Points of Agreement. Artemisinins should be the mainstay of first-line treatment in the short-to-medium term, at least First-line treatment for uncomplicated malaria should rely on fixed-dose combinations (coformulations) henceforth
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Immediate goal: ACTs into the hands of those who would have access to chloroquine
Challenge: poor or absent data on numbers of treated episodes (some non-malaria, accepted)
Best guess: 200-400 million treated episodes in Africa, 100 million elsewhere annually
300-500 million treatment courses needed per year
About US$1 per course of treatment wholesale, after competition, economies of scale kick in (2 years?)
TOTAL SUBSIDY: US$300-500 million/yr
Drug resistance is more likely to:
Borne out by experience with CQ and other drugs. Hence the importance of combinations over monotherapy in Asia, S. America.
Widespread access to ACTs can halt the erosion of past gains against malaria, but more is needed to make real progress. Even greater access to ACTs and other effective drugs, anti-mosquito measures (insecticide-treated nets, house spraying, environmental measures), and eventually vaccines all will be needed to gain ground on malaria in the most heavily endemic places.