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Despite the scaling-up of existing control measures and the
commitment to controlling malaria the global situation has
worsened. Concurrently, the drug, which was hailed as the
biggest hope for eradicating malaria, Artemisinin by having
significant activity against developing gametocytes, is
showing signs of resistance at the Thailand-Cambodia border.
This article purports to draw on lessons learnt from this
epicentre of drug resistance and raise a red flag for
sub-Saharan Africa. Firstly, the limitations of the current
weapons of the WHO Global Malaria Control Strategy will be
highlighted in both low transmission and high transmission
settings. Secondly, it will be explored how a
malaria-transmission blocking vaccine (TBV) as a community
approach would have a high value in combination with drug
treatment and other stage vaccines to break the vicious
cycle of antimalarial drug resistance. Thirdly, it will be
argued that prioritising vaccine development over improving
diagnostic capacity may constitute a threat
to the control strategy. Finally, it will be argued that if
the ambitious aim of achieving malaria elimination is to be
pursued, investment in TBV research should be stepped up.
Key words:
Artemisinin combination therapy,
transmission blocking vaccine, drug resistance, improving
diagnostic capacity.
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