Image courtesy of Chanaki Amaratunga
Drug resistance once again threatens progress against malaria. Beginning in 2008, clinical studies in Cambodia reported that the frontline antimalarial drug, artemisinin, was taking longer to clear the parasites from the blood of malaria-infected patients—a worrying sign that drug resistance was emerging, again (1-3).
At the time, artemisinin was used in combination with a partner drug, piperaquine, which helped to keep the treatment effective. The combination of dihydroartemisinin and piperaquine (DHA-PPQ) seemed to contain the threat, but then in 2013, researchers began reporting a new outbreak of multidrug resistance—this time to DHA-PPQ (4). The simultaneous failure of both drugs renders the combination therapy powerless to treat these multidrug resistant infections. The situation is fragile, and doctors are left to rely on a small number of drugs.