parasitic infection. Efficacious vaccines have proven elusive and parasitic resistance undermines drug treatment. New thinking is necessary to hold back the tide of mortality, particularly among African children, and new drugs are needed to replace those made redundant by resistance. Fortunately, the world has woken up. Promising new ventures are under way led by Roll Back Malaria and Medicines for Malaria and armies of dedicated scientists are exploiting advances in molecular biology to identify new targets for chemotherapy.
‘Antimalarial Chemotherapy: Mechanisms of action, resistance and new directions in drug discovery’ is a collection of reviews from experts in different areas. All have published widely in leading journals and are regular participants at international meetings. Their work can therefore be regarded as authoritative. Rosenthal divides the book into three sections. First there is a collection of reviews dealing with historical issues relating to malaria therapy and biology, and the impact of drug resistance. Second, there is discussion of the major groups of antimalarial agents in current use, together with mechanisms of action and resistance. This section concludes with a general review of drugs under development. The final section, entitled ‘New compounds, new strategies and new targets’ looks at some novel strategies for chemotherapy, revisiting some areas and highlighting those that have received relatively less attention.
While no book, however, authoritative, can hope to be the last word, this collection comes close to being the most definitive text in this area that I have seen in recent times. Of course, the problem is that further research means material easily becomes dated, but as a reference source the book retains its value. One can argue about the arrangement of chapters but I would suspect this is a book to be dipped into or looked at chapter by chapter than to be read at one sitting or even continuously. More seriously, it is reasonable to argue about what is missing. It is somewhat surprising that the controversies of combination chemotherapy are not offered at least one chapter. There is nothing to highlight the advances in clinical pharmacokinetics that have allowed more sensible thinking about dosage regimens in susceptible populations. The majority of authors are based in Europe and the United States. Why aren't Africa and South-east Asia represented? Surely those clinicians working on the ground in these areas have something positive to say?
Yet, I do not want to depart too much from the view that this book is welcome. I will certainly use it as a basis for teaching and to provide a starting point for the new thinking that I have highlighted as being so necessary. Perhaps we might have a second volume to cover those issues that the current publication neglects?