Monitoring malaria drug efficacy and resistance

The emergence of multidrug resistance is a public health concern that threatens the sustainability of global efforts to reduce the burden of malaria. Artemisinin-based combination therapies (ACTs), recommended by WHO for the treatment of uncomplicated malaria, have been an integral part of the remarkable successes in global malaria control seen over the last 20 years. Protecting the efficacy of these medicines is a global public health priority.

As part of its normative role, WHO develops standard protocols to monitor antimalarial drug efficacy, prevention and resistance, and provides technical and financial support to countries to implement these protocols. The results of these studies are included in a global database that is translated into the Malaria Threats Map. These studies also inform updates to national polices on first and second-line malaria treatments.

WHO regularly convenes experts to review any new, evidence-based information. As new evidence becomes available, WHO recommendations are updated, where appropriate, using the Organization’s transparent and rigorous guideline development process.

WHO also issues reports about the status of artemisinin efficacy in affected countries. The most recent report brings together the latest findings and conclusions about the state of resistance to artemisinins and artemisinin-based combination therapy (ACT) and summarizes WHO’s current treatment recommendations.

In November 2022, WHO also launched a strategy to respond to the urgent problem of antimalarial drug resistance in Africa to minimize the threat and impact of resistance in the region by means of 20 recommended interventions.