Dr. Jim Shelton's Pearls: Actions Regarding Artemisinin Resistance

Jim Shelton

CCP | Editor-in-Chief, Global Health Science & Practice

Dr. Jim Shelton's Pearls is an occasional series by USAID’s Global Health Science Advisor that answers commonly asked questions about family planning. 

Question: This artemisinin resistance in Asia does sound like a potentially big problem. But our malaria program is in Africa. Do I need to worry about this artemisisin resistance? Is there something we can be doing to address it?

Answer: Yes and Yes. There is no class of drugs ready to replace the oral artimisinins if they become no longer effective. The key action is to encourage combination therapy, discourage monotherapy and promote rational use as much as possible. Monotherapy in not uncommon in the private sector in many countries.

Actions you can do include:

  1. Support country regulatory and behavior change approaches to discourage use of monotherapy especially its use in the private sector.
  2. Mount surveillance for substandard anti-malarial drugs and support interventions to combat them.
  3. Support training and behavior efforts aimed at providers, as well as efforts to improve malaria diagnostics in order to minimize use of ACTs for other fever-inducing illness.
  4. Mount behavior change efforts toward consumers and providers to promote effective adherence to drug-taking norms especially to discourage partial and incomplete treatment.
  5. Scale up effective prevention activities such as bed nets and indoor residual spraying (IRS) to reduce the overall burden of malaria in the environment.