There are a number of anti-malarial drugs which have seen widespread use over the last century, including quinine, chloroquine, mephloquine, sulfadoxine-pyrimethamine and amodiaquine. Misuse of these drugs, however, has led to growing resistance from malaria parasites.
Over the last decade new artemisinin based drugs - artesunate, artemether and dihydroartemisinin - have become available. In an attempt to prevent resistance, these drugs are now used in combination with drugs from a different class forming Artemisinin Combination Therapies (ACTs).
ACTs are currently the quickest acting and most effective anti-malarial drugs available and they are also safe for pregnant women to use after the first trimester. However, they are expensive and time-intensive to produce, which has restricted availability and use of these vital drugs. At present ACTs have a short shelf life, therefore, stock needs to be carefully planned and managed to prevent wastage. Cheaper, mass produced, quality artemisinin-derived drugs are needed in order to facilitate widespread use in the developing world.
Prompt diagnosis of malaria is essential as just a few hours can mean the difference between life and death. Traditional diagnosis is via microscopy in a laboratory. However, many of the most severely malaria-endemic areas lack the facilities to carry out high quality microscopy. In these areas diagnosis is often based solely on symptoms and given the prevalence of malaria, a child with a fever tends to be automatically treated (if treatment is available) for malaria.
Rapid diagnosis tests offer a quick, relatively cheap and on-the-spot diagnostic tool which require little training and can help reduce the number of unnecessary malaria treatments.
Communication and Information
Without support and information to help develop awarenss and understanding of malaria and how to protect themselves, communities will not be able to benefit fully from improved provision of health services and products such as nets.
This requires communication and information (or behaviour change communications (BCC)) to help people gain the awareness, knowledge and ability to participate in their own development. In the context of malaria prevention, BCC aims to encourage individuals and communities at risk from the disease to change their perspectives and behaviour as they learn how to control the impact of the disease, creating demand for, and sustained use of malaria services and products.
The disease, the process of its transmission, and the range of preventative measures available are complex. The connection between actions to control malaria and the illness people suffer may not be obvious to those living in malaria-endemic areas. However, without the cooperation of these potential beneficiaries, the success of the Global Malaria Action Plan will be limited. It is therefore crucial that people understand the causes of malaria and are both aware of the actions that they can take to protect themselves and are accepting of efforts made by others on their behalf.