The Artemisinin Resistance in Southeast Asia: An Imminent Global Threat to Malaria Elimination

Abstract

Malaria remains a leading cause of mortality and morbidity in many low- and mid- dle-income countries. Artemisinin combination therapies (ACTs) have contributed to the substantial decline in the worldwide malaria burden, renewing the optimism that malaria elimination is achievable in some regions of the world. However, this prospect is threatened by the emergence of artemisinin resistance in Plasmodium falciparum leading to clinical failure of ACTs in Southeast Asia. Historically, drug resistance in P. falciparum has emerged in SEA and spread to Africa. Today, resistance to ACTs could reverse all the achievements of control and elimination efforts globally. With no new drug available, P. falciparum malaria must be eliminated from the Greater Mekong before it becomes untreatable.