Skip to main content
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 2003 Nov 17;78(12):1378–1388.

Combination therapy for malaria in Africa: hype or hope?

P B Bloland 1, M Ettling 1, S Meek 1
PMCID: PMC2560651  PMID: 11196485

Abstract

The development of resistance to drugs poses one of the greatest threats to malaria control. In Africa, the efficacy of readily affordable antimalarial drugs is declining rapidly, while highly efficacious drugs tend to be too expensive. Cost-effective strategies are needed to extend the useful life spans of antimalarial drugs. Observations in South-East Asia on combination therapy with artemisinin derivatives and mefloquine indicate that the development of resistance to both components is slowed down. This suggests the possibility of a solution to the problem of drug resistance in Africa, where, however, there are major obstacles in the way of deploying combination therapy effectively. The rates of transmission are relatively high, a large proportion of asymptomatic infection occurs in semi-immune persons, the use of drugs is frequently inappropriate and ill-informed, there is a general lack of laboratory diagnoses, and public health systems in sub-Saharan Africa are generally weak. Furthermore, the cost of combination therapy is comparatively high. We review combination therapy as used in South-East Asia and outline the problems that have to be overcome in order to adopt it successfully in sub-Saharan Africa.

Full Text

The Full Text of this article is available as a PDF (339.5 KB).


Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES