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Urgent action is needed to confront artemisinin partial resistance in African malaria parasites

  1. Deus S. Ishengoma

    1. National Institute for Medical Research, Dar es Salaam, and Department of Biochemistry, Kampala International University in Tanzania, Dar es Salaam, Tanzania.

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  2. Roly Gosling

    1. Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK and Malaria Elimination Initiative, Institute of Global Health Sciences, University of California San Francisco, San Francisco, CA, USA.

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  3. Rosario Martinez-Vega

    1. Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.

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  4. Khalid B. Beshir

    1. Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.

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  5. Jeffrey A. Bailey

    1. Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA.

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  6. John Chimumbwa

    1. Southern Africa Development Community Malaria Elimination Eight, Windhoek, Namibia.

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  7. Colin Sutherland

    1. Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.

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  8. Melissa D. Conrad

    1. Department of Medicine, University of California San Francisco, San Francisco, CA, USA.

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  9. Fitsum G. Tadesse

    1. Armauer Hansen Research Institute, Addis Ababa, Ethiopia.

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  10. Jonathan J. Juliano

    1. Institute for Global health and Infectious Diseases, University North Carolina, Chapel Hill, NC, USA.

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  11. Moses R. Kamya

    1. Makerere University, Kampala, and Infectious Diseases Research Collaboration, Kampala, Uganda.

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  12. Wilfred F. Mbacham

    1. The Fobang Institutes for Innovations in Science & Technology, Yaounde, and the Biotechnology Centre, University of Yaounde I, Yaounde, Cameroon.

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  13. Didier Ménard

    1. UR3073, Pathogens Host Arthropods Vectors Interactions, University of Strasbourg, Laboratory of Parasitology and Medical Mycology, Centre Hospitalier Universitaire Strasbourg, Strasbourg, and Malaria Parasite Biology and Vaccines Unit, Institut Pasteur, Paris, France.

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  14. Philip J. Rosenthal

    1. Department of Medicine, University of California San Francisco, San Francisco, CA, USA.

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  15. Jaishree Raman

    1. Centre of Emerging Zoonotic and Parasitic Disease, National Institute for Communicable Diseases, Johannesburg, Wits Research Institute for Malaria, University of Witwatersrand, Johannesburg, UP Institute for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa.

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  16. Allison Tatarsky

    1. Malaria Elimination Initiative, Institute of Global Health Sciences, University of California San Francisco, San Francisco, CA, USA.

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  17. Sofonias K. Tessema

    1. Department of Medicine, EPPIcenter, University of California San Francisco, San Francisco, CA, USA.

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  18. David A. Fidock

    1. Department of Microbiology and Immunology Columbia University Irving Medical Center, New York, and Center for Malaria Therapeutics and Antimicrobial Resistance, Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.

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  19. Abdoulaye A. Djimde

    1. Malaria Research and Training Center, University of Science, Techniques and Technologies of Bamako, Bamako and Pathogens Genomic Diversity Network Africa, Imm. Gwancoura, Sotuba, Bamako, Mali.

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Resistance to antimalarial drugs is a recurring challenge for effective treatment of Plasmodium falciparum infection and for achieving the goal of eliminating malaria1. Beginning with chloroquine, resistance has compromised the efficacies of most major classes of antimalarial drugs. Partial resistance to artemisinin (ART-R) is becoming a major threat to the efficacy of artemisinin-based combination therapies (ACTs) and intravenous artesunate, which are critical for the treatment of uncomplicated malaria and severe malaria, respectively. Already ubiquitous throughout the Greater Mekong subregion of Southeast Asia, ART-R has emerged in several countries in eastern Africa2. For the prevention of a potential public health disaster in sub-Saharan Africa, the time for decisive action to confront emerging ART-R is now.

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Nature Medicine 30, 1807-1808 (2024)

doi: https://doi.org/10.1038/d41591-024-00028-y

Acknowledgements

D.S.I., J.A.B. and J.J.J. are funded by the Bill & Melinda Gates Foundation (INV-0022022) and the National Institute of Allergy and Infectious Diseases (NIAID) of the US National Institutes of Health (NIH) (R01AI156267 to D.S.I., J.A.B. and J.J.J., and K24AI134990 to J.J.J.). D.A.F. is funded in part by the NIH NIAID (R01 AI109023 and R01 AI124678). J.R. is funded in part by the Bill & Melinda Gates Foundation (INV-024346). M.D.C. and P.J.R. are funded by the NIH NIAID (R01AI173557, R01AI075045 and U19AI089674) and by the Bill & Melinda Gates Foundation (INV-035751). D.M. is funded by the Institut Pasteur, Paris; the French Government (Agence Nationale de la Recherche); the Laboratoire d’Excellence (LabEx) “French Parasitology Alliance for Health Care” (ANR-11–15 LABX-0024-PARAFRAP); and the University of Strasbourg. A.A.D. is funded by the Bill & Melinda Gates Foundation (INV-023065 and INV-037659), by an EDCTP2 (European & Developing Countries Clinical Trials Partnership) program supported by the European Union (grant number RIA2017T-2018 WANECAM-2) and by the Science for Africa Foundation with support from Wellcome and the Foreign, Commonwealth and Development Office (grant number Del-22-013).

Competing interests

The authors declare no competing interests.

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